1
|
Kosanovic Rajacic B, Sagud M, Pivac N, Begic D. Illuminating the way: the role of bright light therapy in the treatment of depression. Expert Rev Neurother 2023; 23:1157-1171. [PMID: 37882458 DOI: 10.1080/14737175.2023.2273396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 10/17/2023] [Indexed: 10/27/2023]
Abstract
INTRODUCTION Despite the growing number of different therapeutic options, treatment of depression is still a challenge. A broader perspective reveals the benefits of bright light therapy (BLT). It stimulates intrinsically photosensitive retinal ganglion cells, which induces a complex cascade of events, including alterations in melatonergic, neurotrophic, GABAergic, glutamatergic, noradrenergic, serotonergic systems, and HPA axis, suggesting that BLT effects expand beyond the circadian pacemaker. AREAS COVERED In this review, the authors present and discuss recent data of BLT in major depressive disorder, non-seasonal depression, bipolar depression or depressive phase of bipolar disorder, and seasonal affective disorder, as well as in treatment-resistant depression (TRD). The authors further highlight BLT effects in various depressive disorders compared to placebo and report data from several studies suggesting a response to BLT in TRD. Also, the authors report data showing that BLT can be used both as a monotherapy or in combination with other pharmacological treatments. EXPERT OPINION BLT is an easy-to-use and low-budget therapy with good tolerability. Future studies should focus on clinical and biological predictors of response to BLT, on defining specific populations which may benefit from BLT and establishing treatment protocols regarding timing, frequency, and duration of BLT.
Collapse
Affiliation(s)
- Biljana Kosanovic Rajacic
- Department for Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Marina Sagud
- Department for Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
- School of Medicine University of Zagreb, Zagreb, Croatia
| | - Nela Pivac
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Ruder Boskovic Institute, Zagreb, Croatia
- University of Applied Sciences Hrvatsko Zagorje Krapina, Croatian Zagorje Polytechnic Krapina, Krapina, Croatia
| | - Drazen Begic
- Department for Psychiatry and Psychological Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
- School of Medicine University of Zagreb, Zagreb, Croatia
| |
Collapse
|
2
|
Xu Q, Esterman A, Dorrian J, Warland J. An examination of the relationship between sunlight exposure and hot flush in working women. Chronobiol Int 2020; 37:425-437. [PMID: 32151163 DOI: 10.1080/07420528.2020.1737101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
We examined whether sunlight affects hot flushes in working menopausal women and explored effect modification by shift work and season. In this prospective cohort study, daily hot flush score (outcome) was measured by the 7-day North Central Cancer Treatment Group Daily Vasomotor Symptoms Diary. Daily duration of sunlight (≥2000 lux) was recorded by the HOBO MX2202 pendant. Both variables were measured in two 7-day data collection phases. T0 data were collected during the Australian Summer (December 2017, January and February 2018); and T1 data were collected in the Australian winter (June, July and August 2018). Linear mixed effects model was used. Shift work and season were both confounders and effect modifiers. To detect a median effect size of R2 = 0.2, 34 women were required to achieve an effective sample size of 41. A total of 49 menopausal women were recruited, 11 shift and 38 day workers. Some 13 women had various missing observations. For shift workers, an hour increase in sunlight exposure was associated with a 1.4-point reduction in hot flush score (p = .016). This relationship was not significant for day workers (p = .185). The finding of this study suggests increased sunlight exposure might improve hot flushes in menopausal shift workers who are moderately bothered by hot flushes, but probably not in day workers. The possible role of shift-work associated circadian disruption on estrogen level in regard to elevated intensity and frequency of hot flush in menopausal women is discussed.
Collapse
Affiliation(s)
- Qunyan Xu
- School of Nursing and Midwifery, University of South Australia (Unisa), Adelaide, Australia
| | - Adrian Esterman
- Depart of Biostatistics, Sansom Institute of Health Service Research and School of Nursing and Midwifery, University of South Australia and Australian Institute for Health and Tropical Medicine, James Cook University, Cairns, Australia
| | - Jill Dorrian
- School of Psychology, Social Work and Social Policy, University of South Australia Magill Campus, Magill, Australia
| | - Jane Warland
- School of Nursing and Midwifery, University of South Australia (Unisa), Adelaide, Australia
| |
Collapse
|
3
|
Abstract
SUMMARYBright light therapy is an accepted and commonly used treatment for seasonal affective and circadian rhythm disorders. In the past 20 years, researchers have examined the effectiveness of bright light therapy in improving depression and agitation in older adults with dementia. This article provides clinicians with a summary of the neurophysiology of bright light therapy, bright light research considerations, an evidence-based bright light protocol, problems related to bright light therapy, and clinical implications for bright light therapy in older adults with dementia. Bright light exposure is a safe, non-pharmacological treatment that is currently underutilised in this population. Clinicians may find bright light therapy beneficial as a primary or adjunctive treatment in reducing depression and agitation in older adults with dementia.
