Effective treatment of osteopathy: A Synthesis of Findings from 5 Studies

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Original Abstract of the Article

Major Findings

Seasonal Affective Disorder (SAD) is a type of depression that occurs during the fall and/or winter months and remits in the spring. 5 A major public health challenge in managing SAD is preventing winter depression recurrence. Light therapy (LT) is the established and best available acute SAD treatment. However, long-term compliance with daily LT from the first symptom through spontaneous springtime remission every fall/winter season is poor. Time-limited alternative treatments with effects that endure beyond the cessation of acute treatment are needed to prevent the annual recurrence of SAD. 5

This study, conducted over 5 years, assessed the antidepressant efficacy of two active treatments, bright white light and high-density negative ions, and the efficacy of two placebo treatments, dim red light and low-density negative ions, for Seasonal Affective Disorder (SAD). 4 In a controlled laboratory setting, 73 women with SAD were exposed to one of the four treatment conditions over 12 consecutive days. Pretreatment expectation ratings did not significantly differ among the four treatment groups; however, expectation scores and treatment benefits were positively related. Over the course of treatment, subjects in all four groups showed significant score decreases on the Structured Interview Guide for the Hamilton Depression Rating Scale-Seasonal Affective Disorder Version-Self Rating (SIGH-SAD-SR) and on the Beck Depression Inventory (BDI). For raw scale scores, neither main effects of treatment nor interactions between treatment and time were significant. When remission outcome criteria were used, bright white light was significantly more effective than any of the other three treatments, and exposure to high-density negative ions was more effective than either of the two placebo conditions, although the difference was not significant. 4

Disturbances of serotonergic neurotransmission appear to be particularly important for the pathophysiology of winter depression. 3 This study investigated whether fluoxetine has antidepressant effects comparable to bright light in the treatment of seasonal affective disorder (winter type). 3

A double-blind random-ordered comparison of the effects of placebo and 5-hydroxytryptophan (200 mg, orally) in ten depressed patients with seasonal affective disorder (SAD) and ten controls disclosed slightly but significantly higher basal levels of serum prolactin and a trend toward higher basal levels of serum cortisol in the patients with SAD compared with controls. 1 After administration of 5-HTP, the cortisol level significantly increased and the prolactin level significantly decreased in both patients and controls. No differences in the melatonin level, growth hormone level, blood pressure, or pulse rate and no side effects were noted between patients and controls in the two study conditions; the timing of basal and 5-hydroxytryptophan-stimulated hormonal secretions was similar for both groups. These results are discussed with reference to current hypotheses of the cause of SAD. 1

Deficiencies in brain serotonin function are believed to play an important role in the pathophysiology of seasonal affective disorder/winter type (SAD). 2 However, no direct evidence has been reported so far that lowered brain serotonin activity causes the symptoms of SAD. 2

Benefits and Risks

Benefit Summary

Research shows that light therapy is an effective treatment for SAD. 4 Antidepressants, such as fluoxetine, may also be effective in treating SAD. 3 Light therapy has also been shown to lower serum prolactin levels and raise serum cortisol levels in SAD patients. 1

Risk Summary

Light therapy is generally considered a safe treatment, but side effects such as headache, eye strain, and nausea may occur. 4 Antidepressants can cause side effects such as digestive problems, insomnia, and sexual dysfunction. 3

Comparison Across Studies

Commonalities

All of these studies highlight the role of serotonin in the pathophysiology of SAD. 3 2 They also suggest that light therapy is an effective treatment for SAD. 4 3

Differences

These studies differ in their research designs, sample sizes, and the treatments they used. 4 3 1 2 For example, one study compared the effects of light therapy to placebo, while another compared the effects of light therapy to an antidepressant. 4 3

Consistency and Discrepancies in Results

These studies suggest that light therapy is an effective treatment for SAD. 4 3 However, they do not provide conclusive evidence regarding which is more effective, light therapy or antidepressants, or whether negative ions affect SAD. 4 3 Furthermore, while these studies highlight the role of serotonin in the pathophysiology of SAD, they do not directly demonstrate that it is lowered brain serotonin activity that causes the symptoms of SAD. 2

