Blue‐blocking glasses as additive treatment for mania: a randomized placebo‐controlled trial

Abstract

ObjectivesThe discovery of the blue lightsensitive retinal photoreceptor responsible for signaling daytime to the brain suggested that light to the circadian system could be inhibited by using blue‐blocking orange tinted glasses. Blue‐blocking (BB) glasses are a potential treatment option for bipolar mania. We examined the effectiveness of BB glasses in hospitalized patients with bipolar disorder in a manic state.MethodsIn a single‐blinded, randomized, placebo‐controlled trial (RCT), eligible patients (with bipolar mania; age 18–70 years) were recruited from five clinics in Norway. Patients were assigned to BB glasses or placebo (clear glasses) from 6 p.m. to 8 a.m. for 7 days, in addition to treatment as usual. Symptoms were assessed daily by use of the Young Mania Rating Scale (YMRS). Motor activity was assessed by actigraphy, and compared to data from a healthy control group. Wearing glasses for one evening/night qualified for inclusion in the intention‐to‐treat analysis.ResultsFrom February 2012 to February 2015, 32 patients were enrolled. Eight patients dropped out and one was excluded, resulting in 12 patients in the BB group and 11 patients in the placebo group. The mean decline in YMRS score was 14.1 [95% confidence interval (CI): 9.7–18.5] in the BB group, and 1.7 (95% CI: −4.0 to 7.4) in the placebo group, yielding an effect size of 1.86 (Cohen's d). In the BB group, one patient reported headache and two patients experienced easily reversible depressive symptoms.ConclusionsThis RCT shows that BB glasses are effective and feasible as add‐on treatment for bipolar mania.

Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) 2018 guidelines for the management of patients with bipolar disorder

“…Nutraceuticals such as branched chain amino acids (level 3),175 folic acid (level 2),176 and l ‐tryptophan (level 3),177 as well as other experimental agents such as medroxyprogesterone (level 3),178, 179 memantine (level 4),180 mexiletine (level 4),181 levetiracetam (level 4)182 and phenytoin (level 3),183 have all shown indications of efficacy when used adjunctively with other antimanic agents, as have glasses that block blue light (level 3) 184. Larger controlled trials are needed, however, before a recommendation for their use in mania can be made.…”

Depressive disorders: Processes leading to neurogeneration and potential novel treatments

“…They have been used successfully in pilot studies in permanent night workers (Sasseville et al, 2009), shift workers (Rahman et al, 2013;Sasseville and Hébert, 2010) and adolescents watching television (van der Lely et al, 2015). Recently BB glasses have been used as an additive treatment of mania with a marked effect size beginning after three days and no side effects differing from the placebo group (Henriksen et al, 2016). Other forms of chronotherapy such as dawn simulation (Terman and Terman, 2006), total sleep deprivation, or sleep phase advance, have been alternately used, but also chronotherapeutic combinations including bright light (Benedetti et al, 2014;Gottlieb and Terman, 2012;Wu et al, 2009).…”

Use of gray sunglasses to alleviate hypomanic state in two patients with bipolar II disorder

“…For example, darkness therapy with 14 hours of enforced darkness and rest from 6 pm to 8 am in a light‐sealed isolation room of the ward was proven effective for alleviating manic symptoms in a pilot study . Subsequently, a placebo‐controlled trial examined the use of blue‐blocking (BB) glasses as an add‐on treatment for reducing symptoms of mania because wearing orange glasses (blue‐blockers) in white‐light environments has been shown to preserve melatonin production . Patients with mania were assigned to BB glasses or placebo (clear glasses) groups from 6 pm to 8 am for 7 days.…”