Comparison of effects of bright light therapy alone or combined with fluoxetine on severity of depression, circadian rhythms, mood disturbance, and sleep quality, in patients with non-seasonal depression

Correspondence: Gokben Hizli Sayar Department of Psychiatry, Uskudar University, Neuropsychiatry Istanbul Hospital, Alemdag Caddesi Site Yolu No 29 Umraniye, Istanbul, Turkey Tel +90 216 633 0649 Fax +90 216 634 1250 Email gokben.hizlisayar@uskudar.edu.tr Purpose: To compare effects of bright light therapy (BLT) alone or combined with the selective serotonin reuptake inhibitor (SSRI) fluoxetine, on severity of depression, circadian rhythms, mood disturbance, and sleep quality, in patients with non-seasonal depression. Patients and methods: Drug-free patients who were administered 10,000 lux of BLT for 30 minutes for 7 days comprised the BLT group (n = 7), while patients who started fluoxetine as an add-on treatment day comprised the SSRI + BLT group (n = 8). The primary outcomes were severity of depression, measured using the Hamilton Depression Rating Scale (HAM-D) and the Beck Depression Inventory (BDI); chronotype, measured using the Morningness Eveningness Questionnaire (MEQ); mood disturbance, measured using the Profile of Mood States (POMS) survey; and sleep quality, measured using the Pittsburgh Sleep Quality Index (PSQI), before and after treatment in both groups. Results: All patients completed the study, and none reported obvious side effects. The mean onset age of depression was 26.1 years ± 5.3 years in the BLT group and 27 years ± 9.5 years in the SSRI + BLT group (P = 0.425). The number of past depressive episodes was 1.29 ± 0.76 in the BLT group, and 1.5 ± 0.8 in the SSRI + BLT group (P = 0.427). The difference between preand posttreatment scores revealed no significant difference between groups for the HAM-D scale, BDI, MEQ, POMS survey, and the PSQI. Conclusion: This study suggests that BLT is effective with respect to the severity of depression, circadian rhythms, mood disturbance, and sleep quality, in non-seasonal depression. However, there was no evidence in favor of adjunctive fluoxetine with BLT in the treatment of non-seasonal depression, for any of the rating scales used in our study.