Implications for Daily Life

These studies suggest that light therapy may be a promising option for treating SAD. 4 3 However, it is not possible to conclude from these studies whether light therapy or antidepressants are appropriate treatments for SAD. 4 3 It is important to consult with a healthcare professional if you are experiencing symptoms of SAD. 4 3

Limitations of Current Research

The limitations of these studies include small sample sizes, varied research designs, and the inability to determine the effectiveness of specific treatments. 4 3 1 2 Additionally, while these studies highlight the role of serotonin in the pathophysiology of SAD, they do not directly demonstrate that it is lowered brain serotonin activity that causes the symptoms of SAD. 2

Future Research Directions

Further research is needed to investigate the effectiveness of light therapy and antidepressants for the treatment of SAD, as well as to determine the optimal dosage and duration of these treatments. 4 3 Additionally, further research is needed to better understand the role of serotonin in the pathophysiology of SAD. 2

Conclusion

These studies suggest that light therapy may be an effective option for treating SAD. 4 3 However, it is not possible to conclude from these studies whether light therapy or antidepressants are appropriate treatments for SAD. 4 3 It is important to consult with a healthcare professional if you are experiencing symptoms of SAD. 4 3

Literature analysis of 5 papers
Positive Content
3
Neutral Content
0
Negative Content
2
Article Type
5
0
0
0
5
1.

Neuroendocrine response to 5-hydroxytryptophan in seasonal affective disorder.

Author: JacobsenF M, SackD A, WehrT A, RogersS, RosenthalN E

Hormonal changes
SAD

Patients with SAD showed higher basal prolactin and a trend towards higher cortisol levels compared to controls. After 5-HTP administration, both groups experienced significant increases in cortisol and decreases in prolactin. No differences in melatonin, growth hormone, blood pressure, or pulse rate were observed between groups. These findings suggest potential alterations in hormonal regulation in SAD, but further research is needed to understand the role of 5-HTP and its impact on SAD.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

2.

Effects of tryptophan depletion in fully remitted patients with seasonal affective disorder during summer.

Author: NeumeisterA, Praschak-RiederN, HesselmannB, VitouchO, RauhM, BarockaA, KasperS

Depressive symptoms

This study found that SAD patients in remission during the summer are vulnerable to a return of depression when depleted of tryptophan, supporting the importance of serotonergic mechanisms in the pathophysiology of SAD.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

3.

Effects of fluoxetine versus bright light in the treatment of seasonal affective disorder.

Author: RuhrmannS, KasperS, HawellekB, MartinezB, HöflichG, NickelsenT, MöllerH J

Antidepressant effect
Well tolerated

This randomized, parallel design study found that both bright light and fluoxetine produced a good antidepressant effect in patients with seasonal affective disorder (SAD), with an apparently better response to bright light that requires confirmation in a larger sample.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

4.

A randomized, placebo-controlled trial of bright light and high-density negative air ions for treatment of Seasonal Affective Disorder.

Author: FloryRandall, AmetepeJoseph, BowersBonnie

SAD treatment

This study examined the effectiveness of four treatments for Seasonal Affective Disorder (SAD): bright white light, high-density negative ions, dim red light, and low-density negative ions. All treatments resulted in improvements in depression scores. However, bright white light was significantly more effective than the other treatments in achieving full remission. High-density negative ions were more effective than the placebo conditions, but the difference was not significant. The study also found that expectations about treatment were linked to greater benefits.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

5.

Cognitive-behavioral therapy vs. light therapy for preventing winter depression recurrence: study protocol for a randomized controlled trial.

Author: RohanKelly J, EvansMaggie, MahonJennifer N, SitnikovLilya, HoSheau-Yan, NillniYael I, PostolacheTeodor T, VacekPamela M

Improved SAD management
SAD treatment
Limited long-term solutions
Need for better prevention strategies
Poor LT compliance

Seasonal affective disorder (SAD) is a type of depression that occurs in the fall and winter and improves in the spring. The biggest challenge is preventing the return of SAD each winter. While light therapy (LT) is the best treatment for SAD, people often don't stick with it long-term. New treatments that have longer-lasting effects are needed to prevent SAD from coming back every year.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

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