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Sleep deprivation therapy: A rapid-acting antidepressant
Published in S.R. Pandi-Perumal, Meera Narasimhan, Milton Kramer, Sleep and Psychosomatic Medicine, 2017
Sleep deprivation therapy (SDT), also referred to as “wake therapy,” is a robust, rapid-acting (within 24