Clinical Trials of Three Non-Drug Treatments for Winter Depression (SAD)

June 2, 2015 updated by: New York State Psychiatric Institute

Light and Ion Therapy for Seasonal Affective Disorder

We are offering non-pharmacologic therapy for alleviation of symptoms associated with depressed mood that recurs annually in fall or winter. The treatments are self-administered at home by the patient, with close clinical supervision. Our trials use specially designed devices that replenish two different environmental elements, naturally occurring light and negative ions in the air. Both factors may be reduced in winter, bringing on depression.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

The treatments we are investigating include bright light therapy upon awakening, and two contrasting treatments during the final hours of sleep: negative air ionization (provided at two levels) and dawn simulation (also at two levels), both switched on by a silent electronic timer or microprocessor. We hypothesize that the reduced outdoor light availability in winter, as well as reduced concentration of negative ions in the air circulation are both factors that contribute to depression. By supplementing the indoor environment with either ions or light, we are aiming to recreate summer-like conditions that are therapeutic. Our past studies have shown all three methods to have antidepressant effects in patients with seasonal affective disorder (SAD). Unlike light therapy, negative air ionization is imperceptible (you cannot sense when the ionizer is active).

Applications to the program are accepted and reviewed throughout the year. Screening interviews for entry into the program are scheduled between August and February. Patients and researchers both benefit most when applications are received by the start of the individual's "problem season," because this leaves maximum time to explore alternate treatments. Candidates undergo a two-hour personal interview at Columbia-Presbyterian Medical Center that ascertains whether they meet inclusion criteria. At a second two-hour visit we provide a standard medical examination including blood tests, urinalysis and EKG, all without cost. As an alternative, physicals may be performed by one's personal physician. Once the study is underway, there are about five additional one-hour appointments for clinical evaluations, flexibly scheduled during the business day, usually about 10 days apart.

We provide the treatment apparatus on loan. All treatments are scheduled in the morning around the time of awakening. The bedroom treatments (negative ions or dawn simulation) end by the time of awakening. The bright light treatment takes place for half an hour after waking up. Initially, patients are randomly assigned to one of the treatment groups. The treatment must be taken consistently for three weeks at the same time every day, after which it is temporarily suspended to determine whether symptoms return. Given sufficient time within the winter season, patients then have the opportunity to try one of the alternate treatments to determine which works best for them. This provides an informed, confident basis for a treatment plan for subsequent years.

As part of the protocol, patients provide saliva samples on two evenings, which are used to test for the level of melatonin, a hormone that becomes active at night. Results reveal whether a person's internal circadian rhythm is early, late or normal, information that can be used to guide the timing of future treatment. This constitutes a distinct benefit for research participants, since such a diagnostic test is not yet available in medical practice.

Study Type

Interventional

Enrollment (Actual)

150

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • New York
      • New York, New York, United States, 10032
        • Columbia Presbyterian Medical Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 70 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Diagnosis of major depression or bipolar disorder, with regular onset of depression in fall or winter and remission in spring
  • Able to maintain a regular sleep schedule

Exclusion Criteria:

  • Presence of psychiatric disorders other than major depression or bipolar depression
  • Current use of antidepressant or recreational drugs, or psychotropic medication or supplements that may affect mood
  • Current medical illness or medication that might interfere with response to treatment
  • Long-distance travel during the program

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: bright light box
30 min exposure shortly after wake-up
Device: bright light box
10,000 lux bright light therapy
Active Comparator: high-output negative ion generator
90 min exposure prior to wake-up
Device: high-output negative ion generator
automated air ion delivery in bedroom prior to wake-up
Placebo Comparator: low-output negative ion generator
90 min exposure prior to wake-up
Device: low-output negative ion generator
automated air ion delivery in bedroom prior to wake-up
Active Comparator: dawn simulator
naturalistic incremental light exposure 90 min prior to wake-up
Device: dawn simulator
gradual rise in bedroom illumination prior to wake-up
Experimental: dawn light pulse
rectangular pulse light exposure 13 min before wake-up, matched for total illuminance with dawn signal
Device: dawn light pulse
rectangular light pulse matched for lux.time of dawn simulation delivered prior towake-up

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Depression scale score
Time Frame: 3 weeks
reduction from depressed baseline
3 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
time of pineal melatonin onset
Time Frame: 3 weeks
change from depressed baseline
3 weeks

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

New York State Psychiatric Institute

Collaborators

National Institute of Mental Health (NIMH)

Investigators

  • Principal Investigator: Michael Terman, Columbia University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

September 1, 1998

Primary Completion (Actual)

June 1, 2003

Study Completion (Actual)

April 1, 2004

Study Registration Dates

First Submitted

November 22, 2000

First Submitted That Met QC Criteria

November 22, 2000

First Posted (Estimate)

November 23, 2000

Study Record Updates

Last Update Posted (Estimate)

June 3, 2015

Last Update Submitted That Met QC Criteria

June 2, 2015

Last Verified

November 1, 2005

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • #3032/R01 MH42931-01
  • R01MH042931-01 (U.S. NIH Grant/Contract)

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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