title: Bright-light therapy in the treatment of mood disorders.
abstract: Bright-light therapy (BLT) is established as the treatment of choice for seasonal affective disorder/winter type (SAD). In the last two decades, the use of BLT has expanded beyond SAD: there is evidence for efficacy in chronic depression, antepartum depression, premenstrual depression, bipolar depression and disturbances of the sleep-wake cycle. Data on the usefulness of BLT in non-seasonal depression are promising; however, further systematic studies are still warranted. In this review, the authors present a comprehensive overview of the literature on BLT in mood disorders. The first part elucidates the neurobiology of circadian and seasonal adaptive mechanisms focusing on the suprachiasmatic nucleus (SCN), the indolamines melatonin and serotonin, and the chronobiology of mood disorders. The SCN is the primary oscillator in humans. Indolamines are known to transduce light signals into cells and organisms since early in evolution, and their role in signalling change of season is still preserved in humans: melatonin is synthesized primarily in the pineal gland and is the central hormone for internal clock circuitries. The melatonin precursor serotonin is known to modulate many behaviours that vary with season. The second part discusses the pathophysiology and clinical specifiers of SAD, which can be seen as a model disorder for chronobiological disturbances and the mechanism of action of BLT. In the third part, the mode of action, application, efficacy, tolerability and safety of BLT in SAD and other mood disorders are explored.
authors.affiliation: Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.
authors.forename: Gerald
authors.initials: G
authors.lastname: Pail
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Huf
authors.forename: Edda
authors.initials: E
authors.lastname: Pjrek
authors.forename: Dietmar
authors.initials: D
authors.lastname: Winkler
authors.forename: Matthaeus
authors.initials: M
authors.lastname: Willeit
authors.forename: Nicole
authors.initials: N
authors.lastname: Praschak-Rieder
authors.forename: Siegfried
authors.initials: S
authors.lastname: Kasper
mesh_terms: D021081:Chronobiology Disorders / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D002940:Circadian Rhythm / Q000502:physiology; D006801:Humans; D008550:Melatonin / Q000502:physiology; D019964:Mood Disorders / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D010789:Phototherapy / Q000009:adverse effects / Q000379:methods* / Q000523:psychology*; D016574:Seasonal Affective Disorder / Q000503:physiopathology / Q000628:therapy*; D012701:Serotonin / Q000502:physiology; D013493:Suprachiasmatic Nucleus / Q000502:physiology / Q000503:physiopathology
chemical_list: D012701:Serotonin; D008550:Melatonin