Labbate L A, Lafer B, Thibault A, Sachs G S
Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston 02114.
J Clin Psychiatry. 1994 May;55(5):189-91.
Bright light treatment has become an accepted treatment for seasonal affective disorder (SAD), but there have been few studies about adverse effects from using this treatment. We conducted a study to examine the frequency of adverse effects of bright light treatment for SAD.
Thirty patients meeting DSM-III-R criteria for major depression, recurrent, with seasonal pattern as determined by the Structured Clinical Interview for DSM-III-R were administered a structured interview, the 42-item Systematic Assessment for Treatment Emergent Events, to assess side effects from bright light treatment.
Side effects were limited and mild. They remitted with time or decreased light. No patient discontinued treatment. One patient developed mild hypomania and 3 became agitated. Sleep disturbance occurred in 62% of patients (5 of 8) using evening light. Visual side effects occurred in 26% of patients (8 of 30).
Except for one case of mild hypomania, no other clinically significant treatment-emergent adverse effects developed. Hypomania is an uncommon, but clinically important side effect. Mild visual complaints were common and remitted promptly. In this group of patients with SAD, bright light treatment was well tolerated and resulted in a limited number of adverse effects, none of which compromised treatment. The absence of a control group limits the specificity of these side effects to bright light treatment.
强光疗法已成为季节性情感障碍（SAD）的一种公认治疗方法，但关于使用该疗法产生的不良反应的研究较少。我们开展了一项研究，以调查强光疗法治疗SAD的不良反应发生频率。
对30名符合DSM-III-R复发性重度抑郁症季节性模式标准的患者（通过DSM-III-R结构化临床访谈确定）进行结构化访谈，即42项治疗突发不良事件系统评估，以评估强光疗法的副作用。
副作用有限且轻微。它们会随着时间缓解或因减少光照而减轻。没有患者停止治疗。1名患者出现轻度轻躁狂，3名患者变得烦躁不安。62%（8名中的5名）使用夜间光照的患者出现睡眠障碍。26%（30名中的8名）的患者出现视觉副作用。
除1例轻度轻躁狂外，未出现其他具有临床意义的治疗突发不良反应。轻躁狂是一种罕见但具有临床重要性的副作用。轻度视觉不适很常见且很快缓解。在这组SAD患者中，强光疗法耐受性良好，不良反应数量有限，且无一影响治疗。由于缺乏对照组，这些副作用对强光疗法的特异性有限。
