PURL Example

Light therapy for nonseasonal major depressive disorder?

Practice Changer: Consider treatment with bright light therapy, alone or in combination with fluoxetine, for patients with nonseasonal major depressive disorder (MDD).¹

Strength of recommendation (SOR)
B: Based on a single moderate-quality randomized control trial.
Lam RW, Levitt AJ, Levitan RD, et al. Efficacy of bright light treatment, fluoxetine, and the combination in patients with nonseasonal major depressive disorder: a randomized clinical trial. JAMA Psychiatry. 

Illustrative case: A 38-year old woman recently diagnosed with MDD without a seasonal patter comes to see you for her treatment options. Her Hamilton Depression Rating Scale (HAM-D) is 22, and she is not suicidal. Should you consider bright light therapy in addition to pharmacotherapy?