Prophylactic treatment of seasonal affective disorder (SAD) by using light visors: bright white or infrared light?

Meesters, Ybe; Beersma, Domien; Bouhuys, Antoinette L.; Hoofdakker, RH van den

doi:10.1016/s0006-3223(98)00252-2

Cited by 45 publications

(27 citation statements)

References 38 publications

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“…The effects of treatment do not persist after discontinuation of BLT, thus a relapse can be anticipated few days after stopping the treatment. Some SAD patients may profit from a prophylactic initiation of BLT [144,145] . In this context, psycho-educational training for the detection of early symptoms (difficulties in awakening, daytime fatigue and carbohydrate craving) may help to prevent the onset of a full-blown episode of SAD.…”

Section: Administrationmentioning

confidence: 99%

Bright-Light Therapy in the Treatment of Mood Disorders

et al. 2011

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Bright-light therapy (BLT) is established as the treatment of choice for seasonal affective disorder/winter type (SAD). In the last two decades, the use of BLT has expanded beyond SAD: there is evidence for efficacy in chronic depression, antepartum depression, premenstrual depression, bipolar depression and disturbances of the sleep-wake cycle. Data on the usefulness of BLT in non-seasonal depression are promising; however, further systematic studies are still warranted. In this review, the authors present a comprehensive overview of the literature on BLT in mood disorders. The first part elucidates the neurobiology of circadian and seasonal adaptive mechanisms focusing on the suprachiasmatic nucleus (SCN), the indolamines melatonin and serotonin, and the chronobiology of mood disorders. The SCN is the primary oscillator in humans. Indolamines are known to transduce light signals into cells and organisms since early in evolution, and their role in signalling change of season is still preserved in humans: melatonin is synthesized primarily in the pineal gland and is the central hormone for internal clock circuitries. The melatonin precursor serotonin is known to modulate many behaviours that vary with season. The second part discusses the pathophysiology and clinical specifiers of SAD, which can be seen as a model disorder for chronobiological disturbances and the mechanism of action of BLT. In the third part, the mode of action, application, efficacy, tolerability and safety of BLT in SAD and other mood disorders are explored.

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Section: Administrationmentioning

confidence: 99%

Bright-Light Therapy in the Treatment of Mood Disorders

et al. 2011

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“…The placebo effect is hardly controlled in bright light studies (for more detail see Eastman 1990;Bouhuys et al 1994;Meesters et al 1999;Putilov & Danilenko, in press;Putilov et al 1999Putilov et al , 2005. In particular, the problem is that the difference between presumably less and more effective treatments (i.e.…”

Section: Explanation Of Antidepressant Effectsmentioning

confidence: 99%

Antidepressant effects of combination of sleep deprivation and early evening treatment with melatonin or placebo for winter depression

Putilov¹,

Danilenko

2005

Biological Rhythm Research

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Patients with winter depression (seasonal affective disorder) respond beneficially to sleep deprivation and bright light, but the mechanisms of these responses remain unknown. The study was designed to test whether afternoon/evening melatonin can prevent further relapse after sleep deprivation (presumably due to a pharmacologically induced advance shift of circadian phase). Compared to phase advancing by alteration of sleep -wake schedule or by bright light exposure, the melatonin intake is a more tolerated treatment procedure, and it provides a possibility of blind comparison between chronotherapeutic and placebo treatments. The depression was scored in 16 female patients with winter depression and 17 age-matched female controls before and after total night sleep deprivation and after subsequent six-day administration of melatonin (0.5 mg) or placebo under double blind conditions. The melatonin intake was scheduled at 17:00 in order to produce a phase advance of circadian rhythms. Sleep deprivation resulted in 38% reduction of depression score in patients, but it did not reduce depression score in controls. After subsequent treatment with placebo or melatonin, slight but significant improvement of mood was found in controls. These treatments also stabilized the antidepressant response to sleep deprivation in patients. However, neither differential effect of melatonin and placebo on depression score nor alteration of habitual sleep timing was found in patients and controls. Thus, the study results do not provide evidence for the antidepressant potential of melatonin in patients with winter depression under realistic clinical conditions. The finding of stabilization of mood in patients with placebo points to the contribution of psychological factors to the therapeutic action of this and other types of innovative treatments for winter depression. To include psychosocial aspects in the theoretical framework of seasonal depression, we conceptualized depression as an evolved feature of emotional response to psychosocial rather than physical environment. The seasonality of depression might be explained by cumulative effects of aperiodical psychosocial factors and periodical physical factors on one of the mechanisms of brain neurotransmission.

