Light and dark as a “drug”

Wirz‐Justice, Anna

doi:10.1007/978-3-0348-9289-6_12

Cited by 7 publications

(3 citation statements)

References 106 publications

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“…Light has been referred to as a drug with respect to its effects on alertness, sleep timing and mood [ 75 ]. Bright light, preferably sunlight, or artificial full spectrum white light has immediate alerting effects as well as phase-shifting effects on the circadian system [ 76 , 77 ].…”

Section: Stimulantsmentioning

confidence: 99%

Approaches to the Pharmacological Management of Jet Lag

Arendt

2018

Drugs

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For many years now a treatment mitigating the debilitating effects of jet lag has been sought. Rapid travel across time zones leads, in most people, to temporary symptoms, in particular poor sleep, daytime alertness and poor performance. Mis-timed circadian rhythms are considered to be the main factor underlying jet-lag symptoms, together with the sleep deprivation from long haul flights. Virtually all aspects of physiology are rhythmic, from cells to systems, and circadian rhythms are coordinated by a central pacemaker or clock in the suprachiasmatic nucleus (SCN) of the hypothalamus. The SCN adapts slowly to changes in time zone, and peripheral clocks or oscillators adapt at different rates, such that the organism is in a state of desynchrony from the external environment and internally. Light exposure is the main factor controlling the circadian system and needs to be considered together with any pharmacological interventions. This review covers the relatively new chronobiotic drugs, which can hasten adaptation of the circadian system, together with drugs directly affecting alertness and sleep propensity. No current treatment can instantly shift circadian phase to a new time zone; however, adaptation can be hastened. The melatoninergic drugs are promising but larger trials in real-life situations are needed. For short stopovers it is recommended to preserve sleep and alertness without necessarily modifying the circadian system. New research suggests that modification of clock function via genetic manipulation may one day have clinical applications.

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Section: Stimulantsmentioning

confidence: 99%

Approaches to the Pharmacological Management of Jet Lag

Arendt

2018

Drugs

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“…30 Investigations regarding classical antidepressants are still scarce, however, and the respective results are inconsistent. 31 Furthermore, there is no evidence of a phase delay of hormonal rhythms (melatonin as well as cortisol) during a 3-week trial with the tricyclic antidepressant desipramine in human subjects; rather, there is a trend in the opposite direction. 32 …”

Section: Phasementioning

confidence: 99%

Circadian Rhythm Disturbances in Affective Disorders: Facts and Fictions

Zerssen¹,

Dirlich²,

Zulley³

1989

New Directions in Affective Disorders

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fjie cycling nature of affective disorders has put these psychopathological con-[tions into the focus of medical chronobiology. However, our knowledge is still tther limited in this respect, and too often casual observations and theoretical eculations are accepted as proving profound disturbances of biological (above |, circadian) rhythms in these disorders. It is our intention to evaluate critically gjfb present State of knowledge in this field in order to disentangle proved facts om mere fictions. Particular reference is made to carefully designed observations laffectively ill patients in a time-cue-free environment, as they provide the only |id basis for conclusions regarding the endogenous component of biological |thms. Only those hypotheses are discussed that have drawn most attention in tronobiological research to affective disorders.jssumed Disturbances of Circadian Rhythms hiod 3id cycling in bipolar affective illness was explained by Halberg 1 as a beat phetenon due to the interaction of circadian rhythms entrained to the 24-h routine Jäily life with a free-running rhythm of, for example, adrenocortical activity. cycle length of psychopathology should then be predictable from the period this nonentrained and the entrained (24-h) rhythm-or vice versa: The period ;the free-running circadian rhythm should be predictable from the 24-h period äntrained circadian rhythms and the period of the cycles of the mental disorder. >This concept was demonstrated rather than validated on the basis of data from gle case study in a rapid cycler. 2 Later it was supported by self-assessed oral gerature data in an outpatient suffering from rapidly cycling bipolar affective |s. 3 The same authors also reported the occurrence of free-running biological s in other outpatients with rapidly cycling manic-depressive disease who Aken the measurements themselves during the illness. Unfortunately, it cannot Huded that the abnormalities were entirely caused by unreliable data due to iental state in which the patients took the measurements. jf| e hght is thrown on this problem by case reports from another group of phers. They had found a 22.5-h component in addition to the 24-h component

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“…The results of chronotherapeutic strategies are promising and will undoubtedly garner much interest in the coming years (Wirz-Justice, 1987, 2009). Well-conducted, large-scale clinical trials are warranted to further assess the efficacy and safety of chronobiotics/chronotherapy in the treatment of certain sleep disorders.…”

mentioning

confidence: 99%