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Blog | Alto Pharmacy

A great pharmacy is so much more than a place where patients fill their prescriptions — it’s a partner in their care. The quality of a pharmacy is especially important for specialty medications, which typically include additional considerations like cost, storage requirements, administration, side effects, and more.

There’s no better judge of pharmacy care than the patients themselves. Alto is an industry leader with an NPS score of 85, positioning patients and caregivers to regard your medication in the highest possible light.

What to Consider When Choosing Your Limited Distribution Drug Partner

A great pharmacy is so much more than a place where patients fill their prescriptions — it’s a partner in their care. The quality of a pharmacy is especially important for specialty medications, which typically include additional considerations like cost, storage requirements, administration, side effects, and more.

There’s no better judge of pharmacy care than the patients themselves. Alto is an industry leader with an NPS score of 85, positioning patients and caregivers to regard your medication in the highest possible light.

Here’s what makes a great patient experience at a specialty pharmacy, and how Alto offers support for specialty medications at every step.

It can be time-consuming and stressful for a patient to get started with any type of medication, from getting that medication covered by insurance to searching for savings opportunities. With limited distribution drugs in particular, there are usually many steps between getting a prescription from a provider and actually beginning treatment, as these medications often require a prior authorization for insurance coverage. And since they are typically more expensive, thorough research into medication cost savings is essential from the standpoint of both a patient’s physical and financial wellness.

Your specialty pharmacy partner should offer the support patients need to access their medications as quickly and affordably as possible. Alto supports the prior authorization process, keeping both patients and providers informed at every step. And with Alto Connect — our free pharmacy communications portal for providers — it’s fast and easy for clinical teams to collaborate with our team on administrative work as needed.

We also conduct price investigations to help patients save on each prescription through manufacturer coupons, assistance programs, and other resources.

Once a medication has been approved by insurance, there shouldn’t be any additional barriers to receiving it. Not only should it be as simple as possible to fill a prescription and place a delivery, patients should be able to trust that their medication will arrive on time, and in the right condition.

Alto’s easy patient onboarding experience features proactive multichannel communication. We send patients a welcome text within 60 minutes of receiving their prescription to help them schedule their first delivery. (Those with a landline will get a call.) And our team is available to answer any questions via in-app messaging or phone.

Our same-day delivery service allows for quick and easy medication access seven days a week, and in-house couriers guarantee reliability and quality. We also offer a free medication bundling service, so those who take multiple medications have the convenience of one easy delivery. And patients are never left wondering where their medication is — the Alto app offers simple and accurate delivery tracking.

Additionally, we use special packaging to ensure that temperature-controlled medications are always stored appropriately before they reach a patient, with clear instructions about safe storage at home. Those who wish to pick up their medication can always visit our pharmacy in person.

Ongoing support with care and patient education is extremely important with specialty medications and limited distribution drugs, which typically require patients to make an ongoing commitment to their health and wellness. Treatment often includes routine testing, clinical monitoring, and side effect management to ensure proper drug utilization and maximize adherence.

So that patients can follow their treatment plan as directed by their doctor, your specialty pharmacy should have robust clinical expertise in specific conditions. It should also have a high-touch model that makes it as easy as possible for patients to benefit from that expertise.

At Alto, patient education and care isn’t a nice-to-have — it’s a must. To ensure that our pharmacists can actively participate in patient health journeys, we have a team of medication therapy management pharmacists who focus entirely on disease state education and support for chronic conditions.

These pharmacists regularly contact patients who take multiple medications or specialty medications to review their regimen by phone. During these calls, our pharmacists ensure that patients understand the purpose of each medication they’re taking and are staying on track with necessary testing.

Coupled with medication management tools like auto refills and medication bundling, our disease state education keeps patients coming back to Alto month after month, improving adherence for the long term.

Choose Alto Pharmacy for your limited distribution network

Alto’s end-to-end dispensing model is specifically built for specialty and specialty lite products. To learn more about partnering with us, reach out to partnerships@alto.com.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

Generic medications, which can cost an average of 80-85% less than their brand-name counterparts, have made treatment more accessible for many, improving medication adherence and health outcomes. They currently account for 90% of all prescription medications dispensed in the United States.

