Total sleep deprivation followed by sleep phase advance and bright light therapy in drug-resistant mood disorders
Abstract
Background Drug-resistant depression is a major therapeutic issue in psychiatry and the development of non-drug therapies that treat drug-resistant depression is required. Sleep deprivation (SD) is a non-drug treatment classified as a form of chronotherapy in addition to bright light therapy (BLT) and sleep phase advance (SPA). Combined chronotherapy is hypothesized to improve drug-resistant depression. In this study, we investigated the benefits of total sleep deprivation (TSD) followed by SPA and BLT in drug-resistant depression alongside ongoing antidepressant medication and observed the added effectiveness of the combined chronotherapy.Methods Thirteen drug-resistant inpatients affected by a major depressive episode were studied. They were treated by TSD followed by SPA (three days) and BLT (five days) with ongoing drug treatment. Effectiveness was rated using the Hamilton Rating Scale for Depression (HAM-D), the Zung Self-Rating Depression Scale (SDS), and the Visual Analogue Scale (VAS) over 3 weeks.Results Significant improvements of depressive symptoms were observed in both objective mood ratings (HAM-D) and subjective mood ratings (SDS and VAS). Eight out of 13 patients maintained this responsiveness (50% or greater changes in HAM-D) across the study period. Moreover, no patients dropped out of the combined chronotherapy procedure.Limitations The study did not have a placebo group, and more subjects may be needed.Conclusion The trial of combined chronotherapy successfully induced rapid improvement in depressive symptoms in drug-resistant patients without early relapse or obvious side effects.
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Shifts in the timing of circadian rhythms relative to the timing of sleep have been shown to cause switches from depression to mania.
“This type of shift in the timing of circadian rhythms relative to the timing of sleep has been shown to cause switches from depression to mania”
From Bipolar mood cycles and lunar tidal cycles (2018) · cites this paper as [29]
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- Authors
- Echizenya, M., Suda, H., Takeshima, M., Inomata, Y., & Shimizu, T.
- Affiliations
- Akita University (JP)
- Corresponding author
- Echizenya, Masaru
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2013-01
- Volume
- 144
- Issue
- 1-2
- Pages
- 28-33
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W1963848315
- Cited by
- 71
- References
- 44
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 2 · 2023: 4 · 2022: 8 · 2020: 10 · 2019: 8 · 2018: 8 · 2017: 7 · 2016: 4 · 2015: 7 · 2014: 4 · 2013: 5
- FWCI
- 3.77
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- total sleep deprivation, sleep phase advance, bright light therapy, chronotherapy, drug-resistant depression, major depressive episode, antidepressants, non-pharmacological treatment, depressive symptoms
- MeSH terms
- Adult, Antidepressive Agents, Combined Modality Therapy, Depression, Female, Humans, Male, Middle Aged, Phototherapy, Sleep Deprivation, Treatment Outcome, Chronotherapy
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