1 of 2 | In the analysis, bright-light therapy consisted of using a fluorescent light box that produced white light for at least 30 minutes. Photo by Kalfatermann/Wikimedia Commons
Bright-light therapy offers major advantages as an addition to treatment with antidepressants for non-seasonal depressive disorders, a new analysis of 11 randomized clinical trials suggests.
The analysis, led by a fourth-year medical student in Brazil, was published Wednesday in JAMA Psychiatry. Advertisement
In that analysis, investigators compared using bright light therapy alone or with antidepressants plus placebo to simply taking antidepressants or receiving exposure to dim red light.
They found better remission and response rates in the participants who had exposure to an artificial light source. The response time to the initial treatment also may be quicker with bright light therapy than without it, they said.
The estimated remission rate with bright-light therapy in patients with non-seasonal depressive disorders was 40.7%, compared to 23.5% in the group not exposed to bright light.
The response rate also was higher in the bright light therapy group than the unexposed group (60.4% versus 38.6%). Advertisement
In the analysis, bright-light therapy consisted of using a fluorescent light box that produced white light for at least 30 minutes. The common brightness range was 10,000 lux — similar to the intensity of natural sunlight.
“Major depressive disorder is currently the leading cause of functional disability and one of the most critical mental health issues,” the researchers wrote. “The estimated response rate to initial treatment is approximately 50%, requiring alternative treatments when the initial approach is insufficient after four to eight weeks.”
Earlier studies explored bright-light therapy as a possible supplemental treatment for major depressive disorder because of its effects on mood and mental function. However, the previous studies established the therapy’s value as an additional regimen only for seasonal depressive disorders.
“My objective was to determine whether patients with non-seasonal depression could benefit from receiving adjunctive treatment with bright-light therapy, as this had previously been unclear,” the study’s lead author, Artur Menegaz de Almeida, a medical student at Federal University of Mato Grosso in Sinop, Brazil, told UPI.
The findings revealed that “patients with unipolar and bipolar depression can benefit from adjunctive treatment with bright-light therapy, showing a greater response to treatment and higher rates of symptom remission,” said Menegaz de Almeida, whose primary interests are neurology and psychiatry. Advertisement
To undertake the analysis, researchers performed a comprehensive search of publications in six health care databases of randomized clinical trials that had evaluated the effects of bright-light therapy in patients with non-seasonal depression.
They assessed differences between patients treated with and without bright light therapy in trials published from Jan. 1, 2000, through March 25 this year.
These 11 trials included data from 858 patients, of which 649 (75.6%) were female and 209 were male (24.4%).
Patients treated with this therapeutic intervention also had a larger reduction on the most widely used scale to assess the severity of depression.
“Bright-light therapy can serve as a low-cost adjunctive treatment option for patients with non-seasonal depression,” Menegaz de Almeida said. “Future guidelines should incorporate new evidence and provide stronger recommendations on the subject.”
The analysis “could help bring to the forefront a treatment for non-seasonal depression that has been limited mostly to seasonal affective disorders,” said Dr. Matthew Sherman, chief of adult outpatient psychiatry and behavioral health at Stony Brook Medicine in New York. He was not involved in the study.
“As mental health clinicians, being able to treat our patients suffering from depression with a practical, affordable, at-home treatment such as bright-light therapy would benefit our patients immensely,” Sherman said. Advertisement
The therapy would add value to standard care that includes antidepressant medications, he said.
Dealing with the complexity of depression requires multiple different types of treatment, so it’s important to discuss options with a clinician, said Dr. Mason Turner, a psychiatrist and senior medical director of the behavioral health program at Intermountain Health in Salt Lake City.
Yet, more than half of people with mental health conditions don’t receive any treatment. Those who do often face difficult choices because successful solutions can be expensive and carry risks of side effects, Turner noted.
“Bright-light therapy is a cost-effective and well-tolerated treatment,” he said. “This study’s findings are welcome as a potential new option in our treatment armamentarium for depression.”
To reap the benefits, it’s essential to buy a high-quality device, which ranges from 5,000- to 10,000-lux light intensity and typically costs $80 or more, said Dr. Paul Desan, an associate professor of psychiatry and director of the Winter Depression Research Clinic at Yale School of Medicine in New Haven, Conn.
Some health plans may cover such therapy lamps, or light boxes, with appropriate documentation from a doctor, Desan said.
