Light therapy for elderly with depression

The bright-light therapy often used to fight seasonal affective disorder may also ease major depression symptoms in the elderly, a small clinical trial suggests.

Dutch Researchers found that of 89 older adults with major depressive disorder, those who were randomly assigned to three weeks of bright light treatment showed improvements comparable to what's been seen in studies of antidepressant drugs.

These latest findings, reported in the Archives of General Psychiatry, suggest that light therapy could offer an alternative to older adults with depression, who often cannot or do not want to take antidepressant drugs.

"I think bright light therapy definitely now deserves a place in the treatment of major depression in older adults," said lead researcher Dr Ritsaert Lieverse, a psychiatrist at GGZ in Geest and the VU University Medical Centre in Amsterdam.

More vulnerable to drug side effects

"Many of them don't receive adequate antidepressant treatment because they refuse or resist (drug) treatment," Dr Lieverse said. Older adults are also more vulnerable to drug side effects compared with younger people, he added.

The current study included 89 men and women age 60 or older who were randomly assigned to one of two groups. In one, participants were given a light-therapy box, donated by Philips Lighting, which emitted pale blue light; they were told to use it every morning for one hour over three weeks.

The rest of the study participants were given boxes that emitted a dim red light, which has no known benefits or harms to the body.

After three weeks of light-therapy, the patients in that group showed a greater improvement in Hamilton Scale for Depression scores, and their evening melatonin level rose by 81%, compared to patients in the control group. In addition, their 24-hour urinary free cortisol levels were 37% lower, and their evening salivary cortisol levels were 34% lower, compared to controls.

50% drop in depression

And three weeks after the therapy ended, more people in the light-therapy group had maintained a response; that is, their depression scores had dropped by at least 50%. Of the light-therapy patients, 58% were responders, vs. 34% of the control group.

There was some evidence that light therapy might also be helpful as an adjunct treatment for older adults whose antidepressants are not working well enough.

One-third of patients in the light-therapy group were already on antidepressants -- but still depressed -- and had the light box added to their drug treatment. They were as likely to improve with light therapy as patients who were not on medication.

The researchers, who reported no financial ties to makers of the light boxes, say longer term studies are still needed to see how the benefits hold up over time.

Dr. Lieverse noted that light boxes are available without a prescription -- online or at drug stores -- for a few hundred dollars, but that patients should be warned not to use them without medical guidance. Light therapy is contraindicated, for example, in patients with diabetic retinopathy.

(Reuters Health, Amy Norton, January 2011)

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