Phototherapy is a useful adjunct in the treatment of depressed in‐patients

Beauchemin, Kathleen M.; Hays, Peter L.

doi:10.1111/j.1600-0447.1997.tb09656.x

Cited by 58 publications

(21 citation statements)

References 8 publications

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“…32,58 Further, the combination of light regimens with antidepressant compounds such as imipramine, sertraline, and citalopram has been shown to significantly improve mood, with faster response rates than an antidepressant-only control group. [59][60][61][62][63] In addition, melatonin levels have also been found to show significant differences in patients with nonseasonal major depression when compared with healthy individuals. 64 Due to the very nature of nonseasonal depression and its multifactorial causes and symptoms, a purely chronobiological light-driven treatment regime would be difficult to apply.…”

Section: Nonseasonal Depressionmentioning

confidence: 99%

An insight into light as a chronobiological therapy in affective disorders

Walsh¹,

Atkinson²,

Corlett³

et al. 2014

CPT

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Abstract:The field of chronobiology has vastly expanded over the past few decades, bringing together research from the fields of circadian rhythms and sleep. The importance of the environmental day-night cycle on our health is becoming increasingly evident as we evolve into a 24-hour society. Reducing or changing sleep times against our natural instincts to rest at night has a detrimental impact on our well-being. The mammalian circadian clock, termed "the suprachiasmatic nucleus", is responsible for synchronizing our behavioral and physiological outputs to the environment. It utilizes light transcoded by specialized retinal photoreceptors as its cue to set internal rhythms to be in phase with the light-dark cycle. Misalignment of these outputs results in symptoms such as altered/disturbed sleep patterns, changes in mood, and physical and mental exhaustion -symptoms shared by many affective clinical disorders. Key links to circadian abnormalities have been found in a number of disorders, such as seasonal affective disorder, nonseasonal depression, and bipolar affective disorder. Furthermore, therapies developed through chronobiological research have been shown to be beneficial in the treatment of these conditions. In this article, we discuss the impact of circadian research on the management of affective disorders, giving evidence of how a misaligned circadian system may be a contributor to the symptoms of depression and how moderating circadian rhythms with light therapy benefits patients.

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Section: Nonseasonal Depressionmentioning

confidence: 99%

An insight into light as a chronobiological therapy in affective disorders

Walsh¹,

Atkinson²,

Corlett³

et al. 2014

CPT

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“…Studies in the 1990s became the basis of a widely cited benchmark for BLT with light intensities of up to 10,000 lux and duration of 30 min/day. 22 Evidence 23 suggests that the melatonergic (MT [1] and MT [2]) and the 5-Hydroxytryptamine (5HT2C) serotonergic receptor subtypes are important modulators of circadian rhythmicity. Melanopsin, a short-wavelength, light-sensitive G-proteincoupled receptor located in human retinal ganglion cells, is known to transduce short-wavelength light signals into neural signals.…”

Section: Discussionmentioning

confidence: 99%

“…1 However, the effect of BLT in non-seasonal depression has been controversial. While some controlled studies reported significant improvements, 2 others failed to do so. 3 Even if the improvement may be less than those seen in SAD, it can be assumed that at least some patients with non-seasonal depression respond to BLT.…”

Section: Introductionmentioning

confidence: 99%

Comparison of effects of bright light therapy alone or combined with fluoxetine on severity of depression, circadian rhythms, mood disturbance, and sleep quality, in patients with non-seasonal depression

