Study: Could light therapy help with non-seasonal depression?

By R. Ryan Patel DO, FAPA OSU-CCS PsychiatristLight 1

For some students, winter can be a difficult time of year. Many people know about seasonal affective disorder (SAD), which is depressive symptoms that occur often during winter months (1,2,3). Treatments for SAD can include a combination of light therapy, counseling, healthy lifestyle habits, and medications (3).

A recent study (4) shows that light therapy can also help with a more common form of depression, major depressive disorder, a form of depression that is NOT seasonal.

What was the study design?

  • 122 individuals ages 19-60 were randomized to 4 different groups,
  • Light monotherapy of 10 000-lux fluorescent white lightbox for 30 min/d in early morning plus placebo pill (n=32)
  • Medication monotherapy of a prescription antidepressant medication, Fluoxetine 20mg per day, (n=31);
  • Combination of medication and light therapy, (n=29);
  • Placebo, (n=30).
  • Study lasted for 8 weeks, using randomized, double-blind, placebo- and sham-controlled study design.

Who was studied?

  • Average age of the 122 participants was 19-60 years
  • They had a diagnosis of Major depressive disorder in outpatient psychiatry clinics in academic medical centers.
  • Results were measured by changes in MADRS score (a validated scale to measure depressive symptoms).

What were the study results?

For each group response rates (improvement in symptoms) were:

  • Placebo 33%
  • 20mg fluoxetine, alone 29%
  • Light therapy 50%
  • Combination of light therapy and medication, 75.9%

The study authors reported that all treatments were well tolerated, with few major differences in side effects.

What are some caveats?

  • For various reasons, light therapy and fluoxetine are NOT suitable for every one (check with your prescriber).
  • Combination of medication with light treatment was more effective than each group alone.
  • In practice, we often see medications work better if the patient is also involved in non medication treatments like counseling and healthy lifestyle habits. Often, the most effective treatment is some combination of biological, psychological and social treatments.
  • Study participants were diagnosed by undergoing a psychiatric evaluation, which is not always available to everyone.
  • The maximum dose of fluoxetine is 60mg but this study only used a 20mg dose which could have impacted results.
  • Finally, we can prescribe many different antidepressant medications, and a single dose of 1 antidepressant cannot be generalized to all combinations/doses of other antidepressant medications.

What are other treatments for depression?

  • Eat a healthy balanced diet of protein/veggies/fruit/whole grains, Omega 3’s
  • Don’t isolate from family, friends, or colleagues and get involved on campus
  • Counseling
  • Talk to your doctor about various treatment options such light therapy, medication, etc.
  • A well balanced exercise program (check with your doctor first)

What are some of OSU’s campus resources that might help with reducing depression?

Are there any other helpful resources?

  • DBSA (Depression and Bipolar Support Alliance)
  • NAMI (National Alliance for Mental Illness)
  • NIMH (National Institute of Mental Health)

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References

1. http://www.nlm.nih.gov/medlineplus/seasonalaffectivedisorder.html

2. Magnusson A. An overview of epidemiological studies on seasonal affective disorder. Acta Psychiatr Scand 2000; 101:176.

3. Uptodate.com Seasonal Affective disorder. Accessed 01/2016.

4. Lam JAMA Psychiatry. 2016 Jan 1;73(1):56-63RW, et al.  Efficacy of Bright Light Treatment, Fluoxetine, and the Combination in Patients With Nonseasonal Major Depressive Disorder: A Randomized Clinical Trial. JAMA Psychiatry. 2016 Jan 1;73(1):56-63.