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Light therapy for bipolar disorder: a case series in women

Authors

  • Dorothy Sit,

    1. Women's Behavioral HealthCARE, Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA
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  • Katherine L Wisner,

    1. Women's Behavioral HealthCARE, Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA
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  • Barbara H Hanusa,

    1. Women's Behavioral HealthCARE, Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA
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  • Stacy Stull,

    1. Women's Behavioral HealthCARE, Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA
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  • Michael Terman

    1. Center for Light Treatment and Biological Rhythms, Department of Psychiatry, Columbia University, New York State Psychiatric Institute, New York, NY, USA
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  • DS has received research funding from the National Alliance for Research on Schizophrenia and Depression (NARSAD) Young Investigator Award and has current pilot funds from the University of Pittsburgh, School of Medicine General Clinical Research Center Clinical Research Feasibility Funds Award and the Office of Research Health Sciences Competitive Medical Research Funds New Investigator Award. KLW has received grant funding from the National Institute of Mental Health (NIMH) and the US Department of Health and Human Services – Health Resource and Services Administration; research funds from Pfizer, Inc., for a study of the pharmacokinetics of ziprasidone during pregnancy; and has served on the speakers bureau for GlaxoSmithKline. MT has received grant funding from NIMH and the National Institute of Neurological Disorders and Stroke. BHH and SS have no reported conflict of interest.

  • The data from this study were presented at the poster session of the Sixth International Conference on Bipolar Disorder, 16–18 June 2005, Pittsburgh, PA, USA.

Dorothy Sit, MD, Women's Behavioral HealthCARE, Department of Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA. Fax: +1 412 246 6960;
e-mail: sitdk@upmc.edu

Abstract

Objectives:  To perform a dose-ranging safety and efficacy study of bright light therapy for depression in women with bipolar disorder (BD).

Methods:  Nine women with DSM-IV BD I or II in the depressed phase were exposed to 50 lux (illuminance at the receiving surface) red light for two weeks, after which they received 7,000 lux light therapy for two-week epochs of 15, 30 and 45 min daily. The Structured Interview Guide for the Hamilton Depression Rating Scale with Atypical Depression Supplement and the Mania Rating Scale were used to assess mood symptoms. Four patients received morning light and five patients received midday light.

Results:  Three of the four subjects treated with morning light developed mixed states. The fourth subject achieved a full, sustained response. To decrease the risk of inducing mixed episodes, we changed the time of light exposure to midday. Of the five women who received midday light therapy, two achieved full response and two showed early improvement but required a dose increase to sustain response. One woman remained depressed with 45 min of midday light but responded fully to a switch to morning light, 30 min daily.

Conclusions:  Women with bipolar illness are highly sensitive to morning bright light treatment; the induction of mixed states is a substantial risk. Initiating treatment with a brief duration (15 min) of midday light for bipolar depression is advisable.

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