Frequently Asked Questions About Generic Medications

Despite the extensive use and effectiveness of generic medications, they are often a source of confusion. To help demystify how these medications work — and how they differ from branded options — we’ve compiled answers to commonly asked questions.

A generic medication has the same active-ingredient formula — and the same therapeutic benefits — as an already marketed brand-name equivalent, typically for a much lower cost. It can be considered an equal substitute for its branded version.

There are generic options for both over-the-counter and prescription medications. For example, ibuprofen is the generic name for Advil® and Motrin®, and acetaminophen is the generic name for Tylenol®. 

Are there any differences between generic and brand-name medications?

In order to become available for use, a generic medication must undergo a rigorous approval process from the U.S. Food and Drug Administration (FDA). Generic medication manufacturers must demonstrate that their product is equivalent to the brand version in several key ways:

It contains the same active ingredient — the substance in a medication formula directly responsible for that medication’s clinical benefits

It has the same strength, dosage form, and administration method

Given these similarities, a generic will not produce different side effects than its branded counterpart.   

A generic medication can differ from its brand-name counterpart in ways that do not affect its safety or effectiveness. This includes differences in appearance, such as shape, size, and color, as well as inactive ingredients, like binding materials, dyes, and preservatives. In fact, given trademark and branding laws, a generic has to look at least slightly different from the branded option.

If a generic has been approved, the FDA has determined its inactive ingredients are safe. However, there is the possibility that you are sensitive or allergic to an inactive ingredient contained in one version but not the other. 

Why do generic medications cost less than brand-name medications?

A common misconception about generic versions of medication is that their lower cost means that they don’t meet the same standards as their brand-name equivalents. There are two main reasons why generic medications are more affordable, and they have nothing to do with quality.

The cost of developing a new medication and then bringing it to market is very high. Manufacturers of an original brand-name medication have to spend millions of dollars on clinical trials and marketing. Companies making generics don’t have to go through the same process and can charge much less for their medications as a result.

Secondly, generics create marketplace competition, further driving down medication costs. This is especially true when multiple generic options have entered the market.

Does every brand-name medication have a generic equivalent?

No. A generic medication cannot be produced until the patent on the original brand-name option expires. The current term of a medication patent is 20 years. Periods of market exclusivity and the testing and approval process also factor into the timeline for developing a generic.

To find out if there is a generic option for your medication, check with your pharmacist or search the FDA’s catalog of approved medications.

Will my insurance cover both versions of a medication?

Insurance coverage varies by plan, but in general, many companies offer better coverage of generic medications due to their lower cost. Some plans don’t cover branded options unless there is no generic equivalent. Always verify the details of your insurance coverage before filling a prescription.

Can a pharmacist substitute a generic for a brand-name medication?

In most states, pharmacists are allowed to automatically substitute a generic for a brand-name medication when filling your prescription unless your doctor has instructed them not to.

There are some exceptions, however. Some medications have a narrow therapeutic window, which means that they require careful dosing and often frequent monitoring. (They may be referred to as narrow therapeutic index (NTI) drugs.) Some people are more sensitive to the differences between generic and brand-name NTIs than others. For this reason, a pharmacist will often consult with a provider before making a substitution for one of these medications.

If I started taking a brand-name medication, can I switch to the generic version?

Generally speaking, yes — since generics are bioequivalent to their branded counterparts, with the same safety, quality, and effectiveness, you can easily switch between versions. However, NTIs may require additional consideration. Your provider or pharmacist can help clarify any questions or concerns you may have about switching to a generic.

Questions about generic medications? Ask away!

As your pharmacy partner, we’re here to give you all the information you need to feel confident taking your medication. If you have questions about generic options, side effects, or anything else related to your treatment, reach out through in-app messaging.

All third party trademarks (including logos and icons) referenced by Alto Pharmacy remain the property of their respective owners. Unless specifically identified as such, Alto’s use of third party trademarks does not indicate any relationship, sponsorship or endorsement between Alto and the owners of these trademarks.

