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Citalopram Plus Light Therapy More Effective Than Citalopram Alone For Major Depression
A DGReview of :"Morning light treatment hastens the antidepressant effect of citalopram: a placebo-controlled trial"
Journal of Clinical Psychiatry
07/09/2003
By Mary Beth Nierengarten
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 (10 mg/day on day 1, titrated to 40 mg/day at day 4) 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. The Hamilton Rating Scale for Depression (HAM-D), Zung Self-Rating Depression Scale (SDS), and Visual Analogue Scale (VAS) were used to measure outcomes.
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. Improvement was seen during the first days of treatment, and lasted throughout the 4 weeks of the study. Both HAM-D and SDS scores showed significant improvement for the light-therapy: HAM-D and SDS scores showed significant improvement at 1 week (p=0.0084; p=0.0015, respectively), 2 weeks (p=0.0058; p=0.0304, respectively), 3 weeks (p=0.0111; p=0.0155, respectively), and 4 weeks (p=0.0269; p=0.0066, respectively).
Overall, the patients treated with additional light therapy had a net relative advantage of 26.8% over the placebo group at 4 weeks.
The authors conclude that adding light therapy to citalopram hastened the effect of citalopram and was more effective than citalopram alone for the treatment of major depression.
J Clin Psychiatry 2003 Jun;64:6:648-53.
"Morning light treatment hastens the antidepressant effect of citalopram: a placebo-controlled trial"
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