Collapse
|
4
|
Sun Y, Li Y, Li D, Chen C, Bai H, Xue F, Chen J. Responses of broilers to the near-continuous lighting, constant 16-h lighting, and constant 16-h lighting with a 2-h night interruption. Livest Sci 2017. [DOI: 10.1016/j.livsci.2017.10.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
5
|
Aan Het Rot M, Miloserdov K, Buijze ALF, Meesters Y, Gordijn MCM. Premenstrual mood and empathy after a single light therapy session. Psychiatry Res 2017. [PMID: 28646784 DOI: 10.1016/j.psychres.2017.06.052] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
To examine whether acute changes in cognitive empathy might mediate the impact of light therapy on mood, we assessed the effects of a single light-therapy session on mood and cognitive empathy in 48 premenstrual women, including 17 who met Premenstrual Symptoms Screening Tool criteria for moderate-to-severe premenstrual syndrome / premenstrual dysphoric disorder (PMS/PMDD). Using a participant-blind between-groups design, 23 women underwent 30min of morning light therapy (5,000lx; blue-enriched polychromatic light, 17,000K) while 25 women had a sham session (200lx, polychromatic light, 5,000K). We administered the Positive Affect and Negative Affect Schedule and the Affect Grid right before and after the intervention, and 60min later upon completion of a computerized empathic accuracy task. There were no significant effects of light condition on cognitive empathy as assessed using the computer task. Nonetheless, bright light reduced negative affect, specifically in women not using hormonal contraceptives. No effects of bright light on mood were observed in women who were using contraceptives. If a single light-therapy session does not alter cognitive empathy, then cognitive empathy may not mediate the impact of light therapy on mood in premenstrual women.
Collapse
Affiliation(s)
- Marije Aan Het Rot
- Department of Psychology, University of Groningen, The Netherlands; School of Behavioral and Cognitive Neurosciences, University of Groningen, The Netherlands.
| | - Kristina Miloserdov
- School of Behavioral and Cognitive Neurosciences, University of Groningen, The Netherlands
| | - Anna L F Buijze
- School of Medical Sciences, University of Groningen, The Netherlands
| | - Ybe Meesters
- Department of Psychiatry, Groningen University Medical Centre, University of Groningen, The Netherlands
| | - Marijke C M Gordijn
- Chronobiology Unit, Groningen Institute for Evolutionary Life Sciences, University of Groningen, Groningen, The Netherlands; Chrono@Work B.V., Groningen, The Netherlands
| |
Collapse
|
6
|
Cawley E, Tippler M, Coupland NJ, Benkelfat C, Boivin DB, Aan Het Rot M, Leyton M. Dopamine and light: effects on facial emotion recognition. J Psychopharmacol 2017. [PMID: 28633582 DOI: 10.1177/0269881117711707] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Bright light can affect mood states and social behaviours. Here, we tested potential interacting effects of light and dopamine on facial emotion recognition. Participants were 32 women with subsyndromal seasonal affective disorder tested in either a bright (3000 lux) or dim light (10 lux) environment. Each participant completed two test days, one following the ingestion of a phenylalanine/tyrosine-deficient mixture and one with a nutritionally balanced control mixture, both administered double blind in a randomised order. Approximately four hours post-ingestion participants completed a self-report measure of mood followed by a facial emotion recognition task. All testing took place between November and March when seasonal symptoms would be present. Following acute phenylalanine/tyrosine depletion (APTD), compared to the nutritionally balanced control mixture, participants in the dim light condition were more accurate at recognising sad faces, less likely to misclassify them, and faster at responding to them, effects that were independent of changes in mood. Effects of APTD on responses to sad faces in the bright light group were less consistent. There were no APTD effects on responses to other emotions, with one exception: a significant light × mixture interaction was seen for the reaction time to fear, but the pattern of effect was not predicted a priori or seen on other measures. Together, the results suggest that the processing of sad emotional stimuli might be greater when dopamine transmission is low. Bright light exposure, used for the treatment of both seasonal and non-seasonal mood disorders, might produce some of its benefits by preventing this effect.
