Morning Light Treatment Hastens the Antidepressant Effect of Citalopram: A Placebo-Controlled Trial. The Journal of Clinical Psychiatry. June 2003; 64(6):648-53
Benedetti F, Colombo C, Pontiggia A, Bernasconi A, Florita M, Smeraldi E.

In the present study we evaluated the effect if morning low-intensity light therapy or placebo combined with the SSRI citalopram in the treatment of patents affected by a major depresive episode"
"The lighting device (Sunnex Biotechnologies, Winnipeg, Manitoba, Canada) provided 400 lux green light, with a spectrum ranging from 485 to 515 nm and peak at 500-505 nm."

"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."

"Timing of morning light therapy administration was chosen on the basis of the observed correlation between the magnitude of the phase advances to morning light therapy and improvement in depression ratings with maximum effects at phase advances of 1.5 to 2.5 hours;"

"Discussion: Morning light therapy was superior to placebo in augmenting the antidepressant effect of citalopram. This effect began during the first days of treatment, as shown by self ratings of perceived mood, and continued throughout the 4 study weeks, resulting in different rates of response between groups."
"After the first 2 weeks of treatment (i.e. when the treatment conditions differed), HAM-D scores decreased to 49.4% of baseline in light therapy patients and to 83.1% of baseline in placebo treated patients, with a 33.7% net relative advantage of light therapy over placebo. The difference remained almost the same over the following weeks: at the end of treatment HAM-D scores decreased to 31.2% of baseline in the light therapy patients, and to 58.0% in the placebo-treated patients, with a 26.8% net advantage of light therapy over placebo." Abstract

From a report on the above study in Doctor's Guide:

"Citalopram (Celexa) combined with light therapy is more effective than citalopram alone as treatment for major depression, say researchers from Italy."

"Because of the delay in onset of efficacy of the selective serotonin reuptake inhibitors (SSRIs), such as citalopram, for the treatment of major depression, there is much interest in finding non-drug, chronobiological interventions, such as light therapy, to supplement and reduce the time it takes for treatment to take effect."

"In a study by Francesco Benedetti, M.D. and colleagues, Università Vita-Salute San Raffaele, Milano, Italy, 21 patients with major depression and 9 patients with bipolar disorder treated with citalopram... were randomised to receive additional 30 minutes of 400 lux green morning light treatment (n=18) or placebo (n=12) during the first 2 weeks of therapy"
"At 4 weeks after initiation of treatment, patients treated with citalopram and additional light therapy showed significant improvement in mood (p<0.05) than patients treated only with citalopram."

From the report of the above study in Medscape:Sept. 22, 2003

"Morning light therapy helps augment therapy with citalopram for inpatients with major depression, according to a presentation on Sept. 22 at the European College of Neuropsychopharmacology meeting held in Prague, the Czech Republic. Treatment with 400 lux green light for 30 minutes was effective compared with placebo and was devoid of adverse effects."

"The study was aimed at speeding up response to selective serotonin reuptake inhibitors (SSRIs) with a chronobiological technique. 'We phase-advanced exposure to morning light of about two hours, by individually timing the exposure to a lamp,' coauthor Francesco Benedetti, MD, from the Universitàà Vita-Salute San Raffaele in Milan, Italy, told Medscape."

"To our surprise, the subjective evaluations of the patients showed that the first signs of amelioration were evident as soon as the third day of treatment. In this respect, the rapidity of action of this technique is similar to that of other chronobiological antidepressant treatments, such as sleep deprivation and phase advance," Dr. Benedetti said. "If these results [are] confirmed in an independent sample, this new strategy is likely to change common clinical practice" For Full Medscape article, click here.

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