[Phototherapy].

UNLABELLED: Recommendations for a light therapy--PREVALENCE OF SEASONAL AFFECTIVE DISORDER (SAD): Ca. 2% of the adult population in Europe; female to male ratio 4:1.

DIAGNOSIS: Recurrent major depressive episodes in winter with full remission in summer.

DURATION OF LIGHT THERAPY: For 10,000 lux light boxes 30 minutes/day, for 2500 lux light boxes 1-2 hours/day.

TIME OF DAY: If possible in the morning after awakening, otherwise at a time of day when a regular daily light therapy is practicable.

ONSET OF LIGHT THERAPY EFFECT: Often already after a week (2-4 weeks treatment produces a stable antidepressant effect).

SIDE EFFECTS: Rare, can be avoided by reducing the light dosis.

OPHTHALMOLOGICAL RISKS: None under normal conditions. Patients with ocular risk factors (e.g. photosensitizing medications) or preexisting retinal diseases should undergo ophthalmologic examination.

LIGHT OR ANTIDEPRESSANT DRUGS: Light therapy is the first line treatment for SAD. For partial or non-response, combination of light with SSRIs is recommended.

LIGHT THERAPY MAY BE AN ADJUVANT TREATMENT FOR OTHER PSYCHIATRIC ILLNESSES WITH A SEASONAL TIME COURSE: Bulimia nervosa, obsessive-compulsive disorder, panic disorder; there is some preliminary evidence for usefulness in premenstrual dysphoric disorder and also for non-seasonal major depression.