Light therapy effective for non-SAD depression

New research finds that light therapy can treat non-seasonal depression and improve the overall wellbeing of people suffering from the disease.

"These results are very exciting because light therapy is inexpensive, easy to access and use, and comes with few side effects," said Dr. Raymond Lam, a UBC professor and psychiatrist at the Djavad Mowafaghian Centre for Brain Health, a partnership between UBC and Vancouver Coastal Health. "Patients can easily use light therapy along with other treatments such as antidepressants and psychotherapy."

The research, published today in JAMA Psychiatry, is the first placebo-controlled trial that shows that light therapy is an effective treatment for depression that is not brought on by seasonal affective disorder.

Lam and his colleagues followed 122 patients and evaluated whether light therapy improved the mood of patients when it was used both with and without the commonly prescribed antidepressant fluoxetine. Light therapy involved 30 minutes of exposure to a fluorescent light box soon after waking up every day for eight weeks. Some study participants were given placebo pills and placebo devices instead of the real therapies. The researchers found that light therapy helped many patients and provided the most benefit to those who were also taking antidepressants.

Depression affects one in 20 people and is among the leading causes of disability worldwide.

Depression can cause significant problems in family and personal relationships, work attendance and productivity, and overall quality of life. It is also associated with an increased risk of death.

According to the researchers, medications are effective for treating depression but only work in about 60 per cent of cases.

"More and more people are seeking help because there is less stigma about having depression," said Lam. "It's important to find new treatments because our current therapies don't work for everyone. Our findings should help to improve the lives of people with depression."

Bright light treatment either alone or combined with an antidepressant was an effective and well tolerated treatment for adults with nonseasonal major depressive disorder (MDD) in a randomized clinical trial, according to an article published online by JAMA Psychiatry.

MDD is among the leading causes of disability worldwide and is associated with impaired quality of life and an increased risk of death. Treatments include psychotherapies and antidepressants but remission rates remain low so more therapeutic options are needed. Light therapy has been effective treatment for seasonal affective disorder (SAD).

Raymond W. Lam, M.D., of the University of British Columbia, Vancouver, Canada, and coauthors conducted a double-blind and placebo-and-sham-controlled trial to test the efficacy of light treatment alone and in combination with fluoxetine hydrochloride compared with a placebo treatment involving an inactive device and a placebo pill.

The eight-week trial randomized 122 patients: light therapy (30 minutes/daily exposure to a fluorescent light box as soon as possible after awakening) and placebo pill (n=32); fluoxetine (20 mg/daily) and placebo device (a negative ion generator, n=31); combination light and fluoxetine treatment (n=29); or placebo device and placebo pill (n=30). The change in a common depression rating scale score was the study's primary outcomes.

The authors report combination therapy and light therapy alone were superior to placebo but fluoxetine alone was not superior to placebo.

Why light therapy appears to work is still unknown but hypotheses in SAD involve resynchronizing circadian rhythms. Nonseasonal MDD also may be associated with disturbances in the circadian rhythms, according to the authors.