Bright light therapy and melatonin in motor restless behaviour in dementia: a placebo-controlled study.
OBJECTIVE
The purpose of this study was to evaluate the effects of bright light therapy combined with melatonin on motor restless behaviour in dementia.


METHODS
Double-blind, placebo-controlled, cross-over trial consisting of four periods. One week wash-out was followed by a 2-week period of light therapy in combination with placebo or melatonin. The second wash-out period of 1 week was followed by 2 weeks of treatment (cross-over).


METHODS
Twenty-four bed medium-stay psychogeriatric ward at a Dutch psychiatric teaching hospital.


METHODS
Ten patients, who met the criteria for dementia (DSM-IV) and motor restless behaviour (subscale 10 of the GIP), were included. Informed consent was obtained by proxy.


METHODS
All subjects were exposed during 2x5 consecutive days for 30 minutes to 10,000 lux bright light and randomly administered 2.5 mg melatonin or placebo at 22.00 h.


METHODS
Clinical Global Impression (CGI), Dutch version of the geriatric behavioural observation scale (GIP), Social Dysfunction and Aggression Scale (SDAS) were assessed after each wash-out and treatment period. Outcome criteria were CGI, assessing motor restless behaviour, the SDAS, measuring extrovert aggression and the GIP, assessing social, psychomotor and emotional behaviour.


RESULTS
Six demented inpatients completed the trial. Positive effects were found for the treatment combined with placebo. Patients were less restless and more co-operative. The condition with melatonin showed no additional positive effects, additionally, patients became more aggressive and showed the same or more disturbed behaviour.


CONCLUSIONS
Bright light therapy has a positive effect on motor restless behaviour. Light therapy in combination with melatonin has no positive effects. The results might be explained by a possible overshoot of chronobiological synchronisation or the timing of the melatonin intake.
Haffmans
P M
PM
Parnassia Research Centre, Monsterseweg 83, 2553 RJ The Hague, The Netherlands. j.haffmans@parnassia.nl
Sival
R C
RC
Lucius
S A
SA
Cats
Q
Q
van Gelder
L
L
D000368:Aged; D000374:Aggression; D000927:Anticonvulsants / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D018592:Cross-Over Studies; D003704:Dementia / Q000150:complications* / Q000523:psychology; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008550:Melatonin / Q000627:therapeutic use*; D010789:Phototherapy; D010919:Placebos; D011595:Psychomotor Agitation / Q000628:therapy*
D000927:Anticonvulsants; D010919:Placebos; D008550:Melatonin