Collapse
Affiliation(s)
- Elizabeth Cawley
- 1 Department of Psychiatry, McGill University, Montreal, Canada.,2 Association of Atlantic Universities, Halifax Nova Scotia, Canada
| | - Maria Tippler
- 1 Department of Psychiatry, McGill University, Montreal, Canada
| | | | | | - Diane B Boivin
- 1 Department of Psychiatry, McGill University, Montreal, Canada
| | - Marije Aan Het Rot
- 4 Department of Psychology and School of Behavioral and Cognitive Neurosciences, University of Groningen, Groningen, The Netherlands
| | - Marco Leyton
- 1 Department of Psychiatry, McGill University, Montreal, Canada.,5 Center for Studies in Behavioral Neurobiology, Concordia University, Montreal, Canada
| |
Collapse
|
7
|
Linden M, Helmbold K, Kempf J, Sippas S, Filss C, Langen KJ, Eisert A, Zepf FD. Dietary tryptophan depletion in humans using a simplified two amino acid formula - a pilot study. Food Nutr Res 2016; 60:29272. [PMID: 27989269 PMCID: PMC5165058 DOI: 10.3402/fnr.v60.29272] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2015] [Revised: 09/26/2016] [Accepted: 11/03/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Acute tryptophan depletion (ATD) is a well-established dietary method in translational brain research used to briefly lower central nervous serotonin (5-hydroxytryptamine (5-HT)) synthesis. A simplified two amino acid ATD formula (ATDPHE/LEU) was developed while reducing the overall amount of amino acids (AAs), with the objective of administration especially in children and adolescents in future studies. OBJECTIVE This study investigated tryptophan (TRP) influx rates across the blood-brain barrier (BBB) after dietary ATDPHE/LEU administration relative to the ATD Moja-De protocol that has been established for use in children and adolescents. DESIGN Seventy-two healthy adults (50% females) were randomized into four groups and administered ATD Moja-De, its TRP-balanced control condition (BAL), ATDPHE/LEU, or its respective control mixture (BALPHE/LEU) in a counterbalanced, double-blind, between-subjects design. Blood samples were collected at baseline and at hourly intervals for 6 h after AA intake. Questionnaires about mood, taste, and challenge tolerance were completed at fixed time points. RESULTS Both challenge mixtures significantly reduced central nervous TRP influx as calculated by Michaelis-Menten kinetics relative to baseline and the respective control conditions with only mild and comparable side effects. A greater decline in TRP influx over the BBB after ATDPHE/LEU administration when compared with ATD Moja-De was detected without group effects for taste, challenge tolerance, and mood. There was unintended initial short increase in plasma TRP concentrations observed after ATDPHE/LEU intake, and a possible redistribution between free and protein-bound TRP triggered by protein synthesis stimulated by the ingested AAs may account for this finding. Moreover, a decline in TRP influx after BALPHE/LEU administration over a 6-h period was observed, and the large amount of PHE in the BALPHE/LEU mixture may be a possible explanation for this particular phenomenon, which could have led to an unexpected increase in displacement of TRP at the BBB in this control condition. CONCLUSIONS This pilot study provides preliminary evidence for the possibility of lowering TRP influx as calculated by Michaelis-Menten kinetics into the brain by using a simplified ATD protocol in humans. The simplified composition of only two AAs, the lower overall AA amount, and the appropriate tolerance are characteristics of the newly developed ATDPHE/LEU protocol. Future studies focusing on the effects of the ATDPHE/LEU protocol and its respective control condition on CSF 5-HIAA concentrations, as well as neurochemical studies in rodents, are needed to further validate this newly developed AA mixture before definite conclusions about its usability in ATD-related research in humans, its specificity, and additional effects can be made.
Collapse
Affiliation(s)
- Maike Linden
- Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen, Germany.,JARA Translational Brain Medicine, Jülich Aachen Research Alliance, Jülich, Germany
| | - Katrin Helmbold
- Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen, Germany.,JARA Translational Brain Medicine, Jülich Aachen Research Alliance, Jülich, Germany
| | - Janina Kempf
- Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen, Germany.,JARA Translational Brain Medicine, Jülich Aachen Research Alliance, Jülich, Germany.,Faculty of Arts and Social Sciences, Maastricht University, Maastricht, The Netherlands
| | - Shabnam Sippas
- Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen, Germany.,JARA Translational Brain Medicine, Jülich Aachen Research Alliance, Jülich, Germany.,Faculty of Arts and Social Sciences, Maastricht University, Maastricht, The Netherlands
| | - Christian Filss
- Section JARA-Brain, Jülich-Aachen Research Alliance (JARA), Jülich, Germany
| | - Karl-Josef Langen
- Section JARA-Brain, Jülich-Aachen Research Alliance (JARA), Jülich, Germany.,Institute of Neuroscience and Medicine (INM-3, -4, -5), Research Centre Jülich, Jülich, Germany.,Department of Nuclear Medicine, RWTH Aachen University Hospital, Aachen, Germany
| | - Albrecht Eisert
- Department of Pharmacy, RWTH Aachen University, Aachen, Germany
| | - Florian Daniel Zepf
- Clinic for Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, RWTH Aachen University, Aachen, Germany.,JARA Translational Brain Medicine, Jülich Aachen Research Alliance, Jülich, Germany.,Centre and Discipline of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, School of Psychiatry and Clinical Neurosciences & School of Paediatrics and Child Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, Perth, Australia.,Specialised Child and Adolescent Mental Health Services (CAMHS), Department of Health in Western Australia, Perth, Australia;
| |
Collapse
|
8
|
Baiardi S, Cirignotta F, Cicolin A, Garbazza C, D’Agostino A, Gambini O, Giordano A, Canevini M, Zambrelli E, Marconi AM, Mondini S, Borgwardt S, Cajochen C, Rizzo N, Manconi M. Chronobiology, sleep-related risk factors and light therapy in perinatal depression: the "Life-ON" project. BMC Psychiatry 2016; 16:374. [PMID: 27814712 PMCID: PMC5225570 DOI: 10.1186/s12888-016-1086-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 10/21/2016] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Perinatal depression (PND) has an overall estimated prevalence of roughly 12 %. Untreated PND has significant negative consequences not only on the health of the mothers, but also on the physical, emotional and cognitive development of their children. No certain risk factors are known to predict PND and no completely safe drug treatments are available during pregnancy and breastfeeding. Sleep and depression are strongly related to each other because of a solid reciprocal causal relationship. Bright light therapy (BLT) is a well-tested and safe treatment, effective in both depression and circadian/sleep disorders. METHODS In a 3-year longitudinal, observational, multicentre study, about 500 women will be recruited and followed-up from early pregnancy (10-15 gestational week) until 12 months after delivery. The primary aim of the present study is to systematically explore and characterize risk factors for PND by prospective sleep assessment (using wrist actigraphy, polysomnography and various sleep questionnaires) and bloodbased analysis of potential markers during the perinatal period (Life-ON study). Secondary aims are to explore the relationship between specific genetic polymorphisms and PND (substudy Life-ON1), to investigate the effectiveness of BLT in treating PND (substudy Life-ON2) and to test whether a short term trial of BLT during pregnancy can prevent PND (substudy Life-ON3). DISCUSSION The characterization of specific predictive and risk factors for PND may substantially contribute to improve preventive medical and social strategies for the affected women. The study results are expected to promote a better understanding of the relationship between sleep disorders and the development of PND and to confirm, in a large sample of women, the safety and efficacy of BLT both in prevention and treatment of PND. TRIAL REGISTRATION ClinicalTrials.gov NCT02664467 . Registered 13 January 2016.
