One in four depressed patients has a circadian subtype with earlier onset, more severe symptoms, and a measurably poorer response to SSRIs and SNRIs. Morning outdoor light exposure can outperform fluoxetine alone in a randomized trial, and combining outdoor light with fluoxetine yields a number needed to treat of 2.4. Outdoor light on a gray morning can still deliver about 10,000 lux compared with roughly 300 lux in the brightest office. Timing, skyview, and duration of outdoor light exposure can be prescribed with the same level of specificity as medication instructions. Disrupted circadian clocks can affect appetite, cortisol rhythms, social energy, and brain circuits involved in rumination.
"One in four depressed patients has a circadian subtype with earlier onset, more severe symptoms, and a measurably poorer response to both SSRIs and SNRIs. These are the patients asking how to stop"
"Morning outdoor light beat fluoxetine alone in a randomized trial; combined, the NNT was 2.4"
"Outdoor light on a gray morning still delivers 10,000 lux versus 300 lux in the brightest office"
"Timing, skyview, and duration belong on a prescription the way medication instructions do."
Read at Psychology Today
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