Chronotherapeutics (light and wake therapy) in affective disorders

Wirz‐Justice, Anna; Benedetti, Francesco; Berger, Thomas; Lam, Raymond W.; Martiny, Klaus; Terman, Michael; Wu, Joseph C.

doi:10.1017/s003329170500437x

Cited by 228 publications

(120 citation statements)

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“…Several studies also indicate that light therapy can be equally effective in treating non-seasonal depression, as well as many other mood disorders . It is thought that light therapy works by shifting the circadian clock, and indeed light therapy given in the morning will produce a phase advance in rhythms while light in the evening produces a phase delay (Wirz-Justice et al, 2005). The potential for light therapy as an effective treatment for a whole spectrum of mood disorders is appealing because it is safe, has few side effects, is relatively easy to use, and is noninvasive.…”

Section: Bright Light Therapymentioning

confidence: 99%

Circadian genes, rhythms and the biology of mood disorders

McClung

2007

Pharmacology & Therapeutics

585

386

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For many years, researchers have suggested that abnormalities in circadian rhythms may underlie the development of mood disorders such as bipolar disorder, major depression and seasonal affective disorder. Furthermore, some of the treatments that are currently employed to treat mood disorders are thought to act by shifting or "resetting" the circadian clock, including total sleep deprivation and bright light therapy. There is also reason to suspect that many of the mood stabilizers and antidepressants used to treat these disorders may derive at least some of their therapeutic efficacy by affecting the circadian clock. Recent genetic, molecular and behavioral studies implicate individual genes that make up the clock in mood regulation. As well, important functions of these genes in brain regions and neurotransmitter systems associated with mood regulation is becoming apparent. In this review, the evidence linking circadian rhythms and mood disorders, and what is known about the underlying biology of this association, is presented.

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Section: Bright Light Therapymentioning

confidence: 99%

Circadian genes, rhythms and the biology of mood disorders

McClung

2007

Pharmacology & Therapeutics

585

386

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“…Light therapy has been applied to a wide range of mood disorders as standalone therapy or as an adjunct to antidepressant pharmacotherapy [90]. Light acts as a synchronizing agent for disturbed circadian rhythms, while sleep deprivation challenges the sleep-wake homeostat [91,92]. Table 2 summarizes the main chronobiological therapies employed for depressive disorders.…”

Section: Chronobiological Treatments For Sleepiness and Depressionmentioning

confidence: 99%

“…Current opinion is that partial sleep deprivation (PSD) in the second half of the night is equally effective as TSD. Sleep deprivation may hasten the onset of antidepressant medication action and repeated trials of SD can also be an efficient treatment strategy in drug refractory depression [37,91,92]. Given that insomnia associated or not with EDS is such a prominent feature of depression, further investigations may consider track- ing EDS as a concomitant outcome measure of sleep deprivation therapy for depression.…”

Section: Chronobiological Treatments For Sleepiness and Depressionmentioning

confidence: 99%

Chronobiology, excessive daytime sleepiness and depression: Is there a link?

2009

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The complaint of excessive daytime sleepiness (EDS), commonly encountered in clinical practice, may arise from a variety of psychiatric disorders, most importantly depression. Even though EDS frequently leads depressed patients to seek medical assistance, it is commonly under-evaluated and under-diagnosed. Therefore, a comprehensive understanding and management of EDS is essential in the clinical assessment of depression. Within a theoretical framework, a chronobiological approach may shed new light on the complex interaction of EDS and depression. In this review, studies on EDS and depression are summarized and discussed within the context of circadian and sleep regulatory mechanisms. Furthermore, potential chronobiological therapeutic strategies are proposed to address some of the unmet needs in the treatment of EDS and depression.

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“…Patients with seasonal affective disorders (SAD) have depressive symptoms during the winter months when daylight is shorter. The bright light therapy has been effectively used to treat SAD (Lam, 2006) and nonseasonal depression and is thought to work by shifting the circadian clock (Wirz-Justice et al, 2005). Similar to 5-HT, melatonin is derived from tryptophan and is a critical regulator of circadian rhythm.…”

Section: Sleep and Circadian Rhythmmentioning

confidence: 99%