Collapse
Affiliation(s)
- Simone Baiardi
- Department of Head, Neck and Sensory System, Neurology Unit, Sant’Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Fabio Cirignotta
- Department of Head, Neck and Sensory System, Neurology Unit, Sant’Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Alessandro Cicolin
- Sleep Medicine Center, Neuroscience Department, AOU Città della Salute e della Scienza - Molinette, Università di Torino, Torino, Italy
| | - Corrado Garbazza
- Sleep and Epilepsy Center, Neurocenter of Southern Switzerland, Civic Hospital, Lugano, Switzerland ,Centre for Chronobiology, Psychiatric Hospital of the University of Basel, Basel, Switzerland ,Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland
| | - Armando D’Agostino
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Orsola Gambini
- Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Alessandra Giordano
- Sleep Medicine Center, Neuroscience Department, AOU Città della Salute e della Scienza - Molinette, Università di Torino, Torino, Italy
| | | | | | - Anna Maria Marconi
- Department of Obstetrics and Gynaecology, DMSD San Paolo, University of Milan, Milan, Italy
| | - Susanna Mondini
- Department of Head, Neck and Sensory System, Neurology Unit, Sant’Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Stefan Borgwardt
- Division of Neuropsychiatry and Brain Imaging, Department of Psychiatry (UPK), Psychiatric University Clinics Basel, University of Basel, Basel, Switzerland
| | - Christian Cajochen
- Centre for Chronobiology, Psychiatric Hospital of the University of Basel, Basel, Switzerland ,Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland
| | - Nicola Rizzo
- Department of Obstetrics and Gynecology, Sant’Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Mauro Manconi
- Sleep and Epilepsy Center, Neurocenter of Southern Switzerland, Civic Hospital, Lugano, Switzerland.
| |
Collapse
|
9
|
Al-Karawi D, Jubair L. Bright light therapy for nonseasonal depression: Meta-analysis of clinical trials. J Affect Disord 2016; 198:64-71. [PMID: 27011361 DOI: 10.1016/j.jad.2016.03.016] [Citation(s) in RCA: 104] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Revised: 02/19/2016] [Accepted: 03/07/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND Bright light therapy (BLT) is a well-established treatment for seasonal depression. In the last two decades, the interest in BLT has expanded to involve other nonseasonal types of depression. The role of BLT for nonseasonal depression remains unsettled. In view of the growing number of studies in this area, this review aimed to assess the efficacy of BLT in nonseasonal depression. METHODS We searched Pubmed; Scopus; PsychINFO; Evidence Based Medicine Guidelines and Cochrane Library until December 2015. The Standardized mean difference was calculated to assess the efficacy of BLT in nonseasonal depression. Data were subgrouped according to different study characteristics. Heterogeneity was assessed by examining the I(2) index. RESULTS Nine trials met the inclusion criteria. After employing the more conservative random-effects model, the overall model showed a significant reduction of depressive symptoms after BLT administration (SMD=-0.62, P<0.001, I(2)=37%). In particular, BLT appears to be efficacious when administered for 2-5 weeks (SMD=-0.78, P<0.001, I(2)=0%), and as monotherapy (SMD=-0.71, P<0.001, I(2)=18%). Studies of BLT for perinatal depression have found statistically insignificant improvement (SMD=-0.17, P>0.05, I(2)=44%). LIMITATIONS The overall heterogeneity of the included trials was moderate. The participants were not adequately blinded to the intervention. The sample size was small for certain subgroups. The long-term effect of BLT on depression was not explored. CONCLUSIONS BLT appears to be efficacious, particularly when administered for 2-5 weeks' duration and as monotherapy. There is an obvious need to optimize the duration and intensity of exposure, the timing and the duration of treatment sessions.
