The Light Heart Study: Daily Light Box Use for Depressive Symptoms in Patients With Stage B Heart Failure

NCT ID: NCT02691000

Last Updated: 2016-10-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

122 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-09-30

Study Completion Date

2018-09-30

Brief Summary

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The Light-Heart study is a randomized, double-blind, controlled trial investigating the effects of bright white light (BWL) therapy on depressive symptoms, quality of life, and functioning in patients with Stage B heart failure. The study is a randomized, double-blind, controlled trial of 8 weeks of morning BWL therapy compared with morning dim red light (DRL) treatment in older (60 years or older) 122 Stage B (early, asymptomatic) HF patients.

Detailed Description

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The Light-Heart study is randomized, double-blind, controlled trial of 8 weeks of morning BWL therapy, compared with DRL in older, Stage B HF patients with clinically significant levels of depressive symptoms. The primary hypothesis of the proposed study is that compared to DRL, BWL therapy will be associated with a significantly greater reduction in depressive symptoms. Important information about compliance and tolerability associated with the BWL intervention in Stage B HF patients will also be gathered. The investigators will examine whether BWL therapy is associated with greater improvements in quality of life and subjective functioning compared to DRL. Finally, the researchers will investigate whether BWL is associated with a sustained improvement in depressive symptoms 2 and 4 weeks following the end of the intervention compared to DRL.

One hundred twenty-two older adults (≥60 years) with Stage B HF and depressive symptoms (Beck Depression Inventory/BDI score ≥10) will be recruited from several University of California, San Diego (UCSD) and Veteran's Affairs (VA) cardiology clinics. The baseline assessment will include evaluation of depressive symptoms (BDI), quality of life (Quality of Life Enjoyment and Satisfaction questionnaire), subjective functioning (Short Form-36), and an assessment of patient expectations regarding the study intervention (single question, 5 point scale). These measures will be assessed again after 4 and 8 weeks of treatment and at 2 and 4 weeks following the end of the BWL therapy intervention along with side effects (Frequency, Intensity, and Burden of Side Effects Rating).

Participants will be randomized to receive BWL (n=61) or DRL (n=61) light therapy boxes (Litebook® Elite; Litebook® Inc., Medicine Hat, CA) to use at home for 60 minutes each morning for 8 weeks. If participants are currently receiving treatment (e.g. antidepressant therapy), participants will continue their usual treatment while in the study. Participants will be told that the effects of a particular light therapy protocol on mood and functioning is being investigated. Participants will be made aware that there is a treatment condition of interest and a comparison condition and that participants will be randomly assigned to one or the other group. Participants will not be told that different colors of light are being used or that BWL is the treatment of interest. The Litebooks® will look identical except for the color of the light. Weekly telephone calls will encourage compliance, and compliance meters will record when the Litebooks® are turned on or off. A blood sample will also be collected from each patient to assess for biomarkers.

Conditions

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Depression Stage B Heart Failure

Keywords

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depression depressive symptoms stage b heart failure bright white light light therapy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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Bright White Light (BWL) Litebook

Participants will be instructed to use the BWL Litebook for an hour every day for 8 weeks.

Group Type EXPERIMENTAL

LiteBook

Intervention Type DEVICE

Light therapy using a Bright White Light Litebook for 1 hour each morning for 8 weeks. This is the experimental intervention.

Dim Red Light (DRL) Litebook

Participants will be instructed to use the DRL (comparison condition) Litebook for an hour every day for 8 weeks.

Group Type PLACEBO_COMPARATOR

LiteBook

Intervention Type DEVICE

Light therapy using a Dim Red Light Litebook for 1 hour each morning for 8 weeks. This is the control.

Interventions

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LiteBook

Light therapy using a Bright White Light Litebook for 1 hour each morning for 8 weeks. This is the experimental intervention.

Intervention Type DEVICE

LiteBook

Light therapy using a Dim Red Light Litebook for 1 hour each morning for 8 weeks. This is the control.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* age ≥ 60 years
* Written informed consent
* BDI score ≥ 10
* Stage B heart failure diagnosis
* no antidepressant pharmacotherapy or on stable dose of antidepressant (\>8 weeks)
* on stable dose of cardiac medications (\>8 weeks)

Exclusion Criteria

* self-reported history of bipolar disorder
* psychiatric diagnoses by Structured Clinical Interview for the Diagnostic and Statistical Manual (DSM) (ie; bipolar disorder, schizophrenia, schizoaffective disorder, major neurocognitive disorder)
* serious suicide or homicide risk (outpatient care judged unsafe)
* recent initiation or change of dose in antidepressant or cardiac medications (within past 8 weeks)
* current use of supplements with putative effects on mood or sleep (e.g St. John's Wort, melatonin)
* recent initiation of evidence based psychotherapy for mood
* prior use of BWL therapy
* unstable medical illness requiring hospitalization
* uncontrolled seizure disorder
* retinopathies
* macular degeneration
* shift work
Minimum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Retirement Research Foundation

OTHER

Sponsor Role collaborator

University of California, San Diego

OTHER

Sponsor Role lead

Responsible Party

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Jeanne Maglione

Assistant Clinical Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jeanne Maglione, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

University of California, San Diego

Locations

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University of California, San Diego

La Jolla, California, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Olga Korelova, MD

Role: CONTACT

Phone: 8583860549

Email: [email protected]

Facility Contacts

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Olga Korelova, MD

Role: primary

References

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Abramson J, Berger A, Krumholz HM, Vaccarino V. Depression and risk of heart failure among older persons with isolated systolic hypertension. Arch Intern Med. 2001 Jul 23;161(14):1725-30. doi: 10.1001/archinte.161.14.1725.

