考虑到季节性变化的可预测性与 SAD 症状发作的风险，应与患者讨论各时期预防性治疗的风险与获益。[51]Westrin A, Lam RW. Long-term and preventative treatment for seasonal affective disorder. CNS Drugs. 2007;21(11):901-9.http://www.ncbi.nlm.nih.gov/pubmed/17927295?tool=bestpractice.com 可在季节性情绪模式前几个月采取预防性措施，其中包括：[15]Magnusson A, Partonen T. The diagnosis, symptomatology, and epidemiology of seasonal affective disorder. CNS Spectr. 2005 Aug;10(8):625-34.http://www.ncbi.nlm.nih.gov/pubmed/16041294?tool=bestpractice.com[51]Westrin A, Lam RW. Long-term and preventative treatment for seasonal affective disorder. CNS Drugs. 2007;21(11):901-9.http://www.ncbi.nlm.nih.gov/pubmed/17927295?tool=bestpractice.com
结局试验非常有限，但在一定程度上确实支持采用光照治疗预防症状复发。[79]Nussbaumer B, Kaminski-Hartenthaler A, Forneris CA, et al. Light therapy for preventing seasonal affective disorder. Cochrane Database Syst Rev. 2015 Nov 8;(11):CD011269.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD011269.pub2/fullhttp://www.ncbi.nlm.nih.gov/pubmed/26558494?tool=bestpractice.com 缓释型安非他酮是某些国家/地区唯一批准用于预防 SAD 的药物。治疗后无抑郁率：有中等质量证据表明，与安慰剂相比，季节性情感障碍患者每天接受 150 -300 mg 预防性丁胺苯丙酮 XL（当身体状况良好时从秋季开始治疗），能够将重性抑郁复发的相对风险降低 44%。[77]Modell JG, Rosenthal NE, Harriett AE, et al. Seasonal affective disorder and its prevention by anticipatory treatment with bupropion XL. Biol Psychiatry. 2005 Oct 15;58(8):658-67.http://www.ncbi.nlm.nih.gov/pubmed/16271314?tool=bestpractice.com受试者＜200名的随机对照临床试验（RCT）、受试者＞200名且方法学存在缺陷的随机对照临床试验（RCT）、方法学存在缺陷的系统评价或者高质量的观察性（队列）研究。 治疗始于初秋，并且持续至整个冬季。[77]Modell JG, Rosenthal NE, Harriett AE, et al. Seasonal affective disorder and its prevention by anticipatory treatment with bupropion XL. Biol Psychiatry. 2005 Oct 15;58(8):658-67.http://www.ncbi.nlm.nih.gov/pubmed/16271314?tool=bestpractice.com 并未对丁胺苯丙酮用于季节性抑郁发作的急性治疗进行研究。 对于具有双相型障碍史的患者，并不建议使用丁胺苯丙酮。 成功治疗季节性抑郁后开始抗抑郁药物治疗也可能有助于防止复发。[78]Cleare A, Pariante CM, Young AH, et al; Members of the Consensus Meeting. Evidence-based guidelines for treating depressive disorders with antidepressants: a revision of the 2008 British Association for Psychopharmacology guidelines. J Psychopharmacol. 2015 May;29(5):459-525.https://www.bap.org.uk/pdfs/BAP_Guidelines-Antidepressants.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/25969470?tool=bestpractice.com 认知行为疗法也可能有助于预防季节性抑郁的复发。[91]Rohan KJ, Roecklein KA, Lacy TJ, et al. Winter depression recurrence one year after cognitive-behavioral therapy, light therapy, or combination treatment. Behav Ther. 2009 Sep;40(3):225-38.http://www.ncbi.nlm.nih.gov/pubmed/19647524?tool=bestpractice.com
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