Augmentation of Pharmacotherapy by Sleep Deprivation with Sleep Phase Advance in Treatment-Resistant Depression

Kurczewska, Ewa; Ferensztajn‐Rochowiak, Ewa; Jasińska-Mikołajczyk, Anna; Chłopocka-Woźniak, M

doi:10.1055/a-0695-9138

Cited by 15 publications

(8 citation statements)

References 57 publications

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“…Two of these were obtained through contacting the authors directly for their pre-and post-treatment outcome data. 20,23 Notably, one study 25 used late partial sleep deprivation (PSD) exposure with 3 h time-in-bed (2300 h-0200 h) instead of total sleep deprivation (TSD); we decided to include this study in the analysis since this duration of PSD has been shown to be equivalent to TSD in terms of therapeutic response. 9 3.1 | Meta-analyses: primary outcomes Table 1 shows the key characteristics of each of the final included studies.…”

Section: Data Analysesmentioning

confidence: 99%

Meta‐analysis of sleep deprivation in the acute treatment of bipolar depression

Gottlieb

Goel

Chen

et al. 2020

Acta Psychiatr Scand

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Depression dominates the clinical presentation of bipolar disorders, occupying the vast majority of the syndromal and subsyndromal affective burden of this illness. 1 In addition to the symptoms themselves, bipolar depression (BPD) is associated with cognitive impairment, occupational disability, medical morbidity, and suicide. 2 The treatment options for BPD are limited by suboptimal efficacy, pharmacologic side effects, mood destabilization, and delayed therapeutic response. 3 Although pharmacotherapies are the predominant modality of treatment, alternative biological interventions are also available. Chronotherapeutic treatments are a set of interventions that are thought to act on the biological clock. In psychiatry, these interventions are used primarily in the management of affective illness. 4

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Section: Data Analysesmentioning

confidence: 99%

Meta‐analysis of sleep deprivation in the acute treatment of bipolar depression

Gottlieb

Goel

Chen

et al. 2020

Acta Psychiatr Scand

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“…However, the probability of type II error should be considered very low with regard to the observed numerical difference (i.e., the control group showed statistically significant and higher symptom reduction than the TSD/BLT group). Moreover, recent studies on combined chronotherapy have reported lower response rates (20,39,44,58) than the presumed average of 50% (45) with the exception of two cohort studies (22,62). Both groups showed improvement at week 1.…”

Section: Limitationsmentioning

confidence: 80%

Total Sleep Deprivation Followed by Bright Light Therapy as Rapid Relief for Depression: A Pragmatic Randomized Controlled Trial

et al. 2021

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Background: Total sleep deprivation (TSD) combined with bright light therapy (BLT) has been suggested as a valuable add-on to standard treatment for rapid relief of depression. However, there is a lack of randomized controlled trials in real-life clinical settings. The aim of this pragmatic randomized clinical trial was to investigate the effectiveness, acceptance, and feasibility of TSD combined with BLT as add-on to standard treatment for depression in a real-life clinical setting.Methods: Thirty-three inpatients were randomly assigned to either: a) an intervention group receiving a single-night TSD followed by 6 days BLT (10.000 lux, 30 min/day) as add-on to standard treatment; or b) a control group receiving a short sleep-hygiene consultation in addition to standard treatment. The follow-up period was 1 week.Results: No statistical differences were found in response rates, reduction of depressive and insomnia symptoms, length of stay, readmission rate, and clinical improvement. Both groups reported positive experiences toward the received treatment with low drop-out rates.Conclusions: One-night TSD followed by BLT was not effective as a rapid relief for depression at 1-week follow-up; however, the treatment was feasible and well-tolerated.

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“…Long-term accumulation of high levels of glucocorticoids is a direct cause of depression (Zheng et al, 2019). Also, high levels of IL-1β in the brain can directly damage neurons or alter the internal environment in which neurons survive, impairing the ability of neurons to regenerate and repair and causing depression (Kurczewska et al, 2019;. IL-1β can also affect the 5-HT system, and one possi-ble mechanism for these effects is that IL-1β mediated reduction of 5-HT concentrations in synaptic space through the promotion of 5-HT reuptake in midbrain and striatum (Zhang et al, 2007).…”

Section: Discussionmentioning

confidence: 99%

Antidepressant-like mechanism of honokiol in a rodent model of corticosterone-induced depression

Zhang¹,

Yu²,

Liu³

et al. 2020

J. Integr. Neurosci.

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Depression is closely linked to hypothalamus-pituitaryadrenal axis hyperactivity. Honokiol, a biphenolic lignan compound obtained from the traditional Chinese medicine Magnolia officinalis, can reduce the activity of the hypothalamus-pituitary-adrenal axis and improve depression-like behavior caused by hypothalamuspituitary-adrenal axis hyperactivity. The current study investigated the specific mechanism of action of this effect. A depression model was established by repeated injections of corticosterone to study the antidepressantlike effect of honokiol and its potential mechanism. Honokiol prevented the elevated activity of the hypothalamuspituitary-adrenal axis and the depression-like behavior induced by corticosterone. Treatment with honokiol resulted in greater glucocorticoid receptor mRNA expression, greater glucocorticoid receptor-positive expression, and a greater ratio of glucocorticoid receptor to the mineralocorticoid receptor in the hippocampus. Moreover, honokiol treatment led to lower levels of interleukin-1β in serum and the positive expression of the interleukin-1β receptor in the hippocampus. These results demonstrate that the antidepressant-like mechanism of honokiol, which has effects on inflammatory factors, may act through restoring the typical activity of the hypothalamus-pituitary-adrenal axis by regulating the glucocorticoid receptor-mediated negative feedback mechanism and the balance between glucocorticoid and mineralocorticoid receptors.

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Augmentation of Pharmacotherapy by Sleep Deprivation with Sleep Phase Advance in Treatment-Resistant Depression

Abstract: Our preliminary study demonstrated the efficacy of pharmacotherapy augmentation by TSD and SPA in half of the patients with TRD. The main biochemical factors related to clinical response included status of cortisol and increase in IL-10 and IL-1β levels.

Cited by 15 publications

References 57 publications

Meta‐analysis of sleep deprivation in the acute treatment of bipolar depression

Meta‐analysis of sleep deprivation in the acute treatment of bipolar depression

Total Sleep Deprivation Followed by Bright Light Therapy as Rapid Relief for Depression: A Pragmatic Randomized Controlled Trial

Antidepressant-like mechanism of honokiol in a rodent model of corticosterone-induced depression

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