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Review
. 2025 Dec;27(1):249-264.
doi: 10.1080/19585969.2025.2533806. Epub 2025 Jul 24.

Light therapy for bipolar disorders: Clinical recommendations from the international society for bipolar disorders (ISBD) Chronobiology and Chronotherapy Task Force

Pierre A Geoffroy  1   2   3   4 , Laura Palagini  5 , Tone E G Henriksen  6 , Patrice Bourgin  4   7 , Corrado Garbazza  8 , Claude Gronfier  9 , Yuichi Esaki  10 , Diego C Fernandez  11 , Raymond W Lam  12 , Heon-Jeong Lee  13 , Michel Lejoyeux  1   2   3 , Julia Maruani  1   2   3 , Klaus Martiny  14 , Greg Murray  15 , Rixt F Riemersma-Van Der Lek  16 , Philipp Ritter  17 , Peter F J Schulte  18 , Daniel J Smith  19 , Michael Terman  20   21 , Jamie M Zeitzer  22 , Dorothy K Sit  23
Affiliations
Review

Light therapy for bipolar disorders: Clinical recommendations from the international society for bipolar disorders (ISBD) Chronobiology and Chronotherapy Task Force

Pierre A Geoffroy et al. Dialogues Clin Neurosci. 2025 Dec.

Abstract

The International Society for Bipolar Disorders (ISBD) Chronobiology and Chronotherapy Task Force conducted a comprehensive review to deliver concise evidence-based recommendations on the use of bright light therapy (BLT) for bipolar disorder (BD). Adjunctive BLT is likely an efficacious acute treatment for bipolar depression as implicated by higher quality evidence. The position of maintenance BLT for relapse prevention awaits further investigation. Protocols of effective BLT in BD are similar to parameters indicated for treatment of seasonal and non-seasonal major depressive disorder. Anti-manic prophylaxis (especially for BD-I) and clinical monitoring are recommended with initiation of and ongoing light treatment. Administer BLT daily, preferably in the morning or at mid-day. If mornings are prohibitive, then mid-day exposure, implemented to avoid excessively early wake times, is an acceptable alternative. Informed by the literature, target 30 min/day of BLT exposure. Patients wary of emergent hypomania or partial responders, can initiate 15 min/day and increase by 15 min each week to full response (or 30-60 min/day by the fourth week). Consider patient centred outcome assessments to evaluate mood response, safety and side effects. Clinical improvement is typically observed within 1-2 weeks, with response/remission expected by 4-6 weeks. Integration of BLT with other chronotherapeutic strategies may enhance long-term efficacy.

Keywords: Bipolar disorder; chronotherapy; depression; light therapy; phototherapy; seasonal affective disorder.

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Conflict of interest statement

PAG is currently conducting four independent scientific studies (LuBi, Luna, CombiChronoS, and SoLuRep) as principal investigator, utilising light therapy devices manufactured by Dayvia® and Lucimed®, with funding received through French public grants.

PB is currently conducting two independent scientific studies (INSOLUM, HYPERCHRONO) as principal investigator and two as co-investigator (Insolux, CombiChronoS, Light’sAut), using light therapy device manufactured by Lucimed®, with funding received through French public grants.

CG has received funds for research from National Research Agency (ANR: Light-coherence, Comarhythm, SoLuRep, Sleep-Immun), Auvergne Rhône Alpes Region, University of Lyon; honoraria for leading and participating in working groups and taskforces from National French Health Agency (Anses), Inserm Scientific Specialised Commission in Neuroscience; honoraria for ad hoc advising, consulting or speaking from National Institute of Sleep and Vigilance (INSV), Procter and Gamble, PGA Astronics, Vinci Foundation.

RWL has received funds for research (through UBC) from BC Leading Edge Foundation, Brain Canada, Canadian Institutes of Health Research, Canadian Network for Mood and Anxiety Treatments (CANMAT), Grand Challenges Canada, Healthy Minds Canada, Janssen, Michael Smith Foundation for Health Research, MITACS, Ontario Brain Institute, Unity Health, Vancouver Coastal Health Research Institute, and VGH-UBCH Foundation; honoraria for ad hoc advising or consulting from Abbvie, Asia-Pacific Economic Cooperation, Bausch, CB Solutions, CANMAT, Genome BC, Neurotorium, and Otsuka; and honoraria for ad hoc speaking from Canadian Medical Protective Association, Carnot, Lundbeck, Otsuka, and Shanghai Mental Health Centre.

GM has received funds for research from National Health and Medical Research Council, Wellcome Trust, BD^2, and smaller government agencies and professional bodies.

KM has received funds from Independent Research Fund Denmark.

All Other authors report no conflicts of interest related to this research.

Recommendations were developed through group consensus, with members abstaining from voting or leading discussions in areas where direct conflicts might exist.

Figures

Figure 1.
Figure 1.
Pathways of bright light therapy (Courtesy of P. Ritter).
Figure 2.
Figure 2.
Clinical algorithm: Bright light therapy in bipolar disorder.
Figure 3.
Figure 3.
Proper placement of an example of bright light box. (Courtesy of Jessica Rao, www.cet.org).
See this image and copyright information in PMC

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