Generic medications, which can cost an average of 80-85% less than their brand-name counterparts, have made treatment more accessible for many, improving medication adherence and health outcomes. They currently account for 90% of all prescription medications dispensed in the United States.

Despite the extensive use and effectiveness of generic medications, they are often a source of confusion. To help demystify how these medications work — and how they differ from branded options — we’ve compiled answers to commonly asked questions.

Learn more about national medication shortages affecting people and pharmacist everywhere, what causes shortages, steps you can take if you are affected, and other frequently asked questions. Read on.

Medication Shortages, Explained | Alto Pharmacy

Few things are more frustrating — or frightening — than being unable to access the medication your doctor has prescribed. But it has become a common experience in recent years, as medication shortages remain a persistent healthcare challenge in the U.S. And if you take medication, you may be familiar with the panic of struggling to find enough of what you need.

Not only are these shortages incredibly frustrating and debilitating, they are also confusing and unpredictable, arising seemingly at random, and with little known about an anticipated resolution.

While Alto will always go above and beyond to bring you your medications without delay, these shortages are beyond our control, and we share your frustrations and concerns. To provide more clarity and context as to why these shortages occur — and why, unfortunately, there are few short-term solutions — we’ve compiled answers to some of the questions we hear most frequently.

Like every pharmacy across the country — as well as many around the world — Alto has been affected by medication shortages in the last few years. Each pharmacy’s stock fluctuates in tandem with demand, so if you call multiple pharmacies, it’s possible that one will have a greater supply of an affected medication than another on any given day. But ultimately, no pharmacy is immune to these challenges, and if a medication is in short supply, each pharmacy may feel the impact at some point.

If Alto currently does not carry your medication and you would like to transfer your prescription to another pharmacy, be sure to call that new pharmacy to confirm availability of your medication — medication shortages often impact most pharmacies within a specific region. 

The causes of medication shortages are complex, with multiple, and often intersecting, factors at play.

Any issues that affect the production of a medication may lead to reduced supply. This includes disruptions to manufacturing, like when Hurricane Maria damaged production sites in Puerto Rico in 2017.

Covid is another example of how a natural disaster or global crisis can disrupt medication production. The United States relies heavily on other countries for the raw ingredients needed to manufacture a medication.* This leaves us incredibly vulnerable to changes in workforce capacity or manufacturing activities overseas.

*As of 2019, only 28% of our country’s supply of active pharmaceutical ingredients (APIs) — the substances directly responsible for a medication’s therapeutic benefits — were manufactured domestically.

Even when manufacturing circumstances are ideal, rising demand for a medication can lead to low supply. This winter’s difficult cold and flu season, with high cases of Covid, the flu, and R.S.V., contributed to a decreased supply of children’s formulations of ibuprofen, acetaminophen, and several commonly prescribed antibiotics.

Adderall®, a stimulant used to treat attention-deficit/hyperactivity disorder, is another medication whose demand has increased in recent years. Prescriptions for the medication increased by 15.1% in 2020, in comparison to a 7.4% increase in 2019. This comes after a surge in new ADHD diagnoses, which more than doubled between 2007 and 2016 and continue to rise. Worker shortages and production delays experienced by Teva, a leading manufacturer of Adderall, have added additional pressure and compounded the challenges.

High demand has also contributed to recent shortages of the diabetes medications Ozempic® and Wegovy®,  as they have been increasingly prescribed for weight loss.

Addressing increased demand is often easier said than done. Most generic manufacturers decide how much of a medication to produce at the beginning of the year, with virtually no flexibility, so it isn’t an option to simply make more. This is why there is often a seasonal pattern to shortages, with many intensifying at the end of the year.

In the case of Adderall, a Schedule II controlled substance, the Drug Enforcement Administration (DEA) imposes strict production quotas to prevent misuse. With quotas based on estimates, our manufacturing system isn't prepared to respond to unexpected factors like the recent rise in ADHD diagnoses. 

Why are shortages happening more frequently?