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“…Richter et al 1992;Meesters et al 1993Meesters et al , 1999. The comparison of SAD patients with patients without seasonality in terms of the five-factor model of personality (Bagby et al 1996) revealed the significant difference on one of five dimensions: they scored higher than non-SAD patients on the openness dimension.…”

Section: Explanation Of the Effect Of Seasonality On Antidepressant Rmentioning

confidence: 93%

Antidepressant effects of mono- and combined non-drug treatments for seasonal and non-seasonal depression

Putilov

Pinchasov²,

Poljakova³

2005

Biological Rhythm Research

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The involvement of chronobiological mechanisms in the antidepressant response to such non-drug treatments as bright light, physical exercise and sleep deprivation still remain to be clarified. We compare the efficacy of several treatment strategies for seasonal and non-seasonal depression and discuss possible the contribution of chronobiological and psychological mechanisms in antidepressant response. The therapeutic effects were tested at the medical academic hospital near Novosibirsk (55 degrees North) in 138 subjects, either with winter depression or with non-seasonal depression or without depression (n = 41, 64 and 33, respectively). One-week monotreatments were either 2-hour 2500 lux cool-white incandescent light from 14:00 (n = 9, 9, 9, respectively) or 1-hour physical exercise from 13:00 (n = 9, 9, 9, respectively). One-week combined treatments included a night of total sleep deprivation followed by either 2-hour bright light from 14:00 (n = 8, 12, 0, respectively) or 1-hour physical exercise either under ordinary room light from 13:00 (n = 0, 12, 0, respectively) or under bright light from 12:00 (n = 5, 11, 0, respectively). The results indicate that, in subjects left without antidepressant treatment for a week (n = 10, 11, and 15, respectively), the 21-item Hamilton Depression Rating Scale score did not change significantly. The beneficial effects of total sleep deprivation were similar in seasonal and non-seasonal depression. The seasonals exhibited better response to bright light compared to non-seasonals. After sleep deprivation the substantial further improvements were produced by either lighting or exercising. Compared to the patients exercising under ordinary room light, the patients exercising under bright light did not gain an additional benefit. In general, winter depression was well-treated with either exercise or light, while the most promising treatment for non-seasonal depression was physical exercise combined with sleep deprivation. Bright light or physical exercise administered in the middle of the day were not less favorable compared to the treatments in the morning hours, although it is unlikely that they considerably challenged patient's chronobiology. It was concluded that the placebo effect would account for a large portion of clinical response to open non-pharmacological treatments. Therapeutic hops and visibility of such treatments would explain their high antidepressant efficacy in comparison with pharmacological trials applying a double blind cross-over design. In particular, the excellent response of patients with winter depression to light therapy might be related to their tendency to attribute a high symbolic value to bright light and associate their bad mood with a dark season.

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Prophylactic treatment of seasonal affective disorder (SAD) by using light visors: bright white or infrared light?

Abstract: Light visors can be effectively used to prevent the development of SAD. The fact that exposure to infrared light was as effective as exposure to bright white light questions the specific role of visible light in the treatment of SAD.

Cited by 45 publications

References 38 publications

Bright-Light Therapy in the Treatment of Mood Disorders

Bright-Light Therapy in the Treatment of Mood Disorders

Antidepressant effects of combination of sleep deprivation and early evening treatment with melatonin or placebo for winter depression

Antidepressant effects of mono- and combined non-drug treatments for seasonal and non-seasonal depression

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