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Thursday, June 26, 2008

Light Therapy And Depression

light therapy depression
Light and depression is of interest in recent scientific publications. On Science Daily the use of bright light elderly group care facilities in the Netherlands leads to improvements.

The use of daytime bright lighting to improve the circadian rhythm of elderly persons was associated with modest improvement in symptoms of dementia, and the addition of the use of melatonin resulted in improved sleep, according to a new study.

According to one of the authors dr Eus van Someren: "elderly are somewhat less depressed and more active due to the use of bright light in the facilities for the elderly". "Even melatonin level in the elderly in the bright light facilities was significantly higher during the night". You can read the abstract in a recent JAMA issue.

A recent systematic review examined the efficacy of light therapy in nonseasonal depression. Light therapy is efficacious in seasonal depression but its role in non seasonal depression is unclear. The authors identified 62 reports from which 15 were selected according to their selection criteria. The sample sizes were small, blindness is a troublesome issue in this kind of research and publication bias is probable. Negative results are seldom published especially in such a difficult fieled of research. Their conclusion about light therapy for nonseasonal depression:
Overall, bright light therapy is an excellent candidate for inclusion into the therapeutic inventory available for the treatment of nonseasonal depression today, as adjuvant therapy to antidepressant medication.

So there is more to see that meets the eye with light and depression. Bright light therapy alone for the treatment of nonseasonal depression is not efficacious according to results to date. Further research especially with nonseasonal depression and circadian rythm disturbaces are needed.

What are your experiences with light and depression?

Related posts on this blog:
4 Nonseasonal Depressive Disorders treated with Light Therapy
Chronotherapeutics what is it good for?
8 articles about seasonal affective disorder
Riemersma-van der Lek, R.F., Swaab, D.F., Twisk, J., Hol, E.M., Hoogendijk, W.J., Van Someren, E.J. (2008). Effect of Bright Light and Melatonin on Cognitive and Noncognitive Function in Elderly Residents of Group Care Facilities: A Randomized Controlled Trial. JAMA: The Journal of the American Medical Association, 299(22), 2642-2655. DOI: 10.1001/jama.299.22.2642

EVEN, C., SCHRODER, C., FRIEDMAN, S., ROUILLON, F. (2008). Efficacy of light therapy in nonseasonal depression: A systematic review. Journal of Affective Disorders, 108(1-2), 11-23. DOI: 10.1016/j.jad.2007.09.008


Anonymous said...

It's all very well increasing exposure to light for the sake of treating depression, but isn't there evidence that too much light is associated with an increased cancer risk (and I'm not referring to sunlight and melanoma)

Dr. Shock said...

This is all new to me thanks for the information. Nevertheless I consider treating a depressive episode with light and proper environmental circumstances during admission something different from working night shifts. Moreover, psychiatric patients are usually treated in dark departments somewhere far away from other patients which I think is wrong. This research stresses the importance of a well lit friendly environment.
Regards Dr Shock

Aqua said...

I sit in front of an S.A.D. light (10,000 lux) everyday for 1/2 and hour to an hour when I first wake up in the morning. have done this for 3-4 years. I don't know if it does anything for me but it feels good to sit in front of, so I continue to do so.

Do these lights increase your exposure to Vitamin D, like sunlight? Just curious.

The Shrink said...

I have never, ever used it. Which presumably is a bad thing, with my patients missing out on a potentially helpful intervention.

I've never looked at efficacy, sussing out response vs placebo response, NNT vs NNH etc.

Dr. Shock said...

The link between light and cancer is the disruption of the circadian rythm and melatonin balance, the use of light in depression is to enhance the circadian rythm and melatonin balance. To my opinion light therapy is not comparable to the circadian rythm disturbaces as risk factor for cancer, regards Dr Shock

Dr. Shock said...

@Aqua, for vitamin D you need UltraViolet so only sunlight will do, regards Dr Shock

Anonymous said...

I tried light therapy amid much medicine therapy so I never was able to come to a conclusion of it was useful or not. Both medicine and light failed to work, so I finally opted for ECT just last month and I haven't felt this great in years!

I did have one instant where I was going into a hypomanic episode and attributed it to the "new light" I was trying, but I think I was using it to late in the day.

Thanks for this blog. I just found it.