Ağargün¹,

Sayar²,

Bulut³

et al. 2013

CPT

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Purpose:To compare effects of bright light therapy (BLT) alone or combined with the selective serotonin reuptake inhibitor (SSRI) fluoxetine, on severity of depression, circadian rhythms, mood disturbance, and sleep quality, in patients with non-seasonal depression. Patients and methods: Drug-free patients who were administered 10,000 lux of BLT for 30 minutes for 7 days comprised the BLT group (n = 7), while patients who started fluoxetine as an add-on treatment day comprised the SSRI + BLT group (n = 8). The primary outcomes were severity of depression, measured using the Hamilton Depression Rating Scale (HAM-D) and the Beck Depression Inventory (BDI); chronotype, measured using the Morningness Eveningness Questionnaire (MEQ); mood disturbance, measured using the Profile of Mood States (POMS) survey; and sleep quality, measured using the Pittsburgh Sleep Quality Index (PSQI), before and after treatment in both groups. Results: All patients completed the study, and none reported obvious side effects. The mean onset age of depression was 26.1 years ± 5.3 years in the BLT group and 27 years ± 9.5 years in the SSRI + BLT group (P = 0.425). The number of past depressive episodes was 1.29 ± 0.76 in the BLT group, and 1.5 ± 0.8 in the SSRI + BLT group (P = 0.427). The difference between pre-and posttreatment scores revealed no significant difference between groups for the HAM-D scale, BDI, MEQ, POMS survey, and the PSQI. Conclusion: This study suggests that BLT is effective with respect to the severity of depression, circadian rhythms, mood disturbance, and sleep quality, in non-seasonal depression. However, there was no evidence in favor of adjunctive fluoxetine with BLT in the treatment of non-seasonal depression, for any of the rating scales used in our study.

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“…Unlike SAD, non-seasonal patients are more likely to have heterogeneous chronobiological patterns and could have either sleep phase advance or phase delay [28]. Of the 24 studies reviewed, one study demonstrated effective sleep phase delay by morning light timing and improved sleep length by aligning the timing of melatonin secretion [24] as well as enhancing mood [11], [24]. Given the scarce literature on light timing and mood, it is too soon to rule out the timing of light exposure (AM or PM) as insignificant in light treatment.…”

Section: Light Characteristicsmentioning

confidence: 99%

“…The photoperiod can be increased by five to six hours to reverse the seasonal changes using bright (2500 lux), full-spectrum light in the hours of morning, evening and at night [19]. Patients with Nonseasonal Affective disorder (NSAD) or MDD can also benefit from light treatments [20][21][22][23][24]. In fact bright-light therapy for MDD patients was 12-35% more beneficial than dim-light placebos or anti-depressants [25].…”

Section: Introductionmentioning

confidence: 99%

A systematic review of light therapy on mood scores in major depressive disorder: light specification, dose, timing and delivery

Alotaibi

Halaki

Chow

2015

IJBAS

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Background: Depression is associated with prolonged disability, mortality, and morbidity. Ninety percent of patients with Major depressive disorder (MDD) have sleep problems. Light therapy has been shown to be effective in treating sleep disorders and MDD. This review aims to assess the characteristics (colour, intensity), exposure dose (duration and timing) and the mode of delivery (light boxes, visor etc) of light in reducing depression, measured by mood scores, in MDD. Method: a systematic literature search was performed on 6 major databases. The Physiotherapy Evidence Database (PEDro) Scale was applied to assess study quality. Result: Twenty-four articles satisfied the inclusion criteria. Effective light intensities varied from 176 -10,000 lux. Effective modes of delivery included light box, table lamp, visor and light emitting diode (LED) glasses. Effective light colours included white, green, and blue with the white colour being the most commonly used. The duration of light treatment ranged from 30 min to 2 h, and evening light generally improved mood. Conclusion: Light therapy, with exposure durations in the range of 30 min to 2 h per day, intensity range of 176 to 10,000 lux, in any of blue, green, or white light colour and exposure during morning mostly demonstrated a positive change in mood effects. Factors other than the light properties, such as anti-depressant medication use, depression episodes and severity, natural light exposure and sleep deprivation may confound the effects of light therapy.

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Phototherapy is a useful adjunct in the treatment of depressed in‐patients

Cited by 58 publications

References 8 publications

An insight into light as a chronobiological therapy in affective disorders

An insight into light as a chronobiological therapy in affective disorders

Comparison of effects of bright light therapy alone or combined with fluoxetine on severity of depression, circadian rhythms, mood disturbance, and sleep quality, in patients with non-seasonal depression

A systematic review of light therapy on mood scores in major depressive disorder: light specification, dose, timing and delivery

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