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Official RecommendationsIn the 20 years since the initial discovery of light therapy and circadian rhythms, thousands of studies involving several thousand participants have demonstrated the validity of light therapy for the treatment of these chronobiological disturbances.1 2 Dozens of medical journals report on the efficacy of light therapy (See footnotes below for a partial list). The National Institute of Health as well as major research universities and medical associations have established light therapy as a mainstream treatment.3 4 5 6 7 8 These studies have been confirmed through multiple independent replications of placebo-controlled trials. Most northern US hospitals, and all Canadian hospitals have Winter Blues clinics. Treatment of ChoiceReviews in Archives of General Psychiatry, JAMA and other medical journals recommend light therapy as the treatment of choice for Winter Blues.9 10 11 12 13 Light is generally recommended first because of the quick response and high response rate. Most patients respond within a week. Although some studies show response rates as high as 90%, large clinical trials show response rates of 65% and 75%.14 15 Another reason light is preferred is that it is more effective than other treatments and side effects are more benign and better tolerated.16 17 One recent journal concluded, "[Light] meets 3 essential criteria for use in clinical practice: (1) specific antidepressant efficacy as gauged against placebo controls, (2) lack of clinically significant ocular changes, and (3) a favorable side effect profile."18 Official RecommendationsWinter Blues and its treatment are described in the DSM IV.19 Light therapy is also recommended by the Society for Light Treatment and Biological Rhythms (SLTBR),20 the U.S. Public Health Service Agency for Health Care Policy and Research,21 22 American Psychiatric Association,23 and the American Academy of Sleep Medicine (for sleep disturbances).24 The American Medical Association is currently reviewing recommendation guidelines for its Recognition Program.25
1 National Library of Medicine search on 'Circadian Rhythms' and 'Light Therapy'. February 2004. Source: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi
2 Kripke, D. Estimating Circadian Rhythm and Light Therapy Studies on Patients. Correspondence with Apollo February 19, 2004
3 Terman M. et al. A review of efficacy. Neuropsychopharmacol 1989;2:1-22
4 Blehar MC. et al. Psychopharmacol Bull 1990; 26:465-494
5 Lam RW. et al. Can J Psychiatry 1989; 34:14-147
6 Rosenthal NE et al. (eds): New York, Guilford, 1989
7 Thompson C, et al. (eds): London, CNS, 1989
8 Society for Light Treatment and Biological Rhythms: Light Treatment and Biol Rhythms 1990;3:5-9
9Agency for Health Care Policy and Research. Dept of Health and Uman Services; 1993. Publication 93-0551.
10 Rosenthal NE. JAMA. 1993;270:2717-2720
11 Wirz-Justice, A. Beginning to see the light. Arch Gen Psychiatry. 1998; 55:860-862
12 Lamburg, L. Dawn's early light to twilight's last gleaming. JAMA 1998; 280:1556-1558
13 Singer, EA. Seasonal affective disorder: Autumn onset, winter gloom (Board Review). Clinician Reviews 2001; 11: Issue 11
14 Lam, R. et al. Mod Probl Pharmacopsychiatry 1997; 25:215-234
15 Lam R, Levitt A. (eds): Clinical and Academic Publishing
16 Partonin T. Light Therapy. In: Partonen, T, eds. Seasonal Affective Disorder. Oxford UK: Oxford University Press, 2001 65-78
17 Lam, R. et al. (ed): Systematic Medication Management. Mod Probl Pharmacopsychiatry Basel Karger 1997; 25:215-234
18 Terman M, Terman JS. Bright Light Therapy: Side effects and benefits across the spectrum. J Clin Psychiatry. 1999;60:799-808
19 American Psychiatric Association. Washington DC: American Psychiatric Association; 2000:356,365,427
20 Society for Light Treatment and Biological Rhythms. Light Treatment Biol Rhythms. 1991;3:45-50
21 Terman M, Terman JS. Report to the Guidelines Panel USPHS Agency for Health Care Policy and Research. New York, NY: New York State Psychiatric Institute; 1991
22 Agency for Health Care Policy and Research. Clinical Practice Guideline No. 5. Rockville, Md: US Department of Health and Human Services; 1993
23 American Psychiatric Association. P Am J Psychiatry. 1993;150(suppl):1-26
24 Chesson AL, et al. Sleep. 1999;22:641-660
25 Terman M, Terman JS. Light Therapy. In: Kryger MH, Roth T, Dement WC, eds. Principles and Practices of Sleep Medicine. Philadelphia, W.B. Saunders, 2000;1258-1274
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