Collapse
Affiliation(s)
| | - Luqman Jubair
- Griffith University, Gold Coast Campus, Gold Coast, Queensland, Australia
| |
Collapse
|
10
|
Hogenelst K, Schoevers RA, aan het Rot M. The Effects of Tryptophan on Everyday Interpersonal Encounters and Social Cognitions in Individuals with a Family History of Depression. Int J Neuropsychopharmacol 2015; 18:pyv012. [PMID: 25733537 PMCID: PMC4571634 DOI: 10.1093/ijnp/pyv012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Individuals with a family history of depression show subtle abnormalities in the processing of social stimuli. This could negatively affect their interpersonal functioning and contribute to their depression risk. Repeated administration of the serotonin precursor tryptophan has previously been shown to increase agreeable behavior and reduce quarrelsome behavior in irritable people, who are also considered at risk for depression. METHODS To examine the effects of tryptophan on social functioning in individuals with a family history of depression, 40 men and women with at least one first-degree relative with depression received tryptophan (1g three times a day) and placebo for 14 days each in a double-blind crossover design and recorded their social behavior and mood during everyday interpersonal encounters. Participants also provided daily ratings of their positive and negative cognitions concerning their social functioning. RESULTS Tryptophan improved mood. Unexpectedly, tryptophan increased quarrelsome behavior and reduced agreeable behavior, specifically during interactions at home. The behavioral effects of tryptophan were not moderated by mood or by the interaction partner. Negative social cognitions were lower when tryptophan was given second and lower during placebo when placebo was given second. CONCLUSION Overall, tryptophan may not alter social behavior in individuals with a family history of depression as it does in irritable people. However, the behavioral effects of tryptophan at home might be seen as a way for individuals with a family history of depression to achieve more control. Over time, this may positively influence the way they feel and think about themselves in a social context.
Collapse
Affiliation(s)
- Koen Hogenelst
- Department of Psychology (Mr Hogenelst and Dr aan het Rot), School of Behavioral and Cognitive Neurosciences (Mr Hogenelst and Dr aan het Rot), and University Medical Centre Groningen, Department of Psychiatry (Dr Schoevers), University of Groningen, Groningen, The Netherlands.
| | | | | |
Collapse
|
11
|
Abstract
There is a growing body of evidence suggesting that nonpharmacological interventions have an appropriate place in the treatment of major depressive disorders (MDDs) as both stand-alone and supplemental treatments. Because women may be reluctant to use psychotropic medications due to strong values or treatment preferences during specific reproductive events, clinicians need to be able to offer empirically based alternatives to medication. In this review, we present recent findings from studies of acupuncture, bright light therapy, electroconvulsive therapy, omega fatty acid supplementation, physical activity, and psychosocial intervention for women experiencing depressive symptoms in the contexts of menstruation, pregnancy, postpartum, and menopause.
Collapse
|
12
|
Stewart AE, Roecklein KA, Tanner S, Kimlin MG. Possible contributions of skin pigmentation and vitamin D in a polyfactorial model of seasonal affective disorder. Med Hypotheses 2014; 83:517-25. [PMID: 25270233 DOI: 10.1016/j.mehy.2014.09.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Revised: 08/07/2014] [Accepted: 09/10/2014] [Indexed: 01/01/2023]
Abstract
Seasonal affective disorder (SAD) is a polyfactorial and polygenetic disorder that involves biological and psychological sub-mechanisms that differentially involve depression, seasonality, circadian rhythms, retinal sensitivity, iris pigmentation, sleep factors, and the neurotransmitters involved with these systems. Within the framework of the polyfactorial conceptualization of SAD, we review the possible contributions of vitamin D3 with respect to the aforementioned sub-mechanisms. We hypothesize that rather than functioning primarily as a proximal or direct sub-mechanism in the etiology of SAD, vitamin D likely functions in a more foundational and regulative role in potentiating the sub-mechanisms associated with the depressive and seasonality factors. There are several reasons for this position: 1. vitamin D levels fluctuate in the body seasonally, with a lag, in direct relation to seasonally-available sunlight; 2. lower vitamin D levels have been observed in depressed patients (as well as in patients with other psychiatric disorders) compared to controls; 3. vitamin D levels in the central nervous system affect the production of both serotonin and dopamine; and 4. vitamin D and vitamin D responsive elements are found throughout the midbrain regions and are especially concentrated in the hypothalamus, a region that encompasses the circadian timing systems and much of its neural circuitry. We also consider the variable of skin pigmentation as this may affect levels of vitamin D in the body. We hypothesize that people with darker skin pigmentation may experience greater risks for lower vitamin D levels that, especially following their migration to regions of higher latitude, could contribute to the emergence of SAD and other psychiatric and physical health problems.
Collapse
|
13
|
Defrancesco M, Niederstätter H, Parson W, Kemmler G, Hinterhuber H, Marksteiner J, Deisenhammer EA. Bright ambient light conditions reduce the effect of tryptophan depletion in healthy females. Psychiatry Res 2013; 210:109-14. [PMID: 23473652 DOI: 10.1016/j.psychres.2013.02.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2012] [Revised: 02/04/2013] [Accepted: 02/07/2013] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Tryptophan depletion (TD) is an established method to influence the serotonergic system and mood. The purpose of this study was to examine the effect of TD under different ambient light conditions, measured through serotonin-associated plasma levels and a visual analog scale (VAS), on healthy females. METHODS Thirty-eight healthy female s-allele carriers of the serotonin transporter promoter gene (5-HTTLPR) were administered a TD under dim light conditions (75 lx). A sub-group of 8 participants repeated the procedure randomized in two additional light conditions (585 lx and 1530 lx respectively). Prior to, and 5h following administration of TD, various variables (serotonin-associated plasma levels, VAS) were measured. Due to not normal distributed data, non-parametric statistical tests were used. RESULTS Overall analysis showed a significant mood lowering effect of TD. Moreover, TD decreased all measured serotonin-associated plasma levels significantly. Significant differences in varying light conditions were found for the VAS and plasma tryptophan, with the greatest effect of TD in the 75 lx condition. CONCLUSION Results of our study showed an influence of even slight differences in ambient light intensity on the effect of TD concerning mood as well as on the serotonergic system.
