Wellbutrin XL was approved for the prevention of Seasonal Affective Disorder (SAD), based on the results three studies in which over 1,000 patients with SAD (but who were well at study entry) were randomly assigned to either Wellbutrin XL 150 to 300 mg QD or placebo. Patients began treatment in the fall and were observed for depressive relapse. Patients on placebo relapsed at a rate of 28% vs. 16% on Wellbutrin XL. The difference was statistically significant, though not terribly impressive clinically; a less dramatic way to present the data is that 84% of Wellbutrin XL patients stayed well vs. 72% of placebo patients (Biol Psychiatry 2005;58(8):658-667).
Do insurance companies pay for light boxes? Many of them do … or at least they say they do! Among the insurance companies that publish statements authorizing coverage of light boxes are Cigna, Aetna, Harvard Pilgrim, and Tufts Health Plan. Blue Cross plans vary from state to state – for example, BCBS of California covers it, but BCBS of Massachusetts does not. Sun Box, one of the major light box companies, posts some very helpful tips on how to win coverage, including sample appeal letters and suggestions on which diagnostic codes yield the best chances for success (www.sunbox.com/Products/BuyersGuide.asp).
Dr. Joe Goldberg gathered the latest evidence on antidepressants in bipolar disorder at the 9th annual Mood Disorders Summit, and we summarize his findings.
