青い光を遮断するメガネの有効性をマニアに対する補助療法として評価する

Dysregulation of the endogenous biological clock is central to the pathophysiology of mania. The strongest time-giving signal is short wavelength (blue) light to which intrinsically photosensitive retinal ganglion cells containing the pigment melanopsin are primarily sensitive. Blocking blue light in the evening produces a physiological darkness condition.

In a randomized controlled trial with blinded raters conducted in a large academic hospital (Ontario, Canada), inpatients with mania were randomized to adjunctive blue-blocking glasses or lightly tinted glasses until discharge or up to two weeks. The primary outcome, improvement in manic symptoms on the Young Mania Rating Scale (YMRS), was assessed as a group by time interaction using linear mixed models. Secondary outcomes included differences in medication use. Registered on clinicaltrials.gov: NCT05206747.

A total of 42 participants were randomized to blue-blocking glasses (n = 20) or lightly tinted glasses (n = 22). Those prescribed blue-blocking glasses did not show significant improvements in the YMRS relative to those with control lenses (difference of change in estimated marginal means at week 2 favoring control group by 2.1 points on YMRS, group ∗ time interaction p = 0.93). Average antipsychotic dose (7.2 vs. 7.1 mg/day risperidone equivalents, p = 0.29) and benzodiazepine dose (0.7 mg/day lorazepam equivalents for both groups, p = 0.67) did not differ significantly between groups. There were no differences in other secondary outcomes.

Despite the biological plausibility of the intervention and promising prior studies, blue-blocking glasses were not superior to lightly tinted lenses in their effects of manic symptoms in this randomized controlled trial in an inpatient setting.