Collapse
Affiliation(s)
- Michaela Defrancesco
- Department of General Psychiatry, Innsbruck Medical University, Anichstr. 35, A-6020 Innsbruck, Austria.
| | | | | | | | | | | | | |
Collapse
|
14
|
Beute F, de Kort YA. Salutogenic Effects of the Environment: Review of Health Protective Effects of Nature and Daylight. Appl Psychol Health Well Being 2013; 6:67-95. [DOI: 10.1111/aphw.12019] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Femke Beute
- Eindhoven University of Technology; The Netherlands
| | | |
Collapse
|
15
|
Cawley EI, Park S, Rot MAH, Sancton K, Benkelfat C, Young SN, Boivin DB, Leyton M. Dopamine and light: dissecting effects on mood and motivational states in women with subsyndromal seasonal affective disorder. J Psychiatry Neurosci 2013; 38:388-97. [PMID: 23735584 PMCID: PMC3819153 DOI: 10.1503/jpn.120181] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Despite evidence that bright light can improve mood, the neurobiology remains poorly understood. Some evidence implicates the catecholamines. In the present study, we measured the effects of transiently decreasing dopamine (DA) synthesis on mood and motivational states in healthy women with mild seasonal mood changes who were tested in either bright or dim light. METHODS On 2 test days, participants slept overnight in a light-controlled room. On the morning of each session, half of the participants awoke to gradual increases of bright light, up to 3000 lux, and half to dim light (10 lux). For all participants, DA was reduced on 1 of the test days using the acute phenylalanine/tyrosine depletion (APTD) method; on the other day, they ingested a nutritionally balanced control mixture (BAL). Beginning 4 hours postingestion, participants completed subjective mood questionnaires, psychological tests and a progressive ratio breakpoint task during which they worked for successive units of $5. RESULTS Thirty-two women participated in our study. The APTD lowered mood, agreeableness, energy and the willingness to work for monetary reward. The effects on energy and motivation were independent of light, while the effects on mood and agreeableness were seen in the dim condition only, being prevented by bright light. LIMITATIONS Acute phenylalanine/tyrosine depletion might affect systems other than DA. The sample size was small. CONCLUSION These results suggest that increased DA function may be responsible for some of the beneficial effects of light, while adding to the evidence that the neurobiology of mood and motivational states can be dissociated.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Marco Leyton
- Correspondence to: M. Leyton, Department of Psychiatry, McGill University, 1033 Pine Ave. W, Montréal QC H3A 1A1;
| |
Collapse
|
16
|
Young SN. Acute tryptophan depletion in humans: a review of theoretical, practical and ethical aspects. J Psychiatry Neurosci 2013; 38:294-305. [PMID: 23428157 PMCID: PMC3756112 DOI: 10.1503/jpn.120209] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The acute tryptophan depletion (ATD) technique has been used extensively to study the effect of low serotonin in the human brain. This review assesses the validity of a number of published criticisms of the technique and a number of previously unpublished potential criticisms. The conclusion is that ATD can provide useful information when results are assessed in conjunction with results obtained using other techniques. The best-established conclusion is that low serotonin function after tryptophan depletion lowers mood in some people. However, this does not mean that other variables, altered after tryptophan depletion, are necessarily related to low serotonin. Each aspect of brain function has to be assessed separately. Furthermore, a negative tryptophan depletion study does not mean that low serotonin cannot influence the variable studied. This review suggests gaps in knowledge that need to be filled and guidelines for carrying out ATD studies.
Collapse
Affiliation(s)
- Simon N. Young
- Correspondence to: S.N. Young, Department of Psychiatry, McGill University, 1033 Pine Ave. W, Montréal QC H3A 1A1;
| |
Collapse
|
17
|
Abstract
Chronotherapeutics refers to treatments based on the principles of circadian rhythm organization and sleep physiology, which control the exposure to environmental stimuli that act on biological rhythms, in order to achieve therapeutic effects in the treatment of psychiatric conditions. It includes manipulations of the sleep-wake cycle such as sleep deprivation and sleep phase advance, and controlled exposure to light and dark. The antidepressant effects of chronotherapeutics are evident in difficult-to-treat conditions such as bipolar depression, which has been associated with extremely low success rates of antidepressant drugs in naturalistic settings and with stable antidepressant response to chronotherapeutics in more than half of the patients. Recent advances in the study of the effects of chronotherapeutics on neurotransmitter systems, and on the biological clock machinery, allow us to pinpoint its mechanism of action and to transform it from a neglected or “orphan” treatment to a powerful clinical instrument in everyday psychiatric practice.
