title: Blue-blocking glasses as additive treatment for mania: a randomized placebo-controlled trial.
abstract: The discovery of the blue lightsensitive retinal photoreceptor responsible for signaling daytime to the brain suggested that light to the circadian system could be inhibited by using blue-blocking orange tinted glasses. Blue-blocking (BB) glasses are a potential treatment option for bipolar mania. We examined the effectiveness of BB glasses in hospitalized patients with bipolar disorder in a manic state.
  
  
  
  In a single-blinded, randomized, placebo-controlled trial (RCT), eligible patients (with bipolar mania; age 18-70 years) were recruited from five clinics in Norway. Patients were assigned to BB glasses or placebo (clear glasses) from 6 p.m. to 8 a.m. for 7 days, in addition to treatment as usual. Symptoms were assessed daily by use of the Young Mania Rating Scale (YMRS). Motor activity was assessed by actigraphy, and compared to data from a healthy control group. Wearing glasses for one evening/night qualified for inclusion in the intention-to-treat analysis.
  
  
  
  From February 2012 to February 2015, 32 patients were enrolled. Eight patients dropped out and one was excluded, resulting in 12 patients in the BB group and 11 patients in the placebo group. The mean decline in YMRS score was 14.1 [95% confidence interval (CI): 9.7-18.5] in the BB group, and 1.7 (95% CI: -4.0 to 7.4) in the placebo group, yielding an effect size of 1.86 (Cohen's d). In the BB group, one patient reported headache and two patients experienced easily reversible depressive symptoms.
  
  
  
  This RCT shows that BB glasses are effective and feasible as add-on treatment for bipolar mania.
authors.affiliation: Section for Psychiatry, Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.|Division of Mental Health Care, Valen Hospital, Fonna Local Health Authority, Valen, Norway.|Moodnet Research Group, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.
authors.forename: Tone Eg
authors.initials: TE
authors.lastname: Henriksen
authors.affiliation: Dr. Einar Martens Research Group for Biological Psychiatry, Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway.|The Norwegian Centre for Mental Disorder Research (Norment), The KG Jebsen Centre for Psychosis Research, Department of Clinical Science, University of Bergen, Bergen, Norway.
authors.forename: Silje
authors.initials: S
authors.lastname: Skrede
authors.affiliation: Section for Psychiatry, Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.|Moodnet Research Group, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.|The KG Jebsen Centre for Research on Neuropsychiatric Disorders, Department of Clinical Science, University of Bergen, Bergen, Norway.
authors.forename: Ole B
authors.initials: OB
authors.lastname: Fasmer
authors.affiliation: Section for Psychiatry, Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.|Moodnet Research Group, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.|Division of Psychiatry, Stavanger University Hospital, Stavanger, Norway.
authors.forename: Helle
authors.initials: H
authors.lastname: Schoeyen
authors.affiliation: Division of Mental Health Care, Haugesund Hospital, Fonna Local Health Authority, Valen, Norway.
authors.forename: Ieva
authors.initials: I
authors.lastname: Leskauskaite
authors.affiliation: Division of Psychiatry, Stavanger University Hospital, Stavanger, Norway.
authors.forename: Jeanette
authors.initials: J
authors.lastname: Bjørke-Bertheussen
authors.affiliation: Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway.
authors.forename: Jörg
authors.initials: J
authors.lastname: Assmus
authors.affiliation: Department of Physics and Technology, University of Bergen, Bergen, Norway.
authors.forename: Børge
authors.initials: B
authors.lastname: Hamre
authors.affiliation: Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway.|Sleep and Performance Research Center, Washington State University, Spokane, Washington, USA.
authors.forename: Janne
authors.initials: J
authors.lastname: Grønli
authors.affiliation: Section for Psychiatry, Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.|Moodnet Research Group, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.
authors.forename: Anders
authors.initials: A
authors.lastname: Lund
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018692:Antimanic Agents / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology / Q000628:therapy*; D001921:Brain / Q000503:physiopathology; D002940:Circadian Rhythm / Q000502:physiology; D003118:Color Perception / Q000502:physiology*; D003131:Combined Modality Therapy; D005139:Eyeglasses; D005240:Feasibility Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D020419:Photoreceptor Cells, Vertebrate / Q000502:physiology*; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011594:Psychometrics; D015398:Signal Transduction / Q000502:physiology*; D016037:Single-Blind Method; D055815:Young Adult
chemical_list: D018692:Antimanic Agents
keywords: RCT; actigraph; activation; bipolar disorder; blue-blockers; chronotherapy; dark therapy; mania; virtual darkness