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Circadian rhythms: Their role and dysfunction in affective disorder
Date:8/30/2010

a more normal pattern. Light is also an effective antidepressant, acting on many of the same neurotransmitter systems and brain structures as antidepressant drugs. What is fascinating about light therapy is that it is the first treatment in psychiatry that developed directly out of basic neurobiology research related to seasonal hibernation and reproduction in rodents. Light therapy is effective for all groups of major depression not only for the seasonal subtype (SAD), for which it is well recognized as the treatment of choice. As an adjuvant to antidepressants in unipolar depressive patients, or lithium in bipolar patients, morning light hastens and potentiates the antidepressant response. Light therapy shows benefit even for patients with chronic depression of 2 years or more, and provides a viable alternative for patients who refuse, resist or cannot tolerate medication, or for whom drugs may be contraindicated, as in antepartum depression (Wirz-Justice et al., 2005). In addition, light therapy has been successfully used in other psychiatric or neurological illnesses, including bulimia nervosa and Alzheimers disease.

Dark therapy has yielded positive results to control symptoms in acute mania and to calm `rapid-cycling bipolar patients in the manic phase a group with one of the highest suicide rates among the mentally ill. By keeping patients in the dark and extending rest-sleep for periods of 10 to 14 hours, the mania episode could be ended.

Dark therapy is theoretically interesting for its rapid effects, but is not very practical. One alternative at present being investigated is the use of blue-blocking sunglasses. Blue is the wavelength to which the circadian system is particularly sensitive, thus by blocking this range in the light spectrum we can induce "circadian darkness" while not impairing the patient's vision.

Melatonin is a hormone secreted by the pineal gland only at night, and is suppressed by light. Cued by darkness,
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Contact: Sonja Mak
s.mak@update.europe.at
431-405-5734
European College of Neuropsychopharmacology
Source:Eurekalert

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