Collapse
Affiliation(s)
- Francesco Benedetti
- Department of Clinical Neurosciences, Scientific Institute and University Vita-Salute San Raffaele, Milan, Italy.
| |
Collapse
|
18
|
Crowley SK, Youngstedt SD. Efficacy of light therapy for perinatal depression: a review. J Physiol Anthropol 2012; 31:15. [PMID: 22738716 PMCID: PMC3518242 DOI: 10.1186/1880-6805-31-15] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Accepted: 03/20/2012] [Indexed: 11/13/2022] Open
Abstract
Perinatal depression is an important public health problem affecting 10% to 20% of childbearing women. Perinatal depression is associated with significant morbidity, and has enormous consequences for the wellbeing of the mother and child. During the perinatal period, treatment of depression, which could affect the mother and child during pregnancy and lactation, poses a complex problem for both mother and clinician. Bright light therapy may be an attractive treatment for perinatal depression because it is low cost, home-based, and has a much lower side effect profile than pharmacotherapy. The antidepressant effects of bright light are well established, and there are several rationales for expecting that bright light might also be efficacious for perinatal depression. This review describes these rationales, summarizes the available evidence on the efficacy of bright light therapy for perinatal depression, and discusses future directions for investigation of bright light therapy as a treatment for perinatal depression.
Collapse
Affiliation(s)
- Shannon K Crowley
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
| | | |
Collapse
|
19
|
Stephenson KM, Schroder CM, Bertschy G, Bourgin P. Complex interaction of circadian and non-circadian effects of light on mood: shedding new light on an old story. Sleep Med Rev 2012; 16:445-54. [PMID: 22244990 DOI: 10.1016/j.smrv.2011.09.002] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2010] [Revised: 09/22/2011] [Accepted: 09/22/2011] [Indexed: 01/01/2023]
Abstract
In addition to its role in vision, light exerts strong effects on behavior. Its powerful role in the modulation of mood is well established, yet remains poorly understood. Much research has focused on the effects of light on circadian rhythms and subsequent interaction with alertness and depression. The recent discovery of a third photoreceptor, melanopsin, expressed in a subset of retinal ganglion cells, allows major improvement of our understanding of how photic information is processed. Light affects behavior in two ways, either indirectly through the circadian timing system, or directly through mechanisms that are independent of the circadian system. These latter effects have barely been studied in regard to mood, but recent investigations on the direct effects of light on sleep and alertness suggest additional pathways through which light could influence mood. Based on our recent findings, we suggest that light, via melanopsin, may exert its antidepressant effect through a modulation of the homeostatic process of sleep. Further research is needed to understand how these mechanisms interplay and how they contribute to the photic regulation of mood. Such research could improve therapeutic management of affective disorders and influence the management of societal lighting conditions.
Collapse
Affiliation(s)
- Kathryn M Stephenson
- Department of Biological Rhythms, Institut des Neurosciences Cellulaires et Intégratives, CNRS-UPR 3212, Strasbourg, France.
| | | | | | | |
Collapse
|
20
|
aan het Rot M, Coupland N, Boivin DB, Benkelfat C, Young SN. Recognizing emotions in faces: effects of acute tryptophan depletion and bright light. J Psychopharmacol 2010; 24:1447-54. [PMID: 19939873 DOI: 10.1177/0269881109348169] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In healthy never-depressed individuals, acute tryptophan depletion (ATD) may selectively decrease the accurate recognition of fearful facial expressions. Here we investigated the perception of facial emotions after ATD in more detail. We also investigated whether bright light, which can reverse ATD's mood-lowering effect, can also reverse its effect on the perception of facial emotions. On two separate test days, spent in a room that was either bright (n = 14) or dim (n = 16), healthy never-depressed women completed a facial emotion perception task six hours after ingesting tryptophan-deficient and balanced amino acid mixtures. Treatments were administered double blind and in randomized order using a crossover design. In dim light ATD decreased recognition accuracy of anger, disgust, and surprise. The labeling of fear and sadness was not affected. In bright light no effects of ATD were seen. Bright light was identified as a potential confounding factor in task performance. The effects of ATD on facial emotion perception may be less emotion-specific than thought previously, and occurred in a direction opposite to what might be expected based on theories of mood-congruent bias.
Collapse
|
21
|
Jaworska N, Thompson A, Shah D, Fisher D, Ilivitsky V, Knott V. Electrocortical effects of acute tryptophan depletion on emotive facial processing in depression-prone individuals. Eur Neuropsychopharmacol 2010; 20:473-86. [PMID: 20395115 DOI: 10.1016/j.euroneuro.2010.03.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2009] [Revised: 01/05/2010] [Accepted: 03/11/2010] [Indexed: 10/19/2022]
Abstract
This study assessed the effects of acute tryptophan depletion (ATD), which transiently lowers CNS 5-HT, on electrocortical responses to facial expression processing in individuals with a family history of depression (FH+). Electroencephalograph (EEG)-derived event-related potentials (ERPs) were acquired from 18 FH+ individuals during a facial expression recognition task (neutral and sad, joy and surprise at 50% and 100% intensities). Both early positive (P1 and P2) and the face-specific N170 ERP components were differentially altered by emotional intensity and valence. Increased depression, confusion and total mood disturbance scores, and decreased calmness, were observed with ATD (versus placebo). ATD was also associated with enhanced P1 and P2 amplitudes for sad versus joyful expressions. The N170 was not modulated by treatment, but was affected by emotive valence. Therefore, ATD enhanced ERP-indexed early processing of sad facial expressions, and altered the processing of positive ones, in FH+ individuals.
