Alternative techniques: dawn simulation Bright (1700 lux) dawn simulation (4.00-6.00 AM) was not effective in reducing depression scores in seven patients with winter depression compared with a standard bright (1700 lux) morning (6.00-8.00 AM) light buy OTX015 treatment and contributed to early morning

awakening (EMA).32 In comparing a gradual dawn signal with a hypothesized placebo condition, a rapid dawn signal, Avery et al33 found that improvement was similar for both treatments, but that EMA was more common with the gradual dawn condition. In a follow-up study34 of 22 patients with winter depression, 1 week of treatment with 2-h dawn simulation peaking at 250 lux resulted Inhibitors,research,lifescience,medical in significantly lower depression scores than 1 week of treatment with a 30-min dawn simulation peaking at 0.2 lux. Norden and Avery35 also demonstrated that a slow dawn (a gradually increasing illuminance over 45 min peaking at 100 lux) was Inhibitors,research,lifescience,medical better than a rapid dawn (light rapidly increasing over a 4-s period to 100 lux) in 16 patients with subsyndromal winter depression. In a second controlled study of dawn simulation of winter depression, Avery et al36 showed that 1.5 h of 250 lux dawn

simulation with while light resulted in lower depression scores than 1.5 h of a 2 lux, red dawn signal. Linjaerde et al37 found that symptoms Inhibitors,research,lifescience,medical of winter depression improved 57% with lightbox Inhibitors,research,lifescience,medical treatment of 1500 to 2500 lux for 2 h in the morning for 6 days compared with 40% for dawn simulation of 60 to 90 min with 100 to 300 lux for 2 weeks. A controlled study of 95 subjects with SAD38 found that dawn simulation (1.5-h dawn signal from 4.30-6.00 AM peaking at 250 lux), but not bright light treatment (10 000 lux for 30 min from 6.00-6.30 AM), was associated with greater remission rates than placebo (dim red light, 1.5-h dawn signal Inhibitors,research,lifescience,medical from 4.30-6.00 AM peaking at 0.5 lux). Light visor Stewart et al39 reported that a portable, head-mounted unit (HMU) was as efficacious as a standard lightbox for the treatment of winter depression. Carnitine palmitoyltransferase II In a study of 105 subjects across five centers,40

three intensities of a light visor (60, 600, and 3500 lux) for 2 weeks had equal antidepressant efficacy in SAD.Teicher et al41 found no significant differences in therapeutic response between patients with SAD who were treated with a dim (30 lux) red light or a bright (600 lux) white light visor. In a controlled comparison of a lightbox and a HMU in SAD,42 there was no significant difference in response rates between patients with SAD who received 2 weeks of light versus patients who received no visible light by an HMU, or between patients who received the lightbox versus the HMU. Summary The majority of studies support the beneficial effects of particularly morning light in SAD for 2 h with at least 2500 lux.