What is it?
The administration of correctly timed, properly dosed, high-intensity flourescent light to treat various forms of depression.
Bright Light Therapy is the most established type of chronotherapy.
What does it treat?
First line treatment for Seasonal Affective Disorder [7, 9, 29, 31, 33]
Comparable to medications in non-seasonal (ordinary, unipolar Major) depression. [9, 30, 32, 33]
Bipolar depression. [14, 38, 67]
Augmenting and accelerating the action of antidepressant medication. [35, 36, 37]
Other potential uses: antepartum and post-partum depression, and premenstrual dysphoric disorder. [34, 68]
Depression in the elderly. [72]
What's Involved?
Bright light therapy requires a specially designed light box that produces high-intensity, fluorescent illumination, with UV screening.
Light must be correctly timed according to one's own unique, circadian timing and the type of depression involved.
Typically administered in the early morning for between 10 to 90 minutes per session.
Patients sit approximately 12 inches away from the light source, which is positioned slightly above the head and pointing downwards. Patients are free to read or use a computer, while facing towards the light.
References
7. Westrin, A., et al., Seasonal affective disorder: a clinical update. Annals of Clinical Psychiatry, 2007. 19(4): p. 239-46.
9. Golden, R.N., et al., The efficacy of light therapy in the treatment of mood disorders: a review and meta-analysis of the evidence. American Journal of Psychiatry, 2005. 162(4): p. 656-62.
14. Colombo, C., et al., Total sleep deprivation combined with lithium and light therapy in the treatment of bipolar depression: replication of main effects and interaction. Psychiatry Research, 2000. 95(1): p. 43-53.
29. Rosenthal, N.E., et al., Seasonal affective disorder. A description of the syndrome and preliminary findings with light therapy. Archives of General Psychiatry, 1984. 41(1): p. 72-80.
30. Tuunainen, A., et al., Light therapy for non-seasonal depression. Cochrane Database of Systematic Reviews, 2004(2): p. CD004050.
31. Rosenthal, N.E., et al., Seasonal affective disorder and phototherapy. Annals of the New York Academy of Sciences, 1985. 453: p. 260-9.
32. Ravindran, A.V., et al., Canadian Network for Mood and Anxiety Treatments (CANMAT) Clinical guidelines for the management of major depressive disorder in adults. V. Complementary and alternative medicine treatments. Journal of Affective Disorders, 2009. 117 Suppl 1: p. S54-64.
33. Terman, M., et al., Light therapy for seasonal and nonseasonal depression: efficacy, protocol, safety, and side effects. Cns Spectrums, 2005. 10(8): p. 647-63; quiz 672.
34. Epperson, C.N., et al., Randomized clinical trial of bright light therapy for antepartum depression: preliminary findings. Journal of Clinical Psychiatry, 2004. 65(3): p. 421-5.
35. Kuhs, H., et al., Amitriptyline in combination with repeated late sleep deprivation versus amitriptyline alone in major depression. A randomised study. Journal of Affective Disorders, 1996. 37(1): p. 31-41.
36. Benedetti, F., et al., Morning light treatment hastens the antidepressant effect of citalopram: a placebo-controlled trial. Journal of Clinical Psychiatry, 2003. 64(6): p. 648-53.
37. Martiny, K., et al., Adjunctive bright light in non-seasonal major depression: results from clinician-rated depression scales. Acta Psychiatrica Scandinavica, 2005. 112(2): p. 117-25.
38. Wu, J.C., et al., Rapid and Sustained Antidepressant Response with Sleep Deprivation and Chronotherapy in Bipolar Disorder. Biological Psychiatry, 2009. 66(3): p. 298-301.
67. Sit, D., et al., Light therapy for bipolar disorder: a case series in women. Bipolar Disorders, 2007. 9(8): p. 918-27.
68. Krasnik, C., et al., The effect of bright light therapy on depression associated with premenstrual dysphoric disorder. American Journal of Obstetrics and Gynecology, 2005. 193(3): p. 658-661.
72. Lieverse, R., et al., Bright Light Treatment in Elderly Patients With Nonseasonal Major Depressive Disorder: A Randomized Placebo-Controlled Trial, in Archives General Psychiatry 2010. p. 61-70.