About Mind/Body Consultant Services & Protocols

Protocols: Phototherapy Protocol

Psychoactive

Spend at least one hour daily outdoors preferably during the first 6 hours after wakening or during the last two hours of daylight and when there is minimal cloud cover.

Avoid wearing sunglasses or wear sunglasses that are very lightly tinted to block UV light that may harm the eyes and yet allow the maximum amount of light to enter the eye.

Increase light exposure early in a.m. and after dark by keeping house and office lights as bright as possible. If possible set up outdoor lighting so that you experience a mood of continuing illumination into the evening hours.

Get at least 8 hours of sleep nightly with at least two of those hours prior to midnight.

Utilize a dawn/dusk simulator to re-engage reticular activating system of brain on wakening.

Expose eyes to high intensity full-spectrum light following the protocol below:

SETTING:

Desktop/tabletop placement with even, full face exposure initially preferable. Patient should NOT look directly into unit, but let light shine in face.

TIME OF DAY

Phase-delayed patients (symptoms worse in morning): between 6 AM and 8 AM
Phase-advanced patients (symptoms worse in evening): between 5 PM and 7 PM

SESSION LENGTH

Unit intensity/distance at 10,000 Lux:
1. Start: 30 minutes
2. Add: 5 minutes daily to 45 minutes, hold 3-7 days and note results.
3. Maintenance: May be 5-15 minutes less than initially needed.
Unit intensity/distance at 5,000 Lux:
1. Start: 45 minutes
2. Add: 5 minutes daily to 60 minutes and hold 3-7 days.
3. Assess results: Add or decrease time as necessary.
Unit intensity/distance at 2,500 Lux:
1. Start: 60 minutes
2. Add: 5-10 minutes daily up to 100 minutes and hold 3-7 days.
3. Assess results: Add or decrease time as necessary.

SIDE EFFECTS

Normally eyestrain - headache, nausea, eye discomfort in about 50%. Usually gone by fourth day of continuous use.
If persistent, reduce intensity (increase distance from unit) rather than reducing time.
Light-sensitive individuals may require longer session at lesser intensity throughout.
Overuse common Weeks 1-3. Agitation or reappearance of fatigue/depression. Reduce time.

SPLIT USAGE

1/2 session optional (Day 1 on) at "other end" of cycle to counter a "slump".
A 50% AM / 50% PM split schedule often useful for maintenance for patients with PMS or menstrual cycle irregularities, chronic pain, or AM compliance problems.

SPECIAL

Recommend intense, good field unit for younger children.
Geriatric patients often more light-sensitive and may need less intensity (w/longer session).
Contact lenses, medications, other factors may make patients more light-sensitive.
Bipolar I Patients: If well-controlled & Phototherapy within guidelines, unlikely to induce mania.
Bipolar II Patients: Light-induced hypomania possible, but not a contraindication. Monitor PRN.
- The above protocol was provided by Robert Minor, M.D., Dayspring Counseling, Grand Rapids, Michigan
Alternatives to light therapy for SAD that have been proven effective in peer-reviewed research studies are:
- St. John's Wort (hypericum perforatum)
- Timed-release synthetic Melatonin
- Red light-emitting diode light
- 5-Hydroxy-L-tryptophan

See our office for further information if interested. Caution is needed as bright light therapy will potentiate the effects of serotonin-enhancing drugs and hormones such as those above. Also, due to seasonal changes in serotonin and melatonin, levels of medication may need to be changed several times throughout the year.

Additional Notes:

Trials of Ginkgo Biloba in the treatment of SAD have been found to be ineffective.

If SAD symptoms do not improve within 14 days consult our office for additional recommendations.

Warnings: The information above is provided for educational purposes and may not be construed as a medical prescription or as a substitute for the advice of your physician. Do not use this product without first consulting your physician especially if you are pregnant or lactating. Be advised that some herbs and dietary supplements can cause severe allergic reactions in some individuals and may also have an adverse result in conjunction with other medications, or treatments. You should regularly consult your physician in matters regarding your health and particularly in respect to symptoms and conditions which may require diagnosis or medical attention. Reevaluate use of this product after 6 months.

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