Medication shortages are in the headlines more these days, but they are not a new occurrence. They have steadily increased since 2006, becoming a public health crisis in more recent years. The American Society of Health-System Pharmacists (ASHP) reports that, at the end of 2022, ongoing and active shortages were the highest they’ve been since 2014.

The growing intensity of these shortages reflects the strain that Covid put on our entire healthcare system — which we still haven’t fully recovered from — along with other unpredictable healthcare patterns, like growing demand for ADHD medications.

Are certain medications more likely to be affected than others?

Ultimately, any medication can go into shortage, but some types are more prone to recurring supply chain issues.

Medication shortages frequently occur with commonly used (and low-profit) generic medications — like the antibiotic amoxicillin — as pharmaceutical companies have little financial incentive to produce more of them.

Some injectable generics are especially vulnerable to shortages. Fewer manufacturers make these medications, so any production disruption can become a larger issue.

The Adderall shortage illustrates that low stock of a single medication can create a class-wide issue. For many people with ADHD, switching to another medication has proven challenging, as alternatives grow scarce too. This is also the case with Ozempic and other diabetes medications.

Medication shortages are rooted in factors that are far beyond any one person’s control, and unfortunately, there is little we can do to prevent them. Industry experts have proposed solutions, including ramping up domestic production of key pharmaceutical ingredients and building a more resilient medical supply chain. These aren’t quick fixes, and government action is needed for meaningful progress.

What can I do to navigate a medication shortage?

While many medication shortages are unavoidable, there are steps you can take to potentially minimize their stress and impact.

You can track medication shortages on the U.S. Food & Drug Administration or ASHP websites to learn more about a medication’s supply.

To give yourself more time to figure out a short-term solution — such as switching to an alternative medication — refill your medication as far in advance as you can. In some cases, it may be possible to get a 90-day supply of your medication, though this isn’t always an option for controlled substances, and your insurance plan may also limit coverage of refills.

If your medication is in scarce supply, speak with your doctor about alternatives. In addition to taking a different medication, you may be able to switch to a different dose or formulation. Many medications require that you safely taper off of them, which is another reason it’s important to stay on top of refills and ideally learn about supply issues before the last minute.

If an alternative medication costs more or is not covered by your insurance plan, there are resources to help alleviate some of the burden, including coupons, manufacturer-sponsored copay cards, and patient assistance programs. Alto is here to support your savings investigations, and we also suggest reaching out to your insurance provider and verifying your plan’s details — they may be required to cover a branded option if a generic is unavailable.

Our team can answer any questions you have about your medications. We also offer same-day delivery and medication management tools like reminders and auto refills to make it as simple as possible to stay on track with treatment.

To learn more, reach out any time through secure in-app messaging or by phone at 1-800-874-5881.

Learn more about national medication shortages affecting people and pharmacist everywhere, what causes shortages, steps you can take if you are affected, and other frequently asked questions.

The time to prepare for seasonal allergies is earlier than you might expect, as taking medications before everything is in bloom can help significantly to control symptoms. This year, you may want to consider ramping up your prevention efforts even earlier than usual: one consequence of climate change and rising temperatures worldwide is a longer growing season and higher levels of pollen in the air.

Why It’s Never Too Early to Prepare for Seasonal Allergies

The commonly used over-the-counter (OTC) medications below can help make allergy season more manageable — and many are available for purchase at the Essentials Store in our app! To browse the selection, tap the "Store" icon along the bottom of the Alto mobile app or the "Store" icon in your account on desktop.

Over-the-counter allergy medications to take preventatively

Nasal corticosteroid sprays prevent inflammation to reduce allergy symptoms such as stuffiness, sneezing, and a runny nose. Common OTC options include:

When taken in advance, these medications can potentially prevent the onset of allergy symptoms altogether. Many health experts suggest taking them about four weeks before the official start of allergy season, the specific timing of which depends on where you live.

For many people who experience seasonal allergies, symptoms typically first appear when trees start to release pollen in late winter and early spring. However, this pattern is changing as winter temperatures rise, and the timing of pollination also varies by region. To make the best plan, check local pollen levels and consult with your provider.

