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Total sleep deprivation combined with lithium and light therapy in the treatment of bipolar depression: replication of main effects and interaction
Abstract
The clinical usefulness of total sleep deprivation (TSD) in the treatment of bipolar depression is hampered by a high-rate short-term relapse. Previous literature has suggested that both long-term lithium treatment and light therapy could successfully prevent relapse. We randomized 115 bipolar depressed inpatients to receive three cycles of TSD, alone or in combination with morning light exposure, given at an intensity of 150 or 2500 lux. Forty-nine patients were undergoing long-term treatment with lithium salts (at least 6 months), while 66 patients were taking no psychotropic medication. Mood was self-rated by the Visual Analogue Scale three times a day during treatment. The results showed that both light therapy and ongoing lithium treatment significantly enhanced the effects of TSD on the perceived mood, with no additional benefit when the two treatments were combined. Subjective sleepiness during TSD, as rated by the self-administered Stanford Sleepiness Scale, was significantly reduced by light exposure, and was correlated with the outcome. This study confirms the possibility of obtaining a sustained antidepressant response to TSD in bipolar patients.
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“Total sleep deprivation, especially in combination with other chronobiological interventions, such as light therapy, is associated with improved treatment response, especially in bipolar depression (Benedetti et al., 2005; Colombo et al., 2000; Wu et al., 2009).”
From Biological rhythms, higher brain function, and behavior: Gaps, opportunities, and challenges (2009) · cites this paper as Colombo et al., 2000
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Self-citation
Metadata
- Authors
- Colombo, C., Lucca, A., Benedetti, F., Barbini, B., Campori, E., & Smeraldi, E.
- Affiliations
- University of Milan (IT)
- Corresponding author
- Benedetti, Francesco
- Venue
- Psychiatry Research
- Publisher
- Elsevier BV
- Published
- 2000-07
- Volume
- 95
- Issue
- 1
- Pages
- 43-53
- ISSN
- 0165-1781 (ISSN-L)
- OpenAlex
- W1987673504
- Cited by
- 139
- References
- 44
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 3 · 2022: 4 · 2021: 2 · 2020: 9 · 2019: 5 · 2018: 5 · 2017: 6 · 2016: 6 · 2015: 7 · 2014: 5 · 2013: 9 · 2012: 7
- FWCI
- 3.72
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatry Research (publishedVersion)
- PubMed (publishedVersion)
- Archivio Istituzionale della Ricerca - Università Vita-Salute San Raffaele (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Keywords
- total sleep deprivation, bipolar depression, lithium, phototherapy, morning light exposure, relapse prevention, antidepressant response, subjective sleepiness, Stanford Sleepiness Scale, treatment interaction
- MeSH terms
- Adult, Aged, Bipolar Disorder, Combined Modality Therapy, Depressive Disorder, Female, Humans, Male, Middle Aged, Phototherapy, Psychiatric Status Rating Scales, Sleep Deprivation, Lithium Carbonate, Antimanic Agents
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