Adjunctive bright light therapy for bipolar depression: A randomized double-blind placebo-controlled trial

Objective: Patients with bipolar disorder have recurrent major depression, residual mood symptoms, and limited treatment options. Buildingon promising pilot data, the authors conduct ed a6-weekr and omizeddouble-blindplacebo-controlledtrial to investigate the efficacy of adjunctive bright light therapy at midday for bipolar depression. The aims were to determine remission rate, depression symptom level, and rate of mood polarity switch, as well as to explore sleep quality. Method: The study enrolled depressed adults with bipolar I or II disorder who were receiving stable dosages of antimanic medication (excluding patients with hypomania ormania, mixed symptoms, or rapid cycling). Patientswere randomly assigned to treatment with either 7,000-lux bright white light or 50-lux dim red placebo light (N=23 for each group). Symptoms were assessed weekly with the Structured Interview Guide for the Hamilton Depression Scale With Atypical Depression Supplement (SIGH-ADS), the Mania Rating Scale, and the Pittsburgh Sleep Quality Index. Remission was defined as having a SIGH-ADS score of 8 or less. Results: At baseline, both groups had moderate depression and no hypomanic or manic symptoms. Compared with the placebo light group, the group treated with bright white light experienced a significantly higher remission rate (68.2% comparedwith 22.2%; adjusted odds ratio=12.6) at weeks 4-6 and significantly lower depression scores (9.2 [SD=6.6] compared with14.9 [SD=9.2]; adjustedb=-5.91) at the endpoint visit.No mood polarity switcheswere observed. Sleep quality improved in both groups and did not differ significantly between them. Conclusions: The data from this study provide robust evidence that supports the efficacy of midday bright light therapy for bipolar depression.