Bright artificial light and the antidepressant fluoxetine are both effective
treatments for the winter form of seasonal affective disorder (SAD). A
head-to-head comparison conducted in four Canadian cities over three winters is
reported in an article in the May issue of The American Journal of Psychiatry
(AJP), the official journal of the American Psychiatric Association (APA).
The findings are presented in the article, “The CAN-SAD Study: Randomized
Controlled Trial of the Effectiveness of Light Therapy and Fluoxetine in
Patients With Winter Seasonal Affective Disorder” by Raymond W. Lam, M.D., and
colleagues of the Mood Disorder Centre at Vancouver Coastal Health Research
Institute and the University of British Columbia. The rates of remission were 50
percent and 54 percent of enrolled patients for bright light and fluoxetine,
respectively.
Although light therapy and antidepressants are each more effective than placebo,
there have been few direct comparisons of them. In addition, this study was
double-blind-all participants received light and a capsule each day. One group
received low-intensity “placebo” light in addition to fluoxetine. The other
group received a placebo capsule and were exposed to 10,000-lux white
fluorescent light for 30 minutes a day. Patients judged to have serious risk of
suicide were excluded from the study.
“This study gives patients with a common, but significantly debilitating mood
disorder a choice between two effective treatments,” said Robert Freedman, M.D.,
AJP editor-in-chief.
Light therapy showed two advantages over fluoxetine. It worked faster, having a
greater effect at one week. It also produced less agitation and less sleep
disturbance. However, the overall dropout rate and the dropout rate due to side
effects did not differ between treatments.
Winter depression is the most common type of seasonal mood disorder.
Epidemiological studies show prevalence rates as high as 2.7 percent in higher
latitudes. The symptoms may begin in the fall and include profound lack of
energy, excessive sleeping, and overeating, in addition to depressed mood.
Impaired occupational or social functioning is common.
This study was funded by the Canadian Institutes of Health Research (CIHR) and a
CIHR/Wyeth Postdoctoral Fellowship Award. Light boxes were supplied by Uplift
Technologies.
(Am J Psychiatry. 2006; 163: 805-812).
About the American Journal of Psychiatry
The American Journal of Psychiatry, the official journal of the American
Psychiatric Association, publishes a monthly issue with scientific articles
submitted by psychiatrists and other scientists worldwide. The peer review and
editing process is conducted independently of any other American Psychiatric
Association components. Therefore, statements in this press release or the
articles in the Journal are not official policy statements of the American
Psychiatric Association. The Journal's editorial policies conform to the Uniform
Requirements of the International Committee of Medical Journal Editors, of which
it is a member. For further information about the Journal visit:
ajp.psychiatryonline.org.
2-May-2006
