Morning Light Treatment Hastens the Antidepressant Effect of Citalopram: A Placebo-Controlled Trial
J Clin Psychiatry 2003;64:648-653
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Selective serotonin reuptake
inhibitors are effective in approximately 70% of patients with a
major depressive episode, but therapeutic changes usually require
2 weeks of administration to become clinically relevant. Adjunct
light therapy has been proposed to hasten the effects of drug
treatment. The purpose of the present study was to evaluate the
effect of morning light therapy or placebo combined with
citalopram in the treatment of patients affected by a major
depressive episode without psychotic features.
Method: Thirty inpatients (DSM-IV major
depressive disorder [N = 21] and bipolar disorder [N = 9]) were
treated with citalopram, 40 mg, and randomized in a 3:2 manner to
receive 30 minutes of 400 lux green light treatment in the
morning or placebo (exposure to a deactivated negative ion
generator) during the first 2 weeks of drug treatment. Timing of
light therapy was individually defined to obtain a 2-hour phase
advance to morning light. Outcome was measured with the Hamilton
Rating Scale for Depression and the Zung Self-Rating Depression
Scale every week, and with a Visual Analogue Scale 3 times a day
during the first week.
Results: All outcome measures showed
significantly (p < .05) better mood improvement in
light-treated patients, resulting in faster responses to
Conclusion: The combination of citalopram and
light treatment was more effective than citalopram and placebo in
the treatment of major depression. With an optimized timing of
administration, low-intensity light treatment significantly
hastened and potentiated the effect of citalopram, thus providing
the clinical psychiatrists with an augmenting strategy that was
found effective and devoid of side effects.