This is a K23 Career Development Award resubmission of the application 1 K23 MH082114-01A1. My career development goals are to undergo training to learn: 1) treatment trials research design, methods, statistical analysis and ethical conduct;2) the efficacy of bright light therapy for Bipolar Disorder (BD);3) biological rhythms and symptom expression in BD. In my research plan, I propose a randomized controlled trial to examine the efficacy of bright vs. inactive light treatment for bipolar depression. The K23 Award will provide me skills, experience and pilot data to build an independent clinical research career.
The specific aims are to randomize patients to active vs. inactive light and assess: 1) change in depressive symptom levels (SIGH-ADS;Williams et al, 2003), 2) the proportion that respond and remit;3) durability of response (time to relapse, time to response, time to remission). The hypotheses are: 1) greater improvement in depression will occur with active vs. inactive light between Weeks 0 and 6;2) a greater proportion of patients randomized to active vs. inactive light will respond (at least a 50% reduction on the baseline SIGHADS for 2 weeks or more) and remit (SIGHADS of 8 or less, for 3 weeks or more);3) responders to active vs. inactive light will have the most enduring response. Significance. This is a treatment trial to explore an innovative, novel somatic intervention for bipolar illness. The proposal addresses the NIMH priority to develop effective depression treatments for BD. My K23 application builds upon my published pilot data of a robust antidepressant response to Midday Light Therapy in Women with Bipolar Depression (Sit et al, 2007). I will examine the outcomes in men and women and compare the efficacy of active light with a plausible placebo control. Design. Subjects are randomized to active (7000 lux) or inactive (50 lux dim red) light. The light dose is titrated to efficacy over 6 weeks in the acute phase. The pilot findings informed the timing and titration of the light dose. Subjects begin 15 minutes midday active or dim red light daily in Week 1;the dose advances by 15 minutes each week to a maximum 60 minutes daily by Weeks 4-6. Responders are followed for 18 weeks in the continuation phase to assess durability of response.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Mentored Patient-Oriented Research Career Development Award (K23)
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Special Emphasis Panel (ZMH1-ERB-P (01))
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Wynne, Debra K
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University of Pittsburgh
Schools of Medicine
United States
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Sit, Dorothy K; McGowan, James; Wiltrout, Christopher et al. (2018) Adjunctive Bright Light Therapy for Bipolar Depression: A Randomized Double-Blind Placebo-Controlled Trial. Am J Psychiatry 175:131-139
Sit, Dorothy; Luther, James; Buysse, Daniel et al. (2015) Suicidal ideation in depressed postpartum women: Associations with childhood trauma, sleep disturbance and anxiety. J Psychiatr Res 66-67:95-104
Santucci, Aimee K; Singer, Lynn T; Wisniewski, Stephen R et al. (2014) Impact of prenatal exposure to serotonin reuptake inhibitors or maternal major depressive disorder on infant developmental outcomes. J Clin Psychiatry 75:1088-95
Sit, Dorothy; Luther, James; Dills, John Louis Jesse et al. (2014) Abnormal screening for gestational diabetes, maternal mood disorder, and preterm birth. Bipolar Disord 16:308-17
Wisner, Katherine L; Bogen, Debra L; Sit, Dorothy et al. (2013) Does fetal exposure to SSRIs or maternal depression impact infant growth? Am J Psychiatry 170:485-93
Hamad, Giselle G; Helsel, Joseph C; Perel, James M et al. (2012) The effect of gastric bypass on the pharmacokinetics of serotonin reuptake inhibitors. Am J Psychiatry 169:256-63
Bogen, Debra L; Sit, Dorothy; Genovese, Adrienne et al. (2012) Three cases of lithium exposure and exclusive breastfeeding. Arch Womens Ment Health 15:69-72
Sit, Dorothy; Perel, James M; Wisniewski, Stephen R et al. (2011) Mother-infant antidepressant concentrations, maternal depression, and perinatal events. J Clin Psychiatry 72:994-1001
Sit, Dorothy; Seltman, Howard; Wisner, Katherine L (2011) Seasonal effects on depression risk and suicidal symptoms in postpartum women. Depress Anxiety 28:400-5
Sit, Dorothy; Seltman, Howard; Wisner, Katherine L (2011) Menstrual effects on mood symptoms in treated women with bipolar disorder. Bipolar Disord 13:310-7

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