Lightbox

Modulates serotonin, circadian rhythms.

Seasonal winter depression¹
Non-seasonal depression²
Bipolar depression (any season)²
Augments antidepressants and TMS
PTSD³
Vascular depression (post-stroke)²

Bulimia in winter²
Male sexual dysfunction in winter²
Insomnia³
Shift-work syndrome¹
Depression and negative symptoms in schizophrenia²

Features

Bipolar-Safe, Elderly-Preferred, Child-Studied, Generic, Natural, Activating, Weight-Free, Non-sedating, Sexual-free, Elderly-Safe, Tolerable

Handout

Dosing

30-60 minutes in early morning (5-8 am). Can also use 12-2 pm, but do not use after 2 pm that can worsen sleep and mood. Patient must sit under it at close range, but can read or eat while under it.

For insomnia, deliver light at 4-5 am for 1 hour.

For shift work, deliver light when patient wakes up (artificial morning). Use dark therapy before they go to bed.

One time cost ($150).

Management

Consider using a dawn simulator to help patient wake up and use treatment.

TOLERABILITY: Headache, eye strain, photosensitivity.

RISKS: Mania (lower timing or deliver 12-2 pm if manic symptoms occur). Photosensitivity (possible with photosensetizing meds like lamotrigine, tricyclics, antipsychotics). Ocular risks in patients with glaucoma, cataracts, retinal detachment, or retinopathy (the boxes have UV filters so should be safe but can get opthalmology approval).

EMR Text

Depression

Light therapy recommended based on randomized controlled trials in depression.

Light therapy risks, including photosensitivity and opthalmologic, reviewed with patient.

Bipolar Depression

Light therapy recommended based on randomized controlled trials in bipolar depression.