Summary

In elderly patients with major depressive disorder, 3 weeks of bright light therapy (BLT) was associated with significantly improved mood, increased rate of evening melatonin rise, and decreased cortisol levels, relative to placebo.

Design

• N=89 patients, 60 years or older, with nonseasonal major depressive disorder, randomized to receive 3 weeks of 1-hour early-morning:
  • Bright light treatment (pale blue, 7,500 lux) (n=42)
  • Placebo treatment (dim red light, 50 lux) (n=47)
• Primary outcome: Hamilton Scale for Depression scores at end of 3 week-treatment, and again 3 weeks later.
• Saliva Melatonin level, Saliva cortisol levels, and 24-hour urinary free cortisol levels checked at baseline, end of 3-week treatment, and 3 weeks after that.
• Setting: Amsterdam region, 2003-2007. Treatment delivered at home.

Results

• Hamilton Scale for Depression scores were significantly increased in BLT group relative to placebo:
  • 7% (95% CI, 4%-23%) at end of treatment
  • 21% (95% CI, 7%-31%) 3 weeks after end of treatment.
• At end of treatment, evening melatonin levels increased significantly more rapidly (P=0.03) in BLT group compared with placebo.
• Three weeks after the end of treatment, 24-hour urinary cortisol was 37% lower (P=0.003) in the BLT group compared with placebo. Compared with baseline, evening salivary cortisol levels were 34% lower in the BLT group and 7% higher with placebo (P=0.02).

Reference

Lieverse R, Van Someren EJW, Nielen MMA, Uitdehaag BMJ, Smit JH, Hoogendijk WJG. Bright light treatment in elderly patients with nonseasonal major depressive disorder: a randomized placebo-controlled trial. Arch Gen Psychiatry. 2011;68(1):61-70. doi:10.1001/archgenpsychiatry.2010.183.