EXPERT ANALYSIS FROM THE APA ANNUAL MEETING

TORONTO (FRONTLINE MEDICAL NEWS)Transcranial near-infrared light is a promising treatment for depression, Dr. Andrew A. Nierenberg said at the annual meeting of the American Psychiatric Association. The therapy is noninvasive and cheap, and enhances the brain’s bioenergetic metabolism, potentially offering a treatment alternative to patients with refractory symptoms of depression.

“It’s too early for prime time,” said Dr. Nierenberg, a psychiatrist at Massachusetts General Hospital and Harvard Medical School, both in Boston. “You can buy these devices on Amazon, but I wouldn’t recommend it.”

Transcranial near-infrared (NIR) light passes through the skull and stimulates cytochrome c oxidase within the mitochondria, which increases energy production and is anti-inflammatory. “It turns out that transcranial near-infrared light is extremely neuroprotective,” reported Dr. Nierenberg, explaining that it has shown real promise in the treatment of traumatic brain injury and is being studied in mood disorders. “My chairman likes it for his joints,” he added.

A pilot study of the therapy in 10 patients with major depression, including 9 with anxiety, showed a good response at 2 weeks after a single treatment ( Brain Funct. 2009;5:46 ). Patients experienced highly significant reductions in both Hamilton Depression Rating Scale and Hamilton Anxiety Rating Scale scores following treatment, with the greatest reductions occurring at 2 weeks. However, a fair amount of regression was seen at 4 weeks post treatment. “One question is whether you can do repeated exposures,” Dr. Nierenberg said.The sham-controlled, randomized ELATED trial (Transcranial Laser Therapy for Major Depressive Disorder) is ongoing and plans to include 30 patients with structured clinical interview for DSM ( SCID ) diagnosis of major depressive disorder. Findings could be released as early as this summer.

“We’ll see what happens with this over time, but I think it’s a wonderful example of a technology that may actually help people over time,” Dr. Nierenberg said. He added that near infrared therapy isn’t related to sunlight exposure, since there isn’t enough of the near infrared spectrum in regular sunlight to have an effect.

Dr. Nierenberg reported working with several pharmaceutical companies in drug development.

cpnews@frontlinemedcom.com

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