Is Internal Timing Key to Mental Health?.
Science 2007 Sep 14;317(5844):1488-90.
"Although how the technique works is poorly understood, psychiatrists routinely use sleep deprivation to produce a rapid emotional lift in deeply depressed patients, including those hospitalized after a failed suicide attempt. Benedetti and others have shown that this dramatic effect, which invariably vanishes after a day, can be sustained for several weeks by using light therapy to shift the patient’s sleep-wake cycle in the days that follow. The idea again is to bring the circadian rhythms back in alignment. The researchers have reported, in a study published in The Journal of Clinical Psychiatry in 2005, that combining light therapy with initial sleep deprivation can effectively treat bipolar patients" Read article
Phase Advance is an Actimetric Correlate of Antidepressant Response to Sleep
Deprivation and Light Therapy in Bipolar Depression.
Chronobiology International. 2007;24(5):921-37.
Benedetti F, Dallaspezia S, Cigala Fulgosi M, Barbini B, Colombo C, & Smeraldi E.
"The combination of total sleep deprivation (TSD) and light therapy (LT) in bipolar depression causes rapid antidepressant effects."
"TSD was carried out in a room with roughly 80 lux ambient light; patients were administered LT (exposure for 30 min to a 400 lux green light) at 03:00 h during the TSD night and in the morning after recovery sleep, .5 h after awaking.."
"The antidepressant response to repeated TSD and LT treatment in bipolar depression was paralleled by changes in the activity-rest rhythm and sleep, including phase-advance of the acrophase, different pattern of rising activity levels in the morning, higher daytime activity, and reduced nighttime sleep. The repeated TSD and LT treatment could influence the activity-rest rhythm via different mechanisms. Light is a powerful external zeitgeber, and when given in the morning, it advances the phase of the activity-rest rhythm."
Chronotherapeutics in a Psychiatric Ward.
Sleep Med Rev. 2007 Dec;11(6):509-22
Benedetti et al.
"Beneficial antidepressant effects of different chronotherapeutic approaches have been described in all depressive conditions...benefits from LT have been reported in seasonal and non-seasonal major depressive episodes, and in many heterogeneous depressive conditions including the mood fluctuations linked with pregnancy, premenstrual dysphoric disorder, attention deficit hyperactivity disorder, schizophrenia, schizoaffective disorder, alcoholism, Parkinson’s disease, stroke, or Alzheimer disease."
"Acute response rates to chronotherapeutics range from two-third to three-quarters of patients, ... Given that at least 40% of patients treated for depression do not respond to the initial trial of antidepressant drug medication and at least one half of this percentage do not respond satisfactorily to several further treatment trials, the rapid and safe administration of chronotherapeutics should then be tested as a first-line treatment strategy in the majority of depressive syndromes."
"..bipolar patients switch from depression into mania at a lower rate with chronotherapeutics than with antidepressant drugs."
"Chronotherapeutics should therefore be considered the treatment of choice for the depressive phase of bipolar disorder, the safety and efficacy of which has been extensively studied over the years in roughly 500 cases published by our group at the Center of Mood Disorders of the San Raffaele Hospital in Milano"..."Chronotherapeutics can thus be considered powerful therapeutic instruments for the clinical psychiatrist."