Clinical efficacy, onset time and safety of bright light therapy in acute bipolar depression as an adjunctive therapy: A randomized controlled trial

Zhou, Tianhang; Dang, Weimin; Ma, Yantao; Hu, Changqing; Wang, Ning; Zhang, Guoyi; Wang, Gang; Shi, Chuan; Zhang, Hua; Guo, Bin; Zhou, Shuzhe; Feng, Lei; Geng, Shuxia; Tong, Yuzhen; Tang, Guan-wen; He, Zhi‐Guo; Zhen, Long; Yu, Xinguang

doi:10.1016/j.jad.2017.09.038

Cited by 36 publications

(63 citation statements)

References 55 publications

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“…Six articles consisting of six studies published between 2000 and 2018 were included in this review . Sample size ranged from 27 to 80, with a total of 297 participants (Tables and S4).…”

Section: Resultsmentioning

confidence: 99%

“…The criteria used for the diagnosis of bipolar depression varied across studies. Five studies used the DSM, and one study used clinical criteria . The numbers of participants taking medications also varied across studies.…”

Section: Resultsmentioning

confidence: 99%

“…All studies were individual RCT . Five studies were conducted at a secondary‐care facility while the level of care of one study was unknown .…”

Section: Resultsmentioning

confidence: 99%

“…All studies were individual RCT . Five studies were conducted at a secondary‐care facility while the level of care of one study was unknown . Four studies received financial support not related to BLT, one study did not receive any financial support, and one study did not reveal financial support .…”

Section: Resultsmentioning

confidence: 99%

“…However, this meta‐analysis had some limitations that might have affected its results: (i) most included studies were not RCT; (ii) articles were limited to the English language; (iii) databases other than PubMed and http://clinicaltrials.gov were not searched; and (iv) one study consisted of 70% of subjects with major depressive disorder . In addition, recent RCT that examined the efficacy of BLT for BD were not included in this meta‐analysis . Importantly, no meta‐analysis so far has examined the efficacy of BLT for manic states, or for preventing the recurrence of mood episodes in BD.…”

mentioning

confidence: 99%

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Efficacy and safety of bright light therapy for manic and depressive symptoms in patients with bipolar disorder: A systematic review and meta‐analysis

Takeshima

Utsumi

Aoki

et al. 2020

Psychiatry Clin Neurosci

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Aim This systematic review and meta‐analysis evaluated whether bright light therapy (BLT) is an effective and safe treatment for manic/depressive symptoms and a preventive measure for recurrent mood episodes in patients with bipolar disorder. Methods A literature search of major electronic databases was conducted in June 2019, including all published articles up to that date. Two researchers independently selected relevant publications, extracted data, and evaluated methodological quality according to the Cochrane criteria. Results Six randomized controlled trials (RCT) evaluated the efficacy of BLT for bipolar depression. A meta‐analysis found no significant differences between BLT and placebo for the following outcomes: (i) rates of remission from depressive episodes (risk ratio [RR]: 1.81, 95% confidence interval [CI]: 0.43 to 7.64, P = 0.42); (ii) depressive symptom scores (standardized mean difference: −0.25, 95%CI: −0.74 to 0.23, P = 0.30); and (iii) rates of manic switching (RR: 1.00, 95%CI: 0.28 to 3.59, P = 0.26). The sensitivity analysis for studies with low overall indirectness did show a significant antidepressant effect for BLT (RR: 3.09, 95%CI: 1.62 to 5.90, P = 0.006). No RCT investigated the effect of BLT in preventing the recurrence of mood episodes in the euthymic state or in improving manic symptoms in the manic state. No severe adverse events were reported. Conclusion While a meta‐analysis was unable to demonstrate the efficacy of BLT for bipolar depression, a sensitivity analysis did show a significant effect. Further well‐designed studies are needed to clarify the effectiveness of BLT, not only for the depressive state but also for other states, in the treatment of bipolar disorder.

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“…Six articles consisting of six studies published between 2000 and 2018 were included in this review . Sample size ranged from 27 to 80, with a total of 297 participants (Tables and S4).…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…All studies were individual RCT . Five studies were conducted at a secondary‐care facility while the level of care of one study was unknown .…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Efficacy and safety of bright light therapy for manic and depressive symptoms in patients with bipolar disorder: A systematic review and meta‐analysis

Takeshima

Utsumi

Aoki

et al. 2020

Psychiatry Clin Neurosci

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Adjunctive bright light therapy for treating bipolar depression: A systematic review and meta‐analysis of randomized controlled trials

2020

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No antidepressant-like acute effects of bright light on emotional information processing in healthy volunteers

et al. 2021

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Rationale Bright light treatment (BLT) is an efficacious antidepressant intervention, but its mechanism of action is not well understood. Antidepressant drugs acutely affect how emotional information is processed, pushing the brain to prioritise positive relative to negative input. Whether BLT could have a similar effect is not known to date. Objective To test whether BLT acutely influences emotional information processing similar to antidepressant drugs, using an established healthy volunteer assay. Methods Following a double-blind, parallel-group design, 49 healthy volunteers (18–65 years, 26 females) were randomly allocated to 60-min BLT (≥ 10,000 lux) or sham-placebo treatment early in the morning in autumn/winter. Immediately after treatment, emotional information processing was assessed using the Oxford Emotional Test Battery, a validated set of behavioural tasks tapping into emotional information processing in different cognitive domains. Participants also completed questionnaires before and after treatment to assess changes in subjective state. Results The BLT group did not show significantly more positively biased emotional information processing compared to the placebo group (p > 0.05 for all measures). After adjustment for pre-treatment scores, there were also no significant post-treatment differences between groups in subjective state (p > 0.05 for all measures). Conclusions BLT did not show immediate effects on emotional information processing in an established healthy volunteer assay. Thus, BLT might exert its clinical effects through a different (cognitive) mechanism than other antidepressant interventions. Future studies should corroborate this finding including clinical populations and more intensive treatment regimes, and control for potential chronobiological effects.

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Clinical efficacy, onset time and safety of bright light therapy in acute bipolar depression as an adjunctive therapy: A randomized controlled trial

Cited by 36 publications

References 55 publications

Efficacy and safety of bright light therapy for manic and depressive symptoms in patients with bipolar disorder: A systematic review and meta‐analysis

Efficacy and safety of bright light therapy for manic and depressive symptoms in patients with bipolar disorder: A systematic review and meta‐analysis

Adjunctive bright light therapy for treating bipolar depression: A systematic review and meta‐analysis of randomized controlled trials

No antidepressant-like acute effects of bright light on emotional information processing in healthy volunteers

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