Background: Post-stroke depression affects the outcome of stroke rehabilitation and is observed in approximately 30% of all stroke patients. We investigated whether the addition of light treatment to medical antidepressants influences the course of depression as measured by the Hamilton Depression Scale. Methods: The effect of a combination of light therapy and citalopram in stroke victims receiving citalopram was examined by use of two different doses of light therapy under double-blind conditions. Altogether, 63 patients were included in the study. The mean age was 74.9 years. Results: After 4 weeks of therapy, the 6-item subscale of the Hamilton Depression Scale showed a statistically significantly larger improvement in patients receiving high-intensity light treatment compared to those treated with medium-intensity light (p < 0.05). Conclusion: This pilot study demonstrates a dose response effect of light used as an adjunct therapy to antidepressants in post-stroke patients with major depression.

1.
Robertson MM, Katona CCE (eds): Depression and Physical Illness. Chichester, Wiley, 1997.
2.
Gill D, Hatcher S: A systematic review of the treatment of depression with antidepressant drugs in patients who also have physical illness. Evid Based Med 1999;4:105–106.
3.
Andersen G, Vestergaard K, Lauritzen L: Effective treatment of post-stroke depression with the selective serotonin reuptake inhibitor citalopram. Stroke 1994;25:1099–1104.
4.
Rasmussen A, Lunde M, Poulsen DL, Sorensen K, Qvitzau S, Bech P: A double-blind, placebo-controlled study of sertraline in the prevention of depression in stroke patients. Psychosomatics 2003;44:216–221.
5.
Bradley N, Gaynes R, Ekstrom D, Hamer RM, Jacobsen FM, Nemeroff CB, Suppes P, Golden RN: Phototherapy: a systematic review of the evidence (poster). APA, San Francisco, 2003.
6.
Tuunainen A, Kripke DF, Endo T: Light therapy for nonseasonal depression (Cochrane Review); in The Cochrane Library. Chichester, Wiley, issue 2, 2004.
7.
Kripke DF: Light treatment for nonseasonal depression: speed, efficacy and combined treatment. J Affect Disord 1998;49:109–117.
8.
Benedetti F, Colombo C, Pontiggia A, Bernasconi A, Florita M, Smeraldi E: Morning light treatment hastens the antidepressant effect of citalopram: a placebo-controlled trial. J Clin Psychiatry 2003;64:648–653.
9.
Martiny K: Adjunctive bright light in non-seasonal major depression. Acta Psychiatr Scand 2004;425:7–28.
10.
Bech P, Allerup P, Gram LF, Reisby N, Rosenberg R, Jacobsen O, Nagy A: The Hamilton Depression Scale. Evaluation of objectivity using logistic models. Acta Psychiatr Scand 1981;63:290–299.
11.
Bech P: Modern psychometrics in clinimetrics: impact on clinical trials of antidepressants. Psychother Psychosom 2004;73:134–138.
12.
American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Washington, American Psychiatric Association, 1994.
13.
Bech P, Kastrup M, Rafaelsen OJ: Mini-compendium of rating scales for states of anxiety, depression, mania, schizophrenia with corresponding DSM-III syndromes. Acta Psychiatr Scand Suppl 1986;326:1–37.
14.
O’Sullivan RL, Fava M, Agustin C, Baer L, Rosenbaum JF: Sensitivity of the six-item Hamilton Depression Rating Scale. Acta Psychiatr Scand 1997;95:379–384.
15.
Licht RW, Qvitzau S, Allerup P, Bech P: Validation of the Bech-Rafaelsen Melancholia Scale and the Hamilton Depression Scale in patients with major depression; is the total score a valid measure of illness severity? Acta Psychiatr Scand 2005;111:144–149.
16.
Bech P: The Bech-Rafaelsen Melancholia Scale (MES) in clinical trials of therapies in depressive disorders: a 20-year review of its use as outcome measure. Acta Psychiatr Scand 2002;106:252–264.
17.
Wade DT, Collin C: The Barthel ADL Index: a standard measure of physical disability? Int Disabil Stud 1988;10:64–67.
18.
Bech P, Tanghøj P, Andersen HF, Overø K: Citalopram dose-response revisited using an alternative psychometric approach to evaluate clinical effects of four fixed citalopram doses compared to placebo in patients with major depression. Psychopharmacology 2002;163:20–25.
19.
Partonen T: Light therapy; in Partonen T, Magnusson A (eds): Seasonal Affective Disorder, Practice and Research. Oxford, Oxford University Press, 2001, pp 65–79.
20.
Siegel S: Non-Parametric Statistics. New York, McGraw-Hill, 1956.
21.
Fayers PM, Machin D: Quality of Life. Assessment, Analysis and Interpretation. London, Wiley, 2000.
22.
Stage KB, Middelboe T, Pisinger C: Measurement of depression in patients with chronic obstructive pulmonary disease (COPD). Nord J Psychiatry 2003;57:297–301.
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