Pregnancy is a time of many changes. In addition to the physical challenges women face (frequent urination, weight gain, loss of balance, water retention, back aches), they also must cope with shifting hormones and lifestyle changes. Those who are prone to depression may be especially vulnerable during this time. Although some antidepressants are relatively safe during pregnancy (I say relatively safe because only time will tell how safe these medications actually are), not all are responders to these drugs. In addition, many women do not feel comfortable with the unknown risks. The alternatives to drugs aren't especially appealing either. Women can "tough it out" and hope for the best or use electroconvulsive therapy (ECT) if they become severely depressed.
In response to this need for safe, non-drug depression treatments, researchers have begun to investigate a treatment commonly thought of as being only for Seasonal Affective Disorder, or Winter Depression: light therapy. Results have been very promising and have been presented at the annual meeting of the Society for Light Treatment and Biological Rhythms. This new treatment is presently undergoing clinical trials at The University of Pittsburg. Volunteers are being sought to participate.
Who Is Eligible?Participants will include pregnant women between the ages of 18-40 who are currently experiencing depression, whether it began before or during their pregnancy. Throughout the study they will continue to be seen by their own obstetrician. Women can not be involved in the study if they have a current medical illness (including eye diseases) or if they are using psychiatric medication, including antidepressants. Participants also must be able to maintain a regular sleep schedule falling asleep no later than 1 a.m. and waking no later than 10 a.m. All use of alcohol or recreational drugs is prohibited.
How Is Treatment Administered?
Participants will be loaned a portable, lightweight light box for use at home. They will be randomly assigned to one of two dose levels of light under study, both within a comfortable room light range. (Specific information about the dose level is withheld from participants and clinical staff until the trial is completed, in order to enable careful dose comparisons). Participants reserve 60 minutes each morning (specific times individually assigned based on wake-up time) when they sit at the light box and engage in any quiet activity with eyes open, such as reading, writing, listening to music and having breakfast. To make time for treatment, participants may be asked to wake up slightly earlier than has been normal for them. Treatment continues daily for five weeks, during which progress is monitored by log sheets, telephone contact with staff, and periodic clinic visits. Although the trial seeks to demonstrate alleviation of depressive symptoms, supervisory staff may recommend use of the alternate light dose or an entirely different treatment at any point in the trial if the depression worsens significantly.
After the five-week trial participants will have the opportunity to continue with treatment if it has been successful, or try an enhanced treatment regimen if it appears that a higher light dose would be beneficial. The staff will also offer guidance toward treatment following birth of the baby, if that is indicated.
The potential risks of light therapy, as administered in this study, are very low. If patients receive too much light, they can become irritable or show disturbed sleep, but these side effects are readily controlled by adjusting the light dose (for example, by reducing the daily exposure duration). Such a side effect profile compares very favorably with that for standard antidepressants and the rapid reversibility through light dose adjustments distinctly minimizes risk.
How to Inquire About Participation
If you think you may be suffering from antepartum depression and live in the Pittsburg area, you are eligible to apply as a volunteer for the light therapy study. E-mail your confidential inquiry to PittPregnancyLight@msx.upmc.edu, with the following information:
- Your mailing address, including Zip code.
- Phone numbers where we might reached or receive a message during daytime hours. If you called your confidentiality will be preserved. The caller will not identifying the program to anyone but you. Please state if you prefer not to receive voice-mail messages.
- Briefly describe your symptoms of depression, current treatment (if any), medical conditions (if any), and stage of pregnancy (month). All information you provide is held in strict confidence.
You will be responded to by e-mail, regular mail or phone, and will be sent you a more detailed project description and application form if your participation looks possible.