Cochrane Review on Light Therapy for Non-Seasonal Depression

Light Therapy for Non-Seasonal Depression (Cochrane Review). The Cochrane Library, Issue 2, 2004.
Tuunainen A, Kripke DF, Endo T.

"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)"

NOTE: The Benedetti 2003 study, (quality category A) used Lo-LIGHT lamps as the active treatment.


Benedetti 2003


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).


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.


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.


Clinical improvement (50% reduction HDRS).
Mental state (HDRS).
Physiological monitoring (ECG, lab tests).

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