Wake and light therapy for moderate‐to‐severe depression – a randomized controlled trial

Abstract

The antidepressant effect initially achieved could not be maintained during the nine-week study period. However, sleep and general self-efficacy improved.

Sleep deprivation as treatment for depression: Systematic review and meta‐analysis

“…Four RCTs reported statistically significant differences between the treatment groups regarding depressive symptoms during the first week. In three studies, results were in favour of SD 16,24,26 and in one study in favour of the comparator 15 . A meta‐analysis of the post‐treatment HDRS data during the first week was statistically non‐significant for SD combined with standard treatment compared with standard treatment only (SMD = −0.29 [95% CI: −0.84 to 0.25], p = 0.29), with substantial heterogeneity in the analysis ( I 2 = 70%) (Figure 2).…”

“…Six RCTs with a total of 215 patients 15–17,23,24,26,27 and one cohort study 38 in 49 patients compared SD as add‐on to standard treatment. Antidepressant medication was used as standard treatment in all studies except in one RCT where CBT was used 17,27 .…”

“…Furthermore, two studies had small sample sizes limiting the precision 17,24 . Two studies combined SD with chronotherapeutic interventions (light therapy, sleep time stabilization) 16,26 …”

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

“…Another controlled randomized trial showed a faster reduction of depressive symptoms in patients treated by TSD with sleep time stabilization and BLT during pharmacotherapy compared with those who received drugs only. Subjects treated in an integrated way achieved higher general self-efficacy and better sleep maintenance and they less often slept during the daytime [30]. There are reports on the efficacy of SD combined with other chronotherapeutic methods in the therapy for treatment-resistant depression (TRD) [31].…”

Chronobiology comes of age

“…Mette Kragh and colleagues have carried out an exacting and ambitious randomised controlled trial to investigate whether hospitalised therapy‐resistant moderate‐to‐severe depressive patients can profit from adjunct light and sleep deprivation (now more kindly called wake therapy). The findings are important for clinicians to move towards predictors of response and selection of patients to whom these unusual and quite demanding techniques might best apply.…”