Format

Send to

Choose Destination
Am J Psychiatry. 2018 Feb 1;175(2):131-139. doi: 10.1176/appi.ajp.2017.16101200. Epub 2017 Oct 3.

Adjunctive Bright Light Therapy for Bipolar Depression: A Randomized Double-Blind Placebo-Controlled Trial.

Author information

1
From the Department of Psychiatry and Behavioral Sciences and the Department of Preventive Medicine-Biostatistics Division, Feinberg School of Medicine, Northwestern University, Chicago; the Department of Psychiatry, University of Pittsburgh School of Medicine and University of Pittsburgh Medical Center, Pittsburgh; the Epidemiological Data Center, Graduate School of Public Health, University of Pittsburgh, Pittsburgh; the Department of Statistics, Carnegie Mellon University, Pittsburgh; and the Department of Psychiatry, Columbia University and New York State Psychiatric Institute, New York.

Abstract

OBJECTIVE:

Patients with bipolar disorder have recurrent major depression, residual mood symptoms, and limited treatment options. Building on promising pilot data, the authors conducted a 6-week randomized double-blind placebo-controlled trial to investigate the efficacy of adjunctive bright light therapy at midday for bipolar depression. The aims were to determine remission rate, depression symptom level, and rate of mood polarity switch, as well as to explore sleep quality.

METHOD:

The study enrolled depressed adults with bipolar I or II disorder who were receiving stable dosages of antimanic medication (excluding patients with hypomania or mania, mixed symptoms, or rapid cycling). Patients were randomly assigned to treatment with either 7,000-lux bright white light or 50-lux dim red placebo light (N=23 for each group). Symptoms were assessed weekly with the Structured Interview Guide for the Hamilton Depression Scale With Atypical Depression Supplement (SIGH-ADS), the Mania Rating Scale, and the Pittsburgh Sleep Quality Index. Remission was defined as having a SIGH-ADS score of 8 or less.

RESULTS:

At baseline, both groups had moderate depression and no hypomanic or manic symptoms. Compared with the placebo light group, the group treated with bright white light experienced a significantly higher remission rate (68.2% compared with 22.2%; adjusted odds ratio=12.6) at weeks 4-6 and significantly lower depression scores (9.2 [SD=6.6] compared with 14.9 [SD=9.2]; adjusted β=-5.91) at the endpoint visit. No mood polarity switches were observed. Sleep quality improved in both groups and did not differ significantly between them.

CONCLUSIONS:

The data from this study provide robust evidence that supports the efficacy of midday bright light therapy for bipolar depression.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00852592.

KEYWORDS:

Bipolar Disorders; Clinical Trial; Light Therapy; Non-Pharmacological; Non-Seasonal Depression; Novel Intervention

PMID:
28969438
DOI:
10.1176/appi.ajp.2017.16101200
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Atypon
Loading ...
Support Center