Collapse
Affiliation(s)
- Natalia Jaworska
- University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada; Department of Psychology, University of Ottawa, Ottawa, ON, Canada.
| | | | | | | | | | | |
Collapse
|
22
|
Gagne AM, Bouchard G, Tremblay P, Sasseville A, Hebert M. Quand la saison devient synonyme de dépression. Med Sci (Paris) 2010; 26:79-82. [DOI: 10.1051/medsci/201026179] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
23
|
Mischoulon D, Pedrelli P, Wurtman J, Vangel M, Wurtman R. Report of two double-blind randomized placebo-controlled pilot studies of a carbohydrate-rich nutrient mixture for treatment of seasonal affective disorder (SAD). CNS Neurosci Ther 2009; 16:13-24. [PMID: 19769596 DOI: 10.1111/j.1755-5949.2009.00082.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
We investigated a carbohydrate-rich nutrient-drink mix for treatment of seasonal affective disorder (SAD). This mixture may contribute to brain serotonin synthesis, potentially exerting an antidepressant effect and controlling carbohydrate cravings. Two successive double-blind placebo-controlled studies were performed. In Study 1, 18 subjects (50% women; mean age 43 +/- 15 years) with SCID-diagnosed SAD were randomized to 12 days of twice daily carbohydrate beverage (CHO) containing mixed starches, or a placebo beverage (PRO) containing the CHO mix plus casein protein to dampen serotonin synthesis. Following a 2-day washout, subjects were crossed over to the other treatment for 12 days. In Study 2, 32 subjects (63% women; mean age 46 +/- 14 years) with SCID-diagnosed SAD were randomized to 21 days of CHO or PRO. Efficacy in both studies was determined by the first 17 items of the Hamilton Depression Rating Scale (HAM-D-28), an appetite questionnaire, and regular weighing. In Study 1, response rates were 50% for both groups. Remission rates favored CHO (50% vs. 38%), as did the decrease in the HAM-D-17 score, but differences were nonsignificant. In Study 2, response rates were 71% for CHO and 76% for PRO, and remission rates were 71% for each group. Both treatment groups experienced significant improvement in HAM-D-17 scores within 1 week of treatment, which continued through the entire study period. Weight change did not differ significantly between treatment groups in either study. The drink mix was well tolerated and treatment adherence was high. Both the active and placebo intervention were effective in alleviating symptoms of SAD. Replication studies in larger samples appear warranted.
Collapse
Affiliation(s)
- David Mischoulon
- Clinical Research Center, Massachusetts Institute of Technology, Cambridge, MA, USA.
| | | | | | | | | |
Collapse
|
24
|
Richard DM, Dawes MA, Mathias CW, Acheson A, Hill-Kapturczak N, Dougherty DM. L-Tryptophan: Basic Metabolic Functions, Behavioral Research and Therapeutic Indications. Int J Tryptophan Res 2009; 2:45-60. [PMID: 20651948 PMCID: PMC2908021 DOI: 10.4137/ijtr.s2129] [Citation(s) in RCA: 352] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
An essential component of the human diet, L-tryptophan is critical in a number of metabolic functions and has been widely used in numerous research and clinical trials. This review provides a brief overview of the role of L-tryptophan in protein synthesis and a number of other metabolic functions. With emphasis on L-tryptophan's role in synthesis of brain serotonin, details are provided on the research uses of L-tryptophan, particularly L-tryptophan depletion, and on clinical trials that have been conducted using L-tryptophan supplementation. The ability to change the rates of serotonin synthesis in the brain by manipulating concentrations of serum tryptophan is the foundation of much research. As the sole precursor of serotonin, experimental research has shown that L-tryptophan's role in brain serotonin synthesis is an important factor involved in mood, behavior, and cognition. Furthermore, clinical trials have provided some initial evidence of L-tryptophan's efficacy for treatment of psychiatric disorders, particularly when used in combination with other therapeutic agents.
Collapse
Affiliation(s)
- Dawn M Richard
- Neurobehavioral Research Laboratory and Clinic, Department of Psychiatry
| | - Michael A Dawes
- Neurobehavioral Research Laboratory and Clinic, Department of Psychiatry
| | - Charles W Mathias
- Neurobehavioral Research Laboratory and Clinic, Department of Psychiatry
| | - Ashley Acheson
- Research Imaging Center, University of Texas Health Science Center at San Antonio, U.S.A
| | | | - Donald M Dougherty
- Neurobehavioral Research Laboratory and Clinic, Department of Psychiatry
| |
Collapse
|
25
|
Virk G, Reeves G, Rosenthal NE, Sher L, Postolache TT. Short exposure to light treatment improves depression scores in patients with seasonal affective disorder: A brief report. ACTA ACUST UNITED AC 2009. [DOI: 10.1515/ijdhd.2009.8.3.283] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
26
|
Young SN. Rapid tryptophan depletion as a treatment for acute mania: safety and mechanism of the therapeutic effect. Bipolar Disord 2008; 10:850-1. [PMID: 19032719 DOI: 10.1111/j.1399-5618.2008.00597.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|