Transcranial bright light treatment via the ear canals in seasonal affective disorder: a randomized, double-blind dose-response study

SynopsisIn patients with winter seasonal affective disorder (SAD) the onset of a depressive episode is probably associated with the decreasing amount of light during the autumn. A highly predictable onset of a recurrent depressive episode with seasonal pattern provides a rationale for testing the efficacy of bright-light treatment as a preventive measure. Twelve out-patients with winter SAD were assigned to start bright light treatment either when they were well, or not to start it until the first symptoms of depression had already emerged. The severity of depressive symptoms was prospectively rated for a parallel randomized comparison. Bright light given well in advance of the emerging symptoms prevented a depressive episode. Clinical remission was significantly more frequent in the former subgroup of the patients in January and in March. To sum up, bright light can be successfully administered as prophylactic treatment for the prevention of winter SAD.

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Bright Light Treatment of Seasonal Affective Disorder and Nonseasonal Bipolar and Unipolar Affective Syndromes

Recurrent Mood Disorders ◽

10.1007/978-3-642-76646-6_36 ◽

1993 ◽

pp. 301-304

Author(s):

J. A. Deltito

Keyword(s):

Affective Disorder ◽

Seasonal Affective Disorder ◽

Bright Light ◽

Light Treatment ◽

Bright Light Treatment

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Prediction of outcome of bright light treatment in patients with seasonal affective disorder: Discarding the early response, confirming a higher atypical balance, and uncovering a higher body mass index at baseline as predictors of endpoint outcome

Journal of Affective Disorders ◽

10.1016/j.jad.2017.06.038 ◽

2017 ◽

Vol 222 ◽

pp. 126-132 ◽

Cited By ~ 6

Author(s):

Tzvetelina D. Dimitrova ◽

Gloria M. Reeves ◽

Soren Snitker ◽

Manana Lapidus ◽

Aamar R. Sleemi ◽

...

Keyword(s):

Body Mass Index ◽

Affective Disorder ◽

Body Mass ◽

Seasonal Affective Disorder ◽

Bright Light ◽

Early Response ◽

Light Treatment ◽

Prediction Of Outcome ◽

Bright Light Treatment

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Will light brighten the future of the depressed patient?

Acta Neuropsychiatrica ◽

10.1017/s092427080003684x ◽

1997 ◽

Vol 9 (2) ◽

pp. 71-76 ◽

Cited By ~ 2

Author(s):

R.H. Van Den Hoofdakker ◽

M.C.M. Gordijn

Keyword(s):

Affective Disorder ◽

Seasonal Affective Disorder ◽

Seasonal Pattern ◽

Bright Light ◽

Light Treatment ◽

Psychosocial Variable ◽

Clear Cut ◽

Treatment Experiment ◽

History Of ◽

Therapeutic Possibilities

The present explosive growth of interest in the therapeutic possibilities of exposure to light was triggered by a patient, Herbert Kern. He suffered from episodic depressive and manic complaints and discovered, by registering these over the years, a seasonal pattern in their occurrence. Discussions with scientists of the NIMH resulted in his participation in a bright light-treatment experiment when he was depressed in the winter of 1980-1981. He recovered.Next, the same group of investigators defined the criteria for a new syndrome, Seasonal Affective Disorder (SAD): a history of major affective disorder (according to the Research Diagnostic Criteria), at least two consecutive years in which the depressions have occurred during fall or winter and remitted in the following spring or summer, and the absence of any clear-cut seasonally changing psychosocial variable, such as work, stress and so on.

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Effects of rapid tryptophan depletion in patients with seasonal affective disorder in natural summer remission

Psychological Medicine ◽

10.1017/s003329179900152x ◽

2000 ◽

Vol 30 (1) ◽

pp. 79-87 ◽

Cited By ~ 26

Author(s):

R. W. LAM ◽

T. A. BOWERING ◽

E. M. TAM ◽

A. GREWAL ◽

L. N. YATHAM ◽

...

Keyword(s):

Affective Disorder ◽

Repeated Measures ◽

Seasonal Affective Disorder ◽

Bright Light ◽

Light Therapy ◽

Brain Serotonin ◽

Tryptophan Depletion ◽

Control Session ◽

Double Blind ◽

Plasma Tryptophan

Background. Serotonergic mechanisms have been proposed for the pathophysiology of seasonal affective disorder (SAD) and the therapeutic effect of bright-light treatment. Previously, we showed that SAD patients, in clinical remission with light therapy during the winter, experienced transient depressive relapses after a rapid tryptophan depletion (RTD) technique, which results in decreased brain serotonin levels. The objective of this study was to investigate the effect of RTD in SAD patients who were in natural summer remission.Methods. Twelve drug-free patients with SAD by DSM-IV criteria and 10 normal subjects participated in this double-blind, placebo-controlled, crossover study. SAD patients were in natural summer remission for at least 8 weeks. Behavioural ratings and plasma tryptophan levels were obtained before, and 5 h after, ingesting an amino acid (AA) mixture±tryptophan. Experimental RTD and control sessions were scheduled 1 week apart.Results. The RTD session resulted in significant reduction in total and free plasma tryptophan levels compared to the control session. The behavioural data were analysed using repeated measures analysis of variance. This analysis found significant main effects of time (higher scores after AA ingestion) and diagnosis (higher scores in SAD patients), but no main effect of session or significant interaction effects between the three factors. Thus, there were no significant behavioural effects of RTD compared to the sham depletion control session.Conclusions. The summer remission experienced by SAD patients is not dependent on plasma tryptophan levels (and presumably brain serotonin function) in the same manner as that of remission after light therapy. These results conflict with those of other laboratories, perhaps because of differences in study samples.

