Light and Ion Maintenance In Treatment for Depression (LIMIT-D): Feasibility Study

This is an interventional treatment trial for Major Depressive Disorder, Recurrent, in Remission focused on measuring antidepressants, discontinuation, relapse prevention, light therapy, negative ions, depression Read More

Inclusion Criteria:

• Diagnostic and Statistical Manual (DSM-5) criteria for MDD, recurrent episodes (two or more), as determined by the Mini International Neuropsychiatric Interview (MINI).
• Taking a first-line antidepressant at approved doses (Table 1) for 3-12 months, with dose unchanged in the past month.
• Participant desire to discontinue antidepressant treatment because of adverse effects or other reasons;
• In remission as defined by score ≤10 on the clinician-rated Montgomery-Asberg Depression Rating Scale (MADRS) at both the screening visit and baseline visit, at least 2 weeks apart.
• Willing and able to complete self-report and online assessments including sufficient fluency in English or French.

Exclusion Criteria:

• Any psychiatric diagnosis other than MDD that is considered the primary diagnosis, including Bipolar I or Bipolar-II (lifetime). Note that comorbid anxiety disorders (e.g., generalized anxiety disorder, social anxiety disorder) will not be excluded if the anxiety disorder is not the primary diagnosis.
• Diagnosis of MDD with seasonal pattern (i.e., seasonal affective disorder, SAD) or with psychotic features (lifetime).
• Significant personality disorder diagnosis [e.g., antisocial] by MINI and clinical assessment.
• High suicidal risk, defined by clinician judgment.
• History of alcohol or substance use disorder, with a severity of at least moderate or severe, within 6 months before screening.
• Significant neurological disorders, head trauma, or other unstable medical conditions.
• Regular use of psychotropic medication other than an antidepressant or benzodiazepines (e.g., antipsychotics, mood stabilizers).
• History of severe antidepressant discontinuation effects.
• Retinal disease or other eye condition (e.g., macular degeneration) precluding the use of bright light treatment.
• Use of photosensitizing medication (thioridazine, chloroquine, 8-methoxypsoralen) within 1 week of baseline visit.
• Initiated formal psychotherapy (e.g., cognitive-behavioural therapy) within 3 months of Visit 1, or who plan to initiate psychotherapy during the study.
• Continued use of any other evidence-based treatment for depression.