* NOTE: The
Benedetti 2003 study, (quality category A) used the green Sunnex Biotechnologies Lo-LIGHT as the
active treatment.
"Bright light therapy was administered in a wide range of intensities (from 400 lux to
10,000 lux), several colors such as white (active), green (active), red
(control) and yellow (control) wave lengths, and at different times in a
day. The duration of active treatment varied between 30 minutes (Benedetti
2003*); (Loving
2002) and the whole night, i.e., eight (van
den Burg 1990) or nine hours (Giedke
1989)."
Twenty studies (49 reports) were included in the review. Most of the studies applied bright
light as adjunctive treatment to drug therapy, sleep deprivation, or both.
...
Apart from two category A studies (Moffit
1993; Benedetti 2003*), all other studies were located in the quality category B."
Studies with a higher
methodological quality rating (category A) showed unequivocal superiority of
bright light over control treatment (2 studies, 50 patients, SMD -0.90, CI -1.50
to -0.31), even with a more conservative random effects model approach (SMD
-0.90, CI -1.50 to -0.31). The statistical significance of studies with lower
methodological quality (category B) was weaker and did not reach statistical
significance when analyzed with a fixed effect model (16 studies, 455 patients,
SMD -0.12, CI -0.31 to 0.07)
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Study
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Benedetti 2003
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Methods
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Allocation: randomized, 'computer generated randomization with no
stratification', 'in a 3:2 manner'. Blinding: single blind, 'raters
could not keep themselves blind due to patients' questions'.
Duration: 4 weeks (light treatment the first 2 weeks).
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Participants
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Diagnosis: Major depressive disorder without psychotic features.
Major depression (N = 21), bipolar (N = 9). DSM-IV.
Inclusion criteria: absence of following conditions: other diagnoses on
Axis I, mental retardation on Axis II, pregnancy, history of epilepsy,
major medical or neurological disorder, treatment with long-active
neuroleptic drugs within 3 months, treatment with neuroleptics or
irreversible MAOIs within the last month, history of drug or alcohol
dependency or abuse within 6 months.
N = 30.
Age: mean 54.3 years.
Sex: F 24, M 6.
History: duration of illness mean 13.4 years.
Setting: inpatients.
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Interventions
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1. Green light (400 lux in the morning for 30 minutes) +
citalopram 40 mg/day.
N = 18.
2. Deactivated negative ion generator (in the morning 1.5 hours after
the optimal timing for light) + citalopram 40 mg/day. N = 12.
Device: Sunnex Biotechnologies green light box.
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Outcomes
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Clinical improvement (50% reduction HDRS).
Mental state (HDRS).
Physiological monitoring (ECG, lab tests).
Unable to use -
Mental state (ZDRS, VAS - no mean scores and SD available).
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