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Depression and sleep disorders are often managed with Bright light therapy (BLT), however, its effectiveness in poststroke depression (PSD) remains unclear. Thus a study investigated the therapeutic effects and safety of BLT combined with escitalopram oxalate (ESC) in treating insomnia in patients with PSD.
Ischemic stroke patients with depressive symptoms, having a score ≥8 on the Hamilton Depression Scale (HAMD-17) and who met the DSM-IV criteria were diagnosed as having PSD. 112 PSD patients with insomnia patients were randomized to polytherapy (BLT plus ESC) and monotherapy (ESC only) groups for 6 weeks. Changes in Pittsburgh Sleep Quality Index (PSQI) score, a remission rate (PSQI ≤7 at the endpoint), HAMD-17 and Barthel Index (BI) scores were assessed. Adverse effects were also assessed.
106 patients concluded the study. The mean changes in the PSQI scores for the monotherapy and polytherapy groups were 4.85 and 5.87, respectively. Polytherapy showed better improvement in PSQI remission rate and HAMD-17 score than monotherapy. Both treatments showed improvement in the BI score and were well tolerated. However, a few significant differences in treatment-associated adverse events were observed between both treatments.
Thus, BLT combined with ESC comes as an effective and well-tolerated treatment of PSD-associated insomnia.