The sample size is so small. Basically 31 people in each of the four groups.
> symptoms alleviated in six who took fluoxetene and had sham light therapy, and nine who had only placebo treatments.
So fluoxetine is worse than a placebo?
> 17 of those who had both light therapy and fluoxetine, 14 of those who had light therapy and took placebo pills
But fluoxetine improved the outcome of light therapy?
This is on Harvard's medical school's own website and there's no simple way at getting to the original article. That's horrendous. Nonetheless a simple (unnecessary) google found it.
First of all, this is a study on people with a mental health diagnosis, so a subjective diagnosis maybe involving completing a questionnaire to get a diagnosis.
selection criteria:
> were psychotropic medication free for at least 2 weeks prior to the baseline visit
Not good enough. It takes a long time for the effects of psychotropic (and other) medications to stop
> Patients were excluded for seasonal pattern, bipolar and psychotic disorders, substance abuse or dependence within the past year, or serious suicidal risk as judged by the clinician. Patients were also excluded if they had unstable medical illnesses, had retinal disease, were pregnant or breastfeeding, or had previously used fluoxetine or light therapy. Patients were also excluded for treatment resistance during the current episode (lack of response to ≥2 antidepressants at therapeutic doses for >6 weeks) or for using other concurrent treatments for depression, including psychotherapy.
Seems like they basically excluded any and all people who were guaranteed to show this stuff was ineffective !
> Patients used the light box at home and were given standardized verbal and written instructions.
Reliance on patient compliance which could vary significantly between such small groups (people would be far less likely to adhere to a non-pharmacological treatment)
I got bored reading the paper. But have a look at the absolute size of the conflicts of interest paragraph:
Conflict of Interest Disclosures: Dr Lam reported receiving research funds from Brain Canada, Bristol-Myers Squibb, Canadian Institutes of Health Research, Canadian Network for Mood and Anxiety Treatments, Coast Capital Savings, Lundbeck, Pfizer, St Jude Medical, University Health Network Foundation, and Vancouver Coastal Health Research Institute; serving as a consultant to and/or receiving speaker honoraria from AstraZeneca, Bristol-Myers Squibb, Canadian Psychiatric Association, Canadian Network for Mood and Anxiety Treatments, Eli Lilly and Co, Johnson and Johnson, Lundbeck, Lundbeck Institute, Mochida, Otsuka, Pfizer, Servier, and Takeda; receiving royalties from Cambridge University Press, Informa Press, and Oxford University Press; and holding a copyright on the Lam Employment Absence and Productivity Scale (LEAPS). Dr Levitt reported receiving unrestricted salary support from Eli Lilly Canada Inc. Dr Michalak reported receiving consulting honoraria from Lundbeck. Dr Ramasubbu reported receiving research grants from AstraZeneca. Dr Yatham reported serving as an advisory board member for and receiving honoraria and grants or research support from AstraZeneca, Bristol-Myers Squibb, Eli Lilly and Co, GlaxoSmithKline, Johnson and Johnson, Novartis, Pfizer, Abbott, Servier, and Wyeth; serving as an advisory board member for Forest; and receiving grants or research support from the Stanley Foundation, National Alliance for Research on Schizophrenia and Depression, Canadian Institutes of Health Research, and Canadian Psychiatric Foundation. No other disclosures were reported.
I'd nearly say they're looking to create some evidence for light boxes which can then be manufactured and sold, but what do I know
(Edit: and the study length was two months, which is a blip for major depression)
www.health.harvard.edu
