Augmentation of light therapy in difficult-to-treat depressed patients: an open-label trial in both unipolar and bipolar patients

Abstract

ObjectivesWe investigated the clinical benefits of bright light therapy (BLT) as an adjunct treatment to ongoing psychopharmacotherapy, both in unipolar and bipolar difficult-to-treat depressed (DTD) outpatients.MethodsIn an open-label study, 31 depressed outpatients (16 unipolar and 15 bipolar) were included to undergo 3 weeks of BLT. Twenty-five completed the treatment and 5-week follow-up.Main outcome measuresClinical outcomes were evaluated by the Hamilton Depression Rating Scale (HDRS). The Snaith–Hamilton Pleasure Scale and the Depression Retardation Rating Scale were used to assess changes in anhedonia and psychomotor retardation, respectively.ResultsThe adjunctive BLT seemed to influence the course of the depressive episode, and a statistically significant reduction in HDRS scores was reported since the first week of therapy. The treatment was well-tolerated, and no patients presented clinical signs of (hypo)manic switch during the overall treatment period. At the end of the study (after 5 weeks from BLT discontinuation), nine patients (36%, eight unipolar and one bipolar) still showed a treatment response. BLT augmentation also led to a significant improvement of psychomotor retardation.ConclusionBLT combined with the ongoing pharmacological treatment offers a simple approach, and it might be effective in rapidly ameliorating depressive core symptoms of vulnerable DTD outpatients. These preliminary results need to be confirmed in placebo-controlled, randomized, double-blind clinical trial on larger samples.

Adjunctive Bright Light Therapy for Non-Seasonal Major Depressive Disorder: A Randomized Controlled Trial

“…Third, the enrollment of participants with mild depression (HAMD-17 ≥ 13) who were more likely to spontaneously remit might contribute to nontreatment effects. Nonetheless, consistent with other trials [7,[50][51][52], add-on therapy was administered to patients including those with mild depression, implying partial response to antidepressants. Fourth, the majority of our participants had already taken benzodiazepines and Z-drugs for anxiety and sleep symptoms.…”

Sensitivity to Climate and Weather Changes in Euthymic Bipolar Subjects: Association With Suicide Attempts

“…Many different factors, both individual and environment-related, have been recognized as triggers for the development of new episodes and the worsening of residual inter-episode symptoms. Among these factors, seasonality (41), the dysregulation of circadian rhythms (42), as well as abnormalities in the biological response to sunlight (43,44) and moon cycle (45), have been demonstrated to play a significant role. Therefore, climate and weather sensitivity would be expected to be related to the course of the illness as well.…”

“Shedding Light on Light”: A Review on the Effects on Mental Health of Exposure to Optical Radiation

“…Even if light treatment is reported as the treatment of choice for SAD, it may as well have a positive impact for non-seasonal forms of depression and other psychiatric conditions including bipolar disorder [ 135 ], depression in elderly subjects [ 136 , 137 , 138 ], depression in Parkinson’s disease [ 139 ], ante-/postpartum depression [ 140 ], and depression in adolescent patients [ 141 ]. A selection of the most relevant studies referring to this is offered in Table S2 in Supplementary Materials [ 97 , 105 , 135 , 142 , 143 , 144 , 145 , 146 , 147 , 148 , 149 , 150 , 151 , 152 , 153 , 154 , 155 , 156 , 157 , 158 , 159 , 160 , 161 , 162 ].…”