Use of gray sunglasses to alleviate hypomanic state in two patients with bipolar <scp>II</scp> disorder

Shirahama, Masanao; Terao, Takeshi; Hatano, Koji; Ishii, Nobuyoshi

doi:10.1111/bdi.12725

Cited by 5 publications

(4 citation statements)

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“…Light directly affects the mood by having an antidepressant effect such as that seen in light therapy and has an anti‐manic effect on deprivation such as that seen in dark therapy and virtual darkness therapy (blue light‐blocking treatment by means of orange‐tinted glasses; Barbini et al., 2005; Henriksen et al., 2016). We recently reported two cases of bipolar II patients with hypomania who responded to treatment with gray sunglasses used in the daytime (Shirahama et al., 2019). Wirz‐Justice and colleagues reported an interesting case on a refractory bipolar I rapid‐cycling patient, who failed to be treated with only a mood stabilizer, and yet improved by the addition of a combination of dark therapy and daytime light therapy (Wirz‐Justice et al., 1999).…”

Section: Discussionmentioning

confidence: 99%

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

2020

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Section: Discussionmentioning

confidence: 99%

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

2020

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“…For the treatment of acute mania, adjunctive dark-ness therapy is reportedly effective. Furthermore, the use of blue blocking glasses, a kind of sunglass, is also effective in acute mania [17].…”

Section: Circadian Rhythm Sleep-wake Disordersmentioning

confidence: 99%

Pharmacotherapy of mania in Japan

Ichiki

Masuya

Inoue

2020

CNPT

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This review introduces the treatment guidelines of acute mania by the Japanese Society of Mood Disorders (JSMD) and compares it with that of the Canadian Network for Mood and Anxiety Treatments (CANMAT). Lithium alone for mild mania and the combination of lithium and some atypical antipsychotic drugs for more severe mania are recommended by the JSMD guidelines. This recommendation is different from that of the CANMAT. As maintenance treatment after treatment of the acute phase should be considered from the start of treatment and lithium is the most recommended drug for maintenance treatment in the JSMD guideline, lithium becomes the critical drug for the treatment of mania in the JSMD guidelines. The socalled drug lag accounts for the difference between the two guidelines. Safer drugs for extrapyramidal symptoms and cognitive function should be preferred, because these adverse effects interfere with the functional recovery of bipolar patients. The adverse effects of hypnotics or alcohol on cognitive function should be noted carefully, because cognitive impairment influences disabilities and quality of life (QOL) in bipolar patients. New understanding of the pathophysiology of bipolar disorder, that is circadian rhythm dysfunction, may lead to its new diagnosis and treatment.

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“…2 We recently reported two cases of bipolar II patients with hypomania who responded to treatment with gray sunglasses used in the daytime. 3 Therefore, when the patients feel uplifted, we rec- Takeshi Terao https://orcid.org/0000-0001-7545-4304…”

Section: Modified Interpersonal and Social Rhythm Therapy Via Modulatmentioning

confidence: 99%

Modified interpersonal and social rhythm therapy via modulation of ambient light

Terao

2019

Bipolar Disorders

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To the Editors, Interpersonal and social rhythm therapy (IPSRT) is an effective psychotherapy approach for long-term management of bipolar disorder. 1 The main purpose of IPSRT is to regularize social and biological daily rhythms in order to promote mood stability and facilitate good sleep. The patients are required to record daily activities (eg, time out of bed, first contact with another person, meal times, bedtime) on the Social Rhythm Metric (SRM). 1 The SRM is useful for monitoring the dynamic interplay among instabilities in daily routines, patterns of social stimulation, sleep-wake times, and mood fluctuations. However, the SRM does not attach importance to the effect of ambient light.Light has profound effects on circadian rhythms and affects the mood directly. Ambient light exposure during the daytime improves mood and sleep quality. Light therapy has been found to improve bipolar depression but requires patients to sit in front of the device for 30 min to several hours. Therefore, as a simpler addition to their daily routine, when patients feel depressed or sad, we recommend them to increase ambient light exposure by opening the curtains in the morning or walking outside. Also, it is preferable to record the relationship between daily weather (sunny, cloudy, or rainy) and mood on the SRM.In contrast to the antidepressant effect of light, light deprivation has therapeutic effects for mania. Dark therapy (enforced darkness and rest from night to next morning) and virtual darkness therapy (blue light-blocking treatment by means of orange-tinted glasses) were found to improve manic symptoms of bipolar disorder. 2 We recently reported two cases of bipolar II patients with hypomania who responded to treatment with gray sunglasses used in the daytime. 3 Therefore, when the patients feel uplifted, we recommend them to reduce their ambient light exposure by turning down the room light or wearing the sunglasses. We suggest that this modified IPSRT via modulation of ambient light could keep mood more stable in comparison to the current IPSRT for patients with bipolar disorder.

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

Cited by 5 publications

References 5 publications

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

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

Pharmacotherapy of mania in Japan

Modified interpersonal and social rhythm therapy via modulation of ambient light

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