These medications block histamine, a chemical that your immune system releases during an allergic reaction. You may take them up to two weeks before the start of allergy season, as a preventative measure, but they can also be taken on an as-needed basis if you experience symptoms. They offer fast relief, taking anywhere from 15 minutes to two hours to go into effect.

Some antihistamines, including Benadryl® (diphenhydramine), can cause drowsiness and are not recommended to take before driving or other activities that require your attention.

The following antihistamines are less likely to cause drowsiness:

Not all allergy medications can be taken preventatively. While decongestants like Afrin® (oxymetazoline) and Sudafed® (pseudoephedrine) are effective at relieving congestion, they should only be taken on a short-term basis. Longer-term use may worsen allergy symptoms.

When to see a specialist for allergy symptoms

Remember that it may take time and a bit of trial and error to find the best relief for your allergies. If you experience regular symptoms after exploring a few options, work with your provider to find the best solution for your needs.

You may benefit from consulting a specialist such as an allergist or immunologist. These healthcare professionals can help identify more specific allergy triggers. They can also facilitate even more treatment options, including a preventative treatment called immunotherapy, which exposes you to allergens so that you become less sensitive to them. Immunotherapy comes in the form of both allergy shots and sublingual tablets placed beneath the tongue.

Stock up on allergy medications at the Alto Essentials Store

Purchase allergy season essentials like Claritin, Flonase, Zyrtec, Allegra and more right from your Alto account! You can order Essentials products whenever you need them, or add them to your next prescription delivery.

If your allergy symptoms persist even after preventative steps and exploring OTC options, we can support your treatment plan. We’ll coordinate with your doctor and insurance to offer your medications at the best price we can find, and our expert pharmacists are available via in-app messaging to answer any questions you may have about symptoms or side effects.

Some prescription medications used to treat chronic conditions or manage pain also carry the potential for dependence and misuse. These medications fall into a different category than most and are classified as controlled substances.

Managing a Prescription for a Controlled Substance

The distinction between controlled and non-controlled substances is an important one, as controlled substances are more heavily regulated than other prescription medications. There are limits on refills, and additional steps may also be required to get your prescription. Specific restrictions depend on factors such as your insurance plan’s benefits and the laws in your state. For example, many insurance providers limit the quantity of a controlled medication that they will cover over a given period of time.

Read on to learn how to manage your prescription for a controlled substance.

Controlled substances are regulated under federal law. The category includes both prescription medications and illegal drugs.

These substances are further categorized into five schedules, based on factors including their medical use, safety, and potential for misuse or dependency, with Schedule I substances being the most regulated.

Schedule I substances have no currently accepted medical use and are defined by the U.S. Drug Enforcement Administration (DEA) as having a high potential for misuse. Substances categorized into this schedule include heroin, ecstasy, and marijuana.

Schedule II substances are defined by the DEA as having a high potential for misuse and severe psychological or physical dependence. Substances categorized into this schedule include both illegal drugs such as cocaine and methamphetamine as well as prescription medications such as meperidine (Demerol®), oxycodone (OxyContin®), fentanyl, Dexedrine®, Adderall®, and Ritalin®.

Schedule III substances are defined by the DEA as having a moderate to low potential for physical and psychological dependence. Substances categorized into this schedule include some codeine-containing products, like Tylenol® with codeine; ketamine; anabolic steroids; and testosterone.

Schedule IV substances are defined by the DEA as having a low potential for misuse and a low risk of dependence. Substances categorized into this schedule include alprazolam (Xanax®), diazepam (Valium®), lorazepam (Ativan®), zolpidem (Ambien®), and Tramadol (ConZip®, Ultram®).

Schedule V substances are defined by the DEA as having an even lower potential for misuse than Schedule IV substances. Substances categorized into this schedule contain limited quantities of certain narcotics, including Robitussin AC®, Lomotil®, Motofen®, Lyrica®, and Parepectolin®.

Under federal law, there is a 30-day limit on the supply of any controlled substance. Additional federal restrictions on filling or refilling controlled substances vary by schedule. Some states may have additional restrictions or requirements for filling a controlled substance prescription. Here’s a brief overview.

