The Beginning of Light Therapy Daniel F Kripke

The Beginning of Light Therapy Daniel F. Kripke, M. D. University of California, San Diego DKripke 1@san. rr. com www. Brighten. Your. Life. info From presentation at the Society for Light Treatment and Biological Rhythms, San Diego, CA, USA, June 27, 2015

Genesis, Chapter 1 3 And God said, Let there be light: and there was light. 4 And God saw the light, that it was good: and God divided the light from the darkness.

Old & Ancient History • Seasonality: Hippocrates, Aristotle, etc. • Hippocratic & Aesclapian temples • Pinel & Esquirol Wehr & Rosenthal. Am J Psychiatry 1989; 146: 829 -839 • Spas and “a little fresh air” • Kellogg: arc lights and buttermilk • Finsen J. H. Kellogg. Light Therapeutics, Battle Creek, MI, 1910 Free Google book

J. H. Kellogg. Light Therapeutics, Battle Creek, MI, 1910. Free Google book

ARC LIGHTS and BUTTERMILK From Kellogg, 1910

Niels Finsen Nobel Prize, 1903 Sunlight for cutaneous tuberculosis.

PHOTOPERIOD EFFECTS Hoffman RA, Reiter RJ. Responses of some endocrine organs of female hamsters to pinealectomy and light. Life Sci 1966; 5: 1147 -51.

Elliott JA, Stetson MH, Menaker M. Science 1972; 178: 771 -3. Regulation of testis function in golden hamsters: a circadian clock measures photoperiodic time.

Affective disturbances could be evolutionary remnants of the photoperiodic seasonal responses in animals. . internal desynchronization. . . uncoupling. . . free -running component. . . internal phase-angle relationships. . . genetic and age-related features

500 lux Dark asleep 1500 lux 2500 lux Lewy AJ, Wehr TA, Goodwin FK, Newsome DA, Markey SP. Light suppresses melatonin secretion in humans. Science 1980 12; 210: 1267 -9.

CASE REPORT of WINTER DEPRESSION

Added subjects Psychopharm Bull 1983; 19: 526 -530.

Arch Gen Psychiat 1984; 41: 72 -80.

www. SLTBR. org

Kripke, JAD, 1998; 49: 109 -117

Am J Psychiatry 2006; 163: 805 -812. © American Psychiatric Association. All rights reserved.

From: Lam, et al. Efficacy of Bright Light Treatment, Fluoxetine, and the Combination in Patients With Nonseasonal Major Depressive Disorder: A Randomized Clinical Trial JAMA Psychiatry. 2016; 73(1): 56 -63. doi: 10. 1001/jamapsychiatry. 2015. 2235 Change Scores on the Montgomery-Åsberg Depression Rating Scale (MADRS) From Baseline to End Point With Last Observation Carried Forward (LOCF) at Each Treatment Week. Error bars indicate standard error. a. P < . 01 vs placebo and P < . 01 vs fluoxetine. b. P < . 005 vs placebo and P < . 005 vs fluoxetine. c. P < . 05 vs placebo. Date of download: 12/4/2016 Copyright © 2016 American Medical Association. All rights reserved.

MELATONIN TEMPERATURE NOON 6 PM ---SLEEPY-6 AM - MN Preferred Sleep NOON

DELAYED SLEEP PHASE: MELATONIN TEMPERATURE NOON 6 PM MN ---SLEEPY-6 AM NOON Preferred Sleep

MELATONIN MORNING PERSON MIDNIGHT DEPRESSION EVENING PERSON

MELATONIN DURATION SLEEP ONSET OFFSET

MELATONIN DURATION SLEEP ONSET OFFSET

MELATONIN DURATION SLEEP 7 am ONSET 10 am OFFSET

DURATION MELATONIN Morning propranolol for SAD: Schlager DS. Am J Psychiatry. 1994; 151(9): 1383 -1385. SLEEP ONSET OFFSET

Dardente et al. Curr Biol 2010; 20: 2193 -2198 Masumoto et al. Curr Biol 2010; 20: 2199 -2206 MELATONIN Pars Tuberalis EYA 3 12 HOURS

LONG SLEEP or WINTER EYA 3 12 HOURS

LIGHT TREATMENT EYA 3 12 HOURS

DELAYED MELATONIN OFFSET DSPS or WINTER EYA 3 12 HOURS

A review of the neurobiology of photoperiodic hypotheses of depression and mania was presented in 2015, emphasizing work left to be done.

A dramatic phase-shift theory of bipolar disorder was presented in 2016, but it did not support the photoperiodic theories. Moon, J. H. , Cho, C. H. , Son, G. H. , Geum, D. , Chung, S. , Kim, H. , Kang, S. G. , Park, Y. M. , Yoon, H. K. , Kim, L. , Jee, H. J. , An, H. , Kripke, D. F. , and Lee, H. J. Advanced Circadian Phase in Mania and Delayed Circadian Phase in Mixed Mania and Depression Returned to Normal after Treatment of Bipolar Disorder. EBio. Medicine. 8 -132016. EBio. Medicine 2016 11, 285 -295 DOI: (10. 1016/j. ebiom. 2016. 08. 019) Copyright © 2016 Forschungsgesellschaft für Arbeitsphysiologie und Arbeitschutz e. V. Terms and Conditions