Bright light therapy in seasonal bipolar depressions | Luminothérapie et épisodes dépressifs saisonniers du trouble bipolaire
L'Encéphale. 2015-12-01; 41(6): 527-533
DOI: 10.1016/j.encep.2015.09.003
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1. Encephale. 2015 Dec;41(6):527-33. doi: 10.1016/j.encep.2015.09.003. Epub 2015 Oct
16.
[Bright light therapy in seasonal bipolar depressions].
[Article in French]
Geoffroy PA(1), Fovet T(2), Micoulaud-Franchi JA(3), Boudebesse C(4), Thomas
P(2), Etain B(5), Amad A(2).
Author information:
(1)Inserm, U1144, 75006 Paris, France; Pôle de psychiatrie et de médecine
addictologique, GH Saint-Louis – Lariboisière – F.-Widal, AP-HP, 75475 Paris
cedex 10, France; Université Paris-Descartes, UMR-S 1144, 75006 Paris, France;
Université Paris Diderot, Sorbonne Paris-Cité, UMR-S 1144, 75013 Paris, France;
Fondation FondaMental, 94000 Créteil, France. Electronic address:
.
(2)Pôle de psychiatrie, université de Lille, CHU de Lille, 59000 Lille, France.
(3)USR CNRS 3413 SANPSY, CHU Pellegrin, université de Bordeaux, 33076 Bordeaux,
France.
(4)Fondation FondaMental, 94000 Créteil, France; Inserm, U955, psychiatrie
génétique, 94000 Créteil, France; Pôle de psychiatrie, hôpitaux universitaires
Albert-Chenevier-Henri-Mondor, DHU PePSY, AP-HP, 94000 Créteil, France.
(5)Fondation FondaMental, 94000 Créteil, France; Inserm, U955, psychiatrie
génétique, 94000 Créteil, France; Pôle de psychiatrie, hôpitaux universitaires
Albert-Chenevier-Henri-Mondor, DHU PePSY, AP-HP, 94000 Créteil, France; Faculté
de médecine, université Paris Est, 94000 Créteil, France.
INTRODUCTION: Bipolar disorders (BD) are frequent mood disorders associated with
a poor prognosis mainly due to a high relapse rate. Depressive relapses may
follow a seasonal cyclicality, and bright-light therapy (BLT) has been
established as the treatment of choice for seasonal affective disorder (SAD). The
use of BLT for seasonal unipolar depression is well known, but the scientific
literature is much poorer on the management of seasonal depressive episodes in
BD. In addition, some specificities related to BD must be taken into account.
METHODS: We conducted a comprehensive review using Medline and Google Scholar
databases up to August 2014 using the following keywords combination: “bipolar
disorder” and “light therapy” or “phototherapy”. Papers were included in the
review if (a) they were published in an English or French-language peer-reviewed
journal; (b) the study enrolled patients with BD and SAD; and (c) the diagnosis
was made according to the DSM or ICD criteria.
RESULTS: BLT was considered among the first-line treatments for SAD with a size
effect similar to antidepressants. Most of the studies did not distinguish
between patients with unipolar and bipolar disorders. However, it has been
demonstrated that the most significant risk of BLT in patients with BD is the
mood shift. Thus, the most important therapeutic adaptation corresponds to the
use of an effective mood stabilizer, as with any antidepressant. Another
therapeutic adaptation in first intention is that the times of exposure to light
should be shifted from morning to midday. This review also includes therapeutic
guidelines regarding the management of BLT in seasonal bipolar depressive
episodes.
DISCUSSION: There are very few specific data on seasonal bipolar depressive
episodes. This literature review has highlighted that BLT should be handled as a
regular antidepressant treatment in patients suffering from seasonal bipolar
depressive episodes.
Copyright © 2015 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights
reserved.
DOI: 10.1016/j.encep.2015.09.003
PMID: 26481654 [Indexed for MEDLINE]