Light Boxes Out-Perform Prozac in This RCT Throw-Down!

Researchers from the University of British Columbia, University of Toronto, Dalhousie University and the University of Calgary studied the efficacy of light treatment, as a sole therapy and in combination with fluoxetine hydrochloride (Prozac), compared with a sham-placebo condition in adults with non-seasonal major depressive disorder (MDD).

They implemented a randomized, double-blind, placebo- and sham-controlled, 8-week trial with 122 adults (aged 19-60 years) with MDD of at least moderate severity, in outpatient psychiatry clinics in academic medical centers across Canada.

Patients were randomly assigned to one of four conditions:

  1. light therapy alone (active 10 000-lux fluorescent white light box for 30 min/d in the early morning plus placebo pill);

  2. antidepressant medication alone (inactive placebo negative ion generator for 30 min/d plus fluoxetine hydrochloride, 20 mg/d);

  3. combination light and antidepressant therapy; or

  4. placebo both (inactive negative ion generator plus placebo pill).

Outcomes were changes measured on the Montgomery-Åsberg Depression Rating Scale (MADRS) from baseline to the 8-week end point.

A total of 122 patients were randomized to the four conditions. All treatments were generally well tolerated, with few significant differences in treatment-emergent adverse events.

Outcome measures showed that the combination of the two therapies and the light therapy alone were significantly superior to the placebo condition. Prozac by itself, however, was not superior to the placebo.

The investigators conclude that bright light treatment, both as sole therapy and in combination with fluoxetine, was efficacious and well tolerated in the treatment of adults with non-seasonal MDD. The combination treatment had the most consistent effects. Prozac alone, however, did not do better than the placebo.

Citation: Lam RW1, Levitt AJ2, Levitan RD3, Michalak EE1, Morehouse R4, Ramasubbu R5, Yatham LN1, Tam EM1. Efficacy of Bright Light Treatment, Fluoxetine, and the Citation: Combination in Patients With Nonseasonal Major Depressive Disorder: A Randomized Clinical Trial. JAMA Psychiatry. 2015 Nov 18:1-9. doi: 10.1001/jamapsychiatry.2015.2235. [Epub ahead of print]

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