TREATMENT OF SEASONAL DEPRESSION WITH D-FENFLURAMINE

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  • 1 September 1989
    • journal article
    • research article
    • Vol. 50  (9) , 343-347
Abstract
Eighteen patients with seasonal affective disorder (SAD) participated in a double-blind, placebo-controlled crossover study in 1986-1987. Each received, in random order, d-fenfluramine (15 mg p.o. twice daily).sbd.a serotonin-releasing drug previously shown to suppress carbohydrate craving.sbd.or a placebo; these were given for 4 weeks separated by a 2-week washout period. Symptoms were assessed by means of clinical interviews and the Hamilton Rating Scale for Depression (HAM-D) with a special SAD addendum (AAD). Patients were also weighed. Depression scores (mean .+-. SE) were identical before treatment with drug (20.9 .+-. 1.3, HAM-D; 13.3 .+-. 0.8, AAD) or placebo (21.4 .+-. 1.2, HAM-D; 13.2 .+-. 0.6, ADD). During placebo treatment, mean HAM-D scores declined by 22% (p < .02) and AAD scores by 9% (p > .2). During d-fenfluramine treatment, HAM-D scores fell by 71% (p < .001) and AAD scores by 73% (p < .001). Thirteen (72%) of the patients demonstrated complete reversal of their abnormal test scores while taking d-fenfluramine. The group as a whole lost weight (mean = 1.2 kg) while receiving d-fenfluramine (p < .033) but not when taking placebo. A second study, conducted in 1987-1988 with nine subjects who had previously responded to d-fenfluramine, showed that the drug remains effective for the full 3-month annual period of symptoms. These results indicate that d-fenfluramine may be useful in treating SAD and suggest that serotonin is involved in both SAD''s effective and appetitive symptoms.