A reader asks:

 Is it safe to use a light box if I am on intravenous antibiotic therapy with doxycycline for Lyme Disease? I have been instructed to avoid sunlight.


You can use light therapy, but you must use a system that completely shields ultraviolet (UV) light exposure. There is only one such 10,000 lux fluorescent system that clearly meets these standards (for info, see the CET store). In the future, other possibilities may include head-mounted units with light-emitting diodes (LEDs) to generate the signal without UV, however such units have not yet been demonstrated effective relative to placebo controls for antidepressant treatment. One final clinical note: some patients who have responded well to bright light therapy report that their mood worsens and the light becomes aversive while they are taking antibiotics for acute infections. Whether this might also apply to Lyme disease, which is more chronic, we simply do not know.