Effects of bright light therapy for depression during pregnancy: a randomised, double-blind controlled trial

Abstract

ObjectivesApproximately 11%–13% of pregnant women suffer from depression. Bright light therapy (BLT) is a promising treatment, combining direct availability, sufficient efficacy, low costs and high safety for both mother and child. Here, we examined the effects of BLT on depression during pregnancy.DesignRandomised, double-blind controlled trial.SettingPrimary and secondary care in The Netherlands, from November 2016 to March 2019.Participants67 pregnant women (12–32 weeks gestational age) with a DSM-5 diagnosis of depressive disorder (Diagnostic and Statistical Manual of Mental Disorders).InterventionsParticipants were randomly allocated to treatment with either BLT (9000 lux, 5000 K) or dim red light therapy (DRLT, 100 lux, 2700 K), which is considered placebo. For 6 weeks, both groups were treated daily at home for 30 min on awakening. Follow-up took place weekly during the intervention, after 6 weeks of therapy, 3 and 10 weeks after treatment and 2 months postpartum.Primary and secondary outcome measuresDepressive symptoms were measured primarily with the Structured Interview Guide for the Hamilton Depression Scale—Seasonal Affective Disorder. Secondary measures were the Hamilton Rating Scale for Depression and the Edinburgh Postnatal Depression Scale. Changes in rating scale scores of these questionnaires over time were analysed using generalised linear mixed models.ResultsMedian depression scores decreased by 40.6%–53.1% in the BLT group and by 50.9%–66.7% in the DRLT group. We found no statistically significant difference in symptom change scores between BLT and DRLT. Sensitivity and post-hoc analyses did not change our findings.ConclusionsDepressive symptoms of pregnant women with depression improved in both treatment arms. More research is necessary to determine whether these responses represent true treatment effects, non-specific treatment responses, placebo effects or a combination hereof.Trial registration numberNTR5476.

Therapeutic Interventions to Mitigate Mitochondrial Dysfunction and Oxidative Stress–Induced Damage in Patients with Bipolar Disorder

“…BLT, also known as phototherapy, uses glare therapy in the treatment of the symptoms of depression [367][368][369][370][371][372][373][374]. Some research studies have reported that BLT was successful as an adjunctive therapy for BD [375][376][377][378][379][380].…”

Sustained remission from perinatal depression after bright light therapy: A pilot randomised, placebo‐controlled trial

“…In this regard, the antidepressant effects of the higher‐intensity placebo lights used in these studies remain unclear, considering that illuminance levels as low as 100 lux have been demonstrated to phase‐shift human circadian rhythms 10 . In fact, in a recent RCT examining the effectiveness of BLT (9′000 lux, 5′000 K) versus DRL (100 lux, 2′700 K) for 6 weeks, 30 min in the morning after awakening, in a larger sample of pregnant women with AND ( n = 67), Bais et al did not find statistically significant differences between the two treatment groups, with a similar improvement in median depression scores on the SIGH‐SAD, HDRS, and Edinburgh Postnatal Depression Scale (EPDS) at the end of the trial, 3 and 10 weeks after therapy, as well as 2 months postpartum 5 . By contrast, Wirz‐Justice and colleagues using a similar protocol for BLT (7′000 lux, for 6 weeks, 60 min in the morning, n = 16) as in Epperson et al but a lower‐intensity placebo light (70 lux, n = 11), found that women with AND who received BLT had significantly greater scores improvement on the SIGH‐ADS and HDRS than those in the DRL group 11 .…”

“…Bright light therapy (BLT) is a non‐pharmacological intervention based on circadian science, which has been consistently proven effective and safe for treating seasonal and non‐seasonal affective disorders 3 . However, only a few studies have used BLT in either antenatal or postnatal depression, with overall promising but partly divergent findings 4,5 . Five of them were randomised controlled trials (RCT) and two were open trials.…”

“… 3 However, only a few studies have used BLT in either antenatal or postnatal depression, with overall promising but partly divergent findings. 4 , 5 Five of them were randomised controlled trials (RCT) and two were open trials. Oren et al and Corral et al performed the first two opens studies with BLT for women with antenatal depression (AND) ( n = 16, 10′000 lux, for 3–5 weeks, 60 min within 10 min of awakening) and postpartum depression (PPD) ( n = 2, 10′000 lux, for 4 weeks, 30 min between 7:00 am and 9:00), respectively.…”

Bipolinio Sutrikimo Valdymas Nėštumo Ir Pogimdyminiu Laikotarpiu

“…ŠT nėra susijusi su jokia reprodukcine rizika, šviesos taikymas nėštumo metu yra saugus, tačiau ją taikyti draudžiama manijos, hipomanijos ar mišrios nuotaikos epizodų metu. Šalutinis ŠT poveikis yra galvos skausmas, pykinimas ir nervingumas [29].…”