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Treatment of Seasonal Affective Disorder with Light: Preliminary Australian Experience

Australian & New Zealand Journal of Psychiatry ◽

10.3109/00048678909068291 ◽

1989 ◽

Vol 23 (3) ◽

pp. 369-372 ◽

Cited By ~ 8

Author(s):

Iain M. McIntyre ◽

Stuart M. Armstrong ◽

Trevor R. Norman ◽

Graham D. Burrows

Keyword(s):

Affective Disorder ◽

Seasonal Affective Disorder ◽

Eating Habits ◽

Bright Light ◽

Light Treatment ◽

Clinical Effects ◽

Full Spectrum ◽

Significant Clinical Improvement ◽

History Of ◽

Australian Experience

Six patients with a history of Seasonal Affective Disorder (SAD) were treated with bright artificial light. Patients presented with at least two consecutive years of loss of energy, difficulty in working, loss of interest in activities, difficulty in concentrating, increased somnolence, over-eating (carbohydrate craving) and depressed mood. All received seven consecutive days of full-spectrum bright light with an intensity greater than 2,500 lux at a distance of three feet. Evening exposure for two hours resulted in significant clinical improvement. The main improvements were a return to normal sleeping patterns, a reduction in eating habits, improved energy level, a desire to continue with interests and activities and an improvement in mood. Possible mechanisms for the clinical effects of bright light treatment are discussed.

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The effects of bright light treatment via ear canals on quality of sleep and depressive mood among overworked employees: A randomized-controlled clinical trial

Work ◽

10.3233/wor-203282 ◽

2020 ◽

Vol 67 (2) ◽

pp. 323-329

Author(s):

Tetsu Kinoshita ◽

Takeshi Tanigawa ◽

Koutatsu Maruyama ◽

Kanehisa Morimoto

Keyword(s):

Treatment Group ◽

Sleep Disorder ◽

Early Treatment ◽

Bright Light ◽

Depressive Mood ◽

Light Treatment ◽

Randomized Controlled ◽

Ear Canals ◽

Observation Period ◽

Bright Light Treatment

BACKGROUND: Many overworked employees need tools to improve their depressive mood or sleep disorder. In Finland, a new device of bright light therapy was developed. OBJECTIVE: Our objective was to evaluate the effect of bright light treatment via ear canals on improving the depressive mood and sleep disorder. METHODS: We conducted a randomized, controlled, crossover designed, open-label trial. We examined 27 participants aged 23–52 years, assigned to either Early treatment or Later treatment groups. The Early treatment group used the device on weekdays for the first 4 weeks, followed by a 4-week observation period. The Later treatment group had an observation period for the first 4 weeks, followed by device treatment for the subsequent 4 weeks. Every Friday, the participants were asked to answer questionnaires: A Self-rating Depression Scale (SDS), an Athens Insomnia Scale (AIS), and a Profile of Mood States (POMS) Brief Form. RESULTS: While no significant effect was found on the SDS following treatment (p = 0.16), the AIS showed a significant improvement (p = 0.004), and the scores for the Depression (D) and Vigor (V) of POMs decreased significantly (p = 0.045, p = 0.006, respectively). CONCLUSIONS: Bright light treatment via ear canals may improve sleep quality and depressive mood.

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Effects of light treatment on circadian rhythmicity in seasonal affective disorder

European Psychiatry ◽

10.1017/s0924933800003084 ◽

1992 ◽

Vol 7 (3) ◽

pp. 141-142 ◽

Cited By ~ 2

Author(s):

T Partonen ◽

B Appelberg ◽

S Kajaste ◽

M Partinen ◽

M Härmä ◽

...

Keyword(s):

Affective Disorder ◽

Seasonal Affective Disorder ◽

Light Exposure ◽

Bright Light ◽

Light Treatment ◽

Antidepressant Effect ◽

Treatment Intervention ◽

Subjective Sleepiness ◽

The Mean ◽

Bright Light Exposure

SummaryTwelve outpatients with seasonal affective disorder were treated by 1-h morning bright light exposure for 5 days. The light treatment intervention produced a significant phase advance of self-rated sleepiness rhythm, a significant decrease of the mean level of subjective sleepiness, and a significant reduction of depression scores. No significant objective circadian rhythm phase shift nor amplitude changes would account for the antidepressant effect.

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