Randomized Clinical Trial on the Effect of a Single Nights' Wake Followed by Bright Light Therapy on Depression

Abstract

Randomized Clinical Trial on the Effect of a Single Nights' Wake Followed by Bright Light Therapy on Depression Author: Mats Widmark-Jensen, Med.cand. Sahlgrenska Academy, University of Gothenburg Supervisor: Steinn Steingrimsson, MD, PhD, Institution of Neuroscience and Physiology, Sahlgrenska University Hospital Introduction: Wake-therapy (or "Sleep deprivation") has the potential of providing a fast anti-depressive response, however, the effect tends to fade after subsequent sleeping. Bright light therapy has the ability of maintaining the positive effect. Agitation among patients suffering from mood disorders has been scarcely investigated and no study has yet measured the possibility of increased agitation when undergoing wake-therapy. Objectives: To determine the effect of combined wake- and bright light therapy as an enhancement of existing conventional anti-depressive treatment. Methods: Patients suffering from a depressive episode were randomized to either wake-therapy combined with bright light therapy in addition to treatment as usual (TAU) or to the control group (psycho education on sleep hygiene in addition to TAU). On day 1, before wake-therapy or psycho education, patients filled out Montgomery-Åsberg Depression Rating Scale (MADRS-S) and Insomnia Severity Index (ISI). Agitation was assessed using Positive And Negative Symptoms of Schizophrenia (PANSS-EC) on day 1 and 2. On day 7 all patients again filled out MADRS-S and ISI. Results: This ongoing randomized clinical trial will consist of 50 patients in total. In this thesis, the results from the first 8 patients is presented. Wake-therapy combined with bright light therapy in addition to TAU reduced the median MADRS-S score non-significantly by 6 points, compared to 4 points in the control group (p=0.73) ). Median ISI score was reduced non-significantly by 2 and 4 points, respectively (p=0.71). Agitation level among patients undergoing wake-therapy was not significantly raised (p=0.22). Conclusion: So far a non-significant reduction in MADRS-S and ISI has been observed using combined wake- and bright light therapy, whilst agitation levels have not been significantly raised. Pending the final results from this randomized controlled trial, this approach could become a valuable addition to conventional anti-depressive treatment, without significantly adding to harmful effects.