No refills are allowed for schedule II substances. A new prescription from your healthcare provider is required for every fill.

Some states require a hand-written prescription with a provider’s signature.

Some states have expiration dates for Schedule II prescriptions, but there isn’t a federal law.

You are allowed to refill a prescription for these medications with a provider’s authorization.

If your provider has authorized refills, you are typically allowed up to five refills in six months. After five refills, a new prescription is required.

A prescription for a Schedule III, IV, or V medication expires after six months. After six months, a new prescription is required regardless of how many refills are left.

Tips for safe use of a controlled medication

If you are prescribed a controlled substance, it is especially important to keep track of your medication supply and take your medication only as directed. Never adjust the frequency or dose of your medication without consulting your provider. Make sure that anyone who prescribes a medication for you is aware of any other medications you take.

Be aware that some providers ask patients to sign a written agreement to ensure safe use of controlled substances like pain medication. These agreements may require that you only fill your prescription at one pharmacy and don’t take controlled substances prescribed by another provider.

Filling a prescription for a controlled substance at Alto

Given the additional regulations of controlled substances, these medications are currently not eligible for auto refills or medication bundling at Alto. Your convenience and safety is our priority, and we hope to expand these services to include controlled substances in the future.

Delivery of these medications requires a signature from you or an authorized signer. To add an authorized signer to your Alto account, head to Account > Delivery Addresses > Edit Address > Delivery Instructions in the Alto app.

In states where a written prescription is required to fill a controlled medication, these prescriptions cannot be transferred to Alto from another pharmacy.

Our team can answer any questions you have about your prescriptions. We also offer free, same-day delivery and medication management tools like reminders and auto refills to make it as simple as possible to stay on track with your treatment.

Each year, February marks American Heart Month, an important reminder that heart disease is both prevalent and preventable.

Heart disease plays a role in 1 in 3 deaths in the United States every year. While several key risk factors aren’t controllable, including age and family history, your actions and habits can significantly affect your heart health. And since heart disease typically develops gradually, over the course of many years, prevention is important at every stage of life.

Small Changes for a Healthier Heart

Each year, February marks American Heart Month, an important reminder that heart disease is both prevalent and preventable.

Heart disease plays a role in 1 in 3 deaths in the United States every year. While several key risk factors aren’t controllable, including age and family history, your actions and habits can significantly affect your heart health. And since heart disease typically develops gradually, over the course of many years, prevention is important at every stage of life.

You’re probably already familiar with the importance of staying physically active — the American Heart Association (AHA) recommends at least 150 minutes of moderate-intensity physical activity a week — and smoke-free. Other habits can strengthen your heart, and many of them can easily fit into your day. The daily practices below can keep you on the path to a heart-healthy lifestyle for years to come.   

There are some well-documented heart-healthy food choices, like cutting down on saturated fats and trans fats.* But it isn’t just what you eat that matters — the timing of your meals may influence heart health, too.

Several research studies have found a link between good heart health and eating breakfast every day. Those who skip out on a morning meal may be more likely to have diabetes, heart disease, or high cholesterol.

When planning your breakfasts, prioritize heart-healthy staples like fruits, veggies, protein, and whole grains. Pro tip: add some almonds to your morning smoothie — consuming a daily serving of nuts like almonds, peanuts, and walnuts can help lower your cholesterol.

*Common sources of saturated fats include red meat and full-fat dairy products. To find out if a food contains trans fats, check the nutrition label for partially hydrogenated oils.

Here’s yet another reason to brush and floss every day. Good oral hygiene has the potential to lower your risk for cardiovascular disease, as numerous studies have found a link between oral health and heart health.

The underlying cause of this connection isn’t entirely understood, but some experts believe it may have to do with inflammation. Whatever the reason, be sure to brush with a fluoride paste for two minutes twice daily, and don’t forget to clean between the teeth with some diligent flossing!

Gratitude gets a lot of buzz these days — for good reason. Its effects go beyond mental health and into cardiovascular territory.

