Speed:
Wake Therapy is the most rapid antidepressant treatment in current clinical use. [1]
Compared to standard antidepressant treatments that usually require between 2 to 8 weeks to show effects, Wake Therapy produces improvement within hours.
While not as ultra-fast as Wake Therapy, the therapeutic response to light treatment is often evident after several days and is typically complete after one to three weeks. [2, 3, 4]
Effectiveness:
Wake Therapy
In over 150 studies, treating almost 4000 patients over the last 40 years, research has found an
acute reduction in depression in 50 to 60% of patients. [5, 6]
Broadly active in most depressive subtypes including unipolar, bipolar, and melancholic forms.
Bright Light Therapy
Recognized by the American Psychiatric Association as a first-line treatment for Seasonal Affective Disorder. [7, 8]
Comparable effectiveness to antidepressants in non-seasonal depression. [9]
Sustained Response:
When used with one of several other chronotherapeutic interventions and/or psychiatric medications, the initial response to Wake Therapy becomes cemented, generating a sustained remission that can last for months. [10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21]
Safety:
As a biological treatment, chronotherapy shares the same psychiatric risks as any other antidepressant treatment. [22]
As a non-pharmacologic therapy, it avoids the drug side-effects associated with medications.
Non-Pharmacologic Treatment:
Though chronotherapy is often used with antidepressant and/or mood-stabilizing medications, it can be used on its own, affording the option of a fully non-pharmacologic treatment.
Time-Specific Activity:
The therapeutic action of chronotherapeutic treatment depends on its time of administration.
Time-sensitive treatments and chronotherapeutic principles are increasingly being used in cardiology, oncology and sleep medicine. [23, 24, 25, 26, 27, 28]
References
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2. Kripke, D.F., Light treatment for nonseasonal depression: speed, efficacy, and combined treatment. Journal of Affective Disorders, 1998. 49(2): p. 109-117.
3. Lam, R.W., et al., The Can-SAD study: a randomized controlled trial of the effectiveness of light therapy and fluoxetine in patients with winter seasonal affective disorder. American Journal of Psychiatry, 2006. 163(5): p. 805-12.
4. Terman, M., J.S. Terman, and D.C. Ross, A Controlled Trial of Timed Bright Light and Negative Air Ionization for Treatment of Winter Depression. Archives of General Psychiatry, 1998. 55(10): p. 875-882.
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7. Westrin, A., et al., Seasonal affective disorder: a clinical update. Annals of Clinical Psychiatry, 2007. 19(4): p. 239-46.
8. Association, A.P., Practice Guidelines for the Treatment of Psychiatric Disorders. Compendium 2006. 2006.
9. Golden, R.N., et al., The efficacy of light therapy in the treatment of mood disorders: a review and meta-analysis of the evidence. American Journal of Psychiatry, 2005. 162(4): p. 656-62.
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15. Berger, M., et al., Sleep deprivation combined with consecutive sleep phase advance as a fast-acting therapy in depression: an open pilot trial in medicated and unmedicated patients. The American Journal Of Psychiatry, 1997. 154(6): p. 870-872.
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18. Benedetti, F., et al., Antidepressant effects of light therapy combined with sleep deprivation are influenced by a functional polymorphism within the promoter of the serotonin transporter gene. [see comment]. Biological Psychiatry, 2003. 54(7): p. 687-92.
19. Neumeister, A., et al., Bright light therapy stabilizes the antidepressant effect of partial sleep deprivation. Biological Psychiatry, 1996. 39(1): p. 16-21.
20. Loving, R.T., et al., Bright light augments antidepressant effects of medication and wake therapy. Depression & Anxiety, 2002. 16(1): p. 1-3.
21. Moscovici, L., et al., A multistage chronobiologic intervention for the treatment of depression: a pilot study. Journal of Affective Disorders, 2009. 116(3): p. 201-7.
22. Colombo, C., et al., Rate of switch from depression into mania after therapeutic sleep deprivation in bipolar depression. Psychiatry Research, 1999. 86(3): p. 267-70.
23. Abolmaali, K., et al., Circadian variation in intestinal dihydropyrimidine dehydrogenase (DPD) expression: a potential mechanism for benefits of 5FU chrono-chemotherapy. Surgery, 2009. 146(2): p. 269-73.
24. Liao, C., et al., Chronomodulated chemotherapy versus conventional chemotherapy for advanced colorectal cancer: a meta-analysis of five randomized controlled trials. International Journal of Colorectal Disease, 2010. 25(3): p. 343-50.
25. Morgan, T.O. and T.O. Morgan, Does it matter when drugs are taken? Hypertension, 2009. 54(1): p. 23-4.
26. Block, K.I., et al., Making circadian cancer therapy practical. Integrative Cancer Therapies, 2009. 8(4): p. 371-86.
27. Morgenthaler, T.I., et al., Practice parameters for the clinical evaluation and treatment of circadian rhythm sleep disorders. An American Academy of Sleep Medicine report. Sleep, 2007. 30(11): p. 1445-59.
28. Reid, K.J., et al., Circadian rhythm disorders. Seminars in Neurology, 2009. 29(4): p. 393-405.