Light therapy for bipolar disorders: Clinical recommendations from the international society for bipolar disorders (ISBD) Chronobiology and Chronotherapy Task Force.

The International Society for Bipolar Disorders (ISBD) Chronobiology and Chronotherapy Task Force conducted a comprehensive review to deliver concise evidence-based recommendations on the use of bright light therapy (BLT) for bipolar disorder (BD). Adjunctive BLT is likely an efficacious acute treatment for bipolar depression as implicated by higher quality evidence. The position of maintenance BLT for relapse prevention awaits further investigation. Protocols of effective BLT in BD are similar to parameters indicated for treatment of seasonal and non-seasonal major depressive disorder. Anti-manic prophylaxis (especially for BD-I) and clinical monitoring are recommended with initiation of and ongoing light treatment. Administer BLT daily, preferably in the morning or at mid-day. If mornings are prohibitive, then mid-day exposure, implemented to avoid excessively early wake times, is an acceptable alternative. Informed by the literature, target 30 min/day of BLT exposure. Patients wary of emergent hypomania or partial responders, can initiate 15 min/day and increase by 15 min each week to full response (or 30-60 min/day by the fourth week). Consider patient centred outcome assessments to evaluate mood response, safety and side effects. Clinical improvement is typically observed within 1-2 weeks, with response/remission expected by 4-6 weeks. Integration of BLT with other chronotherapeutic strategies may enhance long-term efficacy.
Mental Health
Care/Management

Authors

Geoffroy Geoffroy, Palagini Palagini, Henriksen Henriksen, Bourgin Bourgin, Garbazza Garbazza, Gronfier Gronfier, Esaki Esaki, Fernandez Fernandez, Lam Lam, Lee Lee, Lejoyeux Lejoyeux, Maruani Maruani, Martiny Martiny, Murray Murray, Riemersma-Van Der Lek Riemersma-Van Der Lek, Ritter Ritter, Schulte Schulte, Smith Smith, Terman Terman, Zeitzer Zeitzer, Sit Sit
View on Pubmed
Share
Facebook
X (Twitter)
Bluesky
Linkedin
Copy to clipboard