Negative thinking can lead to depression and inflammation, both of which have been linked to poor heart health. Regularly practicing gratitude can direct your thoughts into heart-healthier territory. Challenge yourself to write down 3-5 things you’re grateful for at the end of the day.

Warming up with a good soak in the tub isn’t just relaxing, it can also give your heart health a boost. One research study found that people who took a bath almost every day had a lower risk for overall heart health issues and strokes.

The reasoning? In dilating your blood vessels, high temperatures can help lower your blood pressure. Plus, hot baths can relieve stress, another common factor in the development of heart disease.

Heart-healthy living also includes staying well-rested. Numerous studies have identified a link between an individual’s sleep habits and their risk for heart disease. The reason? A state of deep sleep gives your heart a chance to recover from how hard it works every day. Your blood pressure drops and your heart rate slows when you enter a state of deep sleep.

Unfortunately, getting the CDC’s recommended seven hours of shuteye each night can be easier said than done. More than a third of adults report that they don’t sleep enough. The good news is that you can take small steps to improve your sleep hygiene.

As a starting point, try to separate screen time from bedtime. It’s best to step away from cell phones, tablets, and computers for at least 30 minutes before you hit the pillow. Not only do these devices stimulate your brain, they emit blue light, which can affect production of the sleep-regulating hormone melatonin.

At Alto, we make it easier to manage your risk for heart health issues like coronary artery disease, and to stay on top of cholesterol-lowering or blood pressure management medications. 

We will work with your doctor, your insurance (if applicable), and any third party savings programs that you may qualify for to offer your medications at the best price we can. And our team of pharmacists is available to chat whenever questions come up.

Reach out any time by phone at 1-800-874-5881 or in-app messaging.

Winter’s shorter, darker days often bring out feelings of sadness, lethargy, and fatigue. In many cases, these feelings are symptoms of seasonal affective disorder (SAD), a form of depression triggered by seasonal shifts. 

While the nature of SAD means that symptoms tend to improve as the season changes, the condition should be taken as seriously as any other mental health disorder; untreated symptoms of SAD can interfere with daily life. And since SAD is often a temporary but recurring health concern, making a plan before the seasons change can help reduce the severity of future episodes.

How to Treat Seasonal Depression

Winter’s shorter, darker days often bring out feelings of sadness, lethargy, and fatigue. In many cases, these feelings are symptoms of seasonal affective disorder (SAD), a form of depression triggered by seasonal shifts. 

While the nature of SAD means that symptoms tend to improve as the season changes, the condition should be taken as seriously as any other mental health disorder; untreated symptoms of SAD can interfere with daily life. And since SAD is often a temporary but recurring health concern, making a plan before the seasons change can help reduce the severity of future episodes.

Here’s what to know about seasonal affective disorder and effective treatment options.

What is seasonal affective disorder (SAD)?

Seasonal affective disorder (SAD), also referred to as seasonal depression, is characterized by season-related mood changes and other depressive symptoms. In the majority of cases, SAD symptoms begin during fall and peak during winter. It is also possible to experience the opposite pattern, with symptoms that present during spring or summer.

Since SAD is considered a type of depression rather than a separate mental health disorder, many symptoms overlap with those of major depressive disorder, the clinical term for what we commonly think of as depression. Those symptoms include:

Loss of interest or pleasure in activities

Feelings of low self-worth, guilt, or hopelessness

Symptoms specifically associated with winter-pattern SAD include:

Withdrawal from social activities or a desire to hibernate

Symptoms specifically associated with summer-pattern SAD include:

If you believe you are experiencing symptoms of seasonal depression, speak with your healthcare provider or a mental health specialist for an evaluation and diagnosis.

Specific causes of seasonal affective disorder haven’t been identified, but reduced sunlight during winter is likely a significant factor, resulting in the following physiological changes.

Shifts in circadian rhythms: As seasons change, a shift in your body’s internal clock, or circadian rhythms, can disrupt your sleep and energy levels. This can also disrupt your body’s production of certain chemicals, like the stress hormone cortisol, which can also contribute to feelings of depression.

