Morning light treatment hastens the antidepressant effect of citalopram: A placebo-controlled trial
Morning light treatment hastens the antidepressant effect of citalopram: A placebo-controlled trial
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DOI：
10.4088/jcp.v64n0605
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发表时间：
2003-06-01
影响因子：
5.3
通讯作者：
Smeraldi, E
中科院分区：
文献类型：
--
作者：
Benedetti, F;Colombo, C;Smeraldi, E
背景资料：选择性5-羟色胺再摄取抑制剂对约70%的重度抑郁发作患者有效，但治疗变化通常需要2周的给药才能具有临床意义。辅助光疗法已被提出来加速药物治疗的效果。本研究的目的是评估晨间光照疗法或安慰剂联合西酞普兰治疗无精神病性特征的重性抑郁发作患者的效果。（DSM-IV重性抑郁障碍[N = 21]和双相情感障碍[N = 9]）接受西酞普兰40 mg治疗，并随机分为3：在药物治疗的前2周期间，以2种方式在早晨接受30分钟的400勒克斯绿色光治疗或安慰剂（暴露于失活的负离子发生器）。单独定义光治疗的时间，以获得2小时的晨光相位提前。每周用汉密尔顿抑郁量表和Zung抑郁自评量表进行评定，第1周每天3次用视觉焦虑量表进行评定。（p <0.05）光治疗患者的情绪改善更好，导致抗抑郁治疗的反应更快。西酞普兰联合轻度治疗对抑郁症的疗效优于西酞普兰和安慰剂。通过优化给药时间，低强度光治疗显著加速并增强了西酞普兰的作用，从而为临床精神科医生提供了一种有效且无副作用的增强策略。
Background: Selective serotonin reuptake inhibitors are effective in approximately 70% of patients with a major depressive episode, but therapeutic changes usually require 2 weeks of administration to become clinically relevant. Adjunct light therapy has been proposed to hasten the effects of drug treatment. The purpose of the present study was to evaluate the effect of morning light therapy or placebo combined with citalopram in the treatment of patients affected by a major depressive episode without psychotic features.Method: Thirty inpatients (DSM-IV major depressive disorder [N = 21] and bipolar disorder [N = 9]) were treated with citalopram, 40 mg, and randomized in a 3:2 manner to receive 30 minutes of 400 lux green light treatment in the morning or placebo (exposure to a deactivated negative ion generator) during the first 2 weeks of drug treatment. Timing of light therapy was individually defined to obtain a 2-hour phase advance to morning light. Outcome was measured with the Hamilton Rating Scale for Depression and the Zung Self-Rating Depression Scale every week, and with a Visual Analogue Scale 3 times a day during the first week.Results: All outcome measures showed significantly (p < .05) better mood improvement in light-treated patients, resulting in faster responses to antidepressant treatment.Conclusion: The combination of citalopram and light treatment was more effective than citalopram and placebo in the treatment of major depression. With an optimized timing of administration, low-intensity light treatment significantly hastened and potentiated the effect of citalopram, thus providing the clinical psychiatrists with an augmenting strategy that was found effective and devoid of side effects.