Reference Type BACKGROUND
PMID: 11485505 (View on PubMed)

Ahmedani BK, Solberg LI, Copeland LA, Fang-Hollingsworth Y, Stewart C, Hu J, Nerenz DR, Williams LK, Cassidy-Bushrow AE, Waxmonsky J, Lu CY, Waitzfelder BE, Owen-Smith AA, Coleman KJ, Lynch FL, Ahmed AT, Beck A, Rossom RC, Simon GE. Psychiatric comorbidity and 30-day readmissions after hospitalization for heart failure, AMI, and pneumonia. Psychiatr Serv. 2015 Feb 1;66(2):134-40. doi: 10.1176/appi.ps.201300518. Epub 2014 Nov 1.

Reference Type BACKGROUND
PMID: 25642610 (View on PubMed)

Cameron IM, Reid IC, MacGillivray SA. Efficacy and tolerability of antidepressants for sub-threshold depression and for mild major depressive disorder. J Affect Disord. 2014 Sep;166:48-58. doi: 10.1016/j.jad.2014.04.078. Epub 2014 May 9.

Reference Type BACKGROUND
PMID: 25012410 (View on PubMed)

Desan PH, Weinstein AJ, Michalak EE, Tam EM, Meesters Y, Ruiter MJ, Horn E, Telner J, Iskandar H, Boivin DB, Lam RW. A controlled trial of the Litebook light-emitting diode (LED) light therapy device for treatment of Seasonal Affective Disorder (SAD). BMC Psychiatry. 2007 Aug 7;7:38. doi: 10.1186/1471-244X-7-38.

Reference Type BACKGROUND
PMID: 17683643 (View on PubMed)

Frasure-Smith N, Lesperance F. Depression--a cardiac risk factor in search of a treatment. JAMA. 2003 Jun 18;289(23):3171-3. doi: 10.1001/jama.289.23.3171. No abstract available.

Reference Type BACKGROUND
PMID: 12813125 (View on PubMed)

Jiang W, Alexander J, Christopher E, Kuchibhatla M, Gaulden LH, Cuffe MS, Blazing MA, Davenport C, Califf RM, Krishnan RR, O'Connor CM. Relationship of depression to increased risk of mortality and rehospitalization in patients with congestive heart failure. Arch Intern Med. 2001 Aug 13-27;161(15):1849-56. doi: 10.1001/archinte.161.15.1849.

Reference Type BACKGROUND
PMID: 11493126 (View on PubMed)

Jimenez JA, Mills PJ. Neuroimmune mechanisms of depression in heart failure. Methods Mol Biol. 2012;934:165-82. doi: 10.1007/978-1-62703-071-7_9.

Reference Type BACKGROUND
PMID: 22933146 (View on PubMed)

Leppamaki SJ, Partonen TT, Hurme J, Haukka JK, Lonnqvist JK. Randomized trial of the efficacy of bright-light exposure and aerobic exercise on depressive symptoms and serum lipids. J Clin Psychiatry. 2002 Apr;63(4):316-21.

Reference Type BACKGROUND
PMID: 12000205 (View on PubMed)

Lieverse R, Van Someren EJ, Nielen MM, Uitdehaag BM, Smit JH, Hoogendijk WJ. Bright light treatment in elderly patients with nonseasonal major depressive disorder: a randomized placebo-controlled trial. Arch Gen Psychiatry. 2011 Jan;68(1):61-70. doi: 10.1001/archgenpsychiatry.2010.183.

Reference Type BACKGROUND
PMID: 21199966 (View on PubMed)

Loving RT, Kripke DF, Elliott JA, Knickerbocker NC, Grandner MA. Bright light treatment of depression for older adults [ISRCTN55452501]. BMC Psychiatry. 2005 Nov 9;5:41. doi: 10.1186/1471-244X-5-41.

Reference Type BACKGROUND
PMID: 16283925 (View on PubMed)

Naus T, Burger A, Malkoc A, Molendijk M, Haffmans J. Is there a difference in clinical efficacy of bright light therapy for different types of depression? A pilot study. J Affect Disord. 2013 Dec;151(3):1135-7. doi: 10.1016/j.jad.2013.07.017. Epub 2013 Aug 7.

Reference Type BACKGROUND
PMID: 23972661 (View on PubMed)

Rutledge T, Reis VA, Linke SE, Greenberg BH, Mills PJ. Depression in heart failure a meta-analytic review of prevalence, intervention effects, and associations with clinical outcomes. J Am Coll Cardiol. 2006 Oct 17;48(8):1527-37. doi: 10.1016/j.jacc.2006.06.055. Epub 2006 Sep 26.

Reference Type BACKGROUND
PMID: 17045884 (View on PubMed)

Terman M, Terman JS. Light therapy for seasonal and nonseasonal depression: efficacy, protocol, safety, and side effects. CNS Spectr. 2005 Aug;10(8):647-63; quiz 672. doi: 10.1017/s1092852900019611.

Reference Type BACKGROUND
PMID: 16041296 (View on PubMed)

Tuunainen A, Kripke DF, Endo T. Light therapy for non-seasonal depression. Cochrane Database Syst Rev. 2004;2004(2):CD004050. doi: 10.1002/14651858.CD004050.pub2.

Reference Type BACKGROUND
PMID: 15106233 (View on PubMed)

Other Identifiers

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151558

Identifier Type: -

Identifier Source: org_study_id