Imbalanced melatonin levels: Seasonal changes can also disrupt your levels of melatonin, a hormone that helps regulate your circadian rhythms, sleep patterns, and mood.

Decreased serotonin levels: Reduced sunlight is linked to decreased serotonin, a chemical in your brain that affects mood.

SAD is diagnosed in more women than in men, for reasons not entirely understood. It also affects younger adults more frequently than older adults.

Given the correlation between reduced sunlight and symptoms of SAD, the condition is more common among those who live further from the equator in either direction, where there are fewer daylight hours during winter months.

The following factors may also increase your risk of seasonal depression:

Family history: Many people who experience SAD have a relative with the condition or another type of depression.

Other depressive disorders: SAD may occur when symptoms of major depression or bipolar disorder intensify with seasonal shifts.

Decreased levels of vitamin D: It’s common to have less vitamin D during the winter as the result of less sunlight. This may play a role in the development of SAD, as vitamin D can boost serotonin activity. If you aren’t getting enough vitamin D from food or other sources, ask your doctor if you would benefit from taking a supplement.

Fortunately, there are many ways to treat symptoms of SAD, including light therapy, medication, and psychotherapy. For many people, a combination of treatment approaches leads to better results. While symptoms tend to naturally resolve as the seasons change, treatment can provide earlier relief.

Light therapy, which consists of daily exposure to bright light to compensate for less daylight, is a frontline treatment option for SAD. In this approach, an individual with SAD will sit in front of a very bright light box for 30 to 45 minutes every day. Treatment typically happens first thing in the morning, but a supplemental evening session may also be necessary in some cases.

Light therapy is safe for most people, as the light boxes filter out harmful UV light. However, it may not be a good fit if you have certain eye diseases or take medication that increases your sensitivity to sunlight.

Never begin light therapy without consulting your provider, and make sure to discuss your options for bright light boxes.

Psychotherapy, or talk therapy, is another common treatment option for seasonal depression. Cognitive behavioral therapy (CBT) is considered one of the most effective therapeutic approaches for this condition.

CBT focuses on changing thoughts and behaviors. If you experience SAD, CBT may offer the following benefits:

Finding the right therapist can take time. If you have insurance coverage of therapy sessions, check your insurance company’s provider network as a starting point. You can also look through reputable online databases like Psychology Today or the American Psychological Association (APA)’s psychologist locator. Some therapists offer sliding scale fees to make sessions more affordable.

Some people with SAD benefit from increased exposure to sunlight, whether it means spending more time outside during daylight hours or working from a space with ample sunlight.

Prioritizing your general health and wellness by staying physically active, eating a nutritious, balanced diet, and getting enough sleep can also ease symptoms. 

While antidepressants aren’t typically prescribed for SAD alone, medication used to treat major depression or another mood disorder may also improve season-related symptoms. Selective serotonin reuptake inhibitors (SSRIs), a type of antidepressant that regulates serotonin, are particularly effective at treating SAD.

Always consult your doctor before stopping an SSRI. In most cases, you will gradually taper to lower doses of the medication before you stop taking it completely. This helps to prevent withdrawal symptoms.

In addition to SSRIs, bupropion (Wellbutrin®), another type of antidepressant, may play a role in the treatment of SAD, as well as supplemental vitamin D.

Though it can be frustrating, finding the right antidepressant can take some trial and error. Even if you don't feel like the medication is working, continue to take it as prescribed so that you can achieve a therapeutic level. If you have been prescribed an SSRI, it may take several weeks to a month to experience your medication’s benefits. If you still have concerns several weeks into treatment, speak with your doctor.

For more on the medications used to treat depression, read A Guide to Commonly Prescribed Antidepressants.

If you have experienced SAD previously, a healthcare provider may recommend starting an antidepressant before winter as a preventative measure.

Choose a flexible and reliable pharmacy partner

Maintaining good mental health is easier with a reliable pharmacy on your side. Our pharmacists can answer any questions you may have about your medications, and we offer free, same-day delivery and medication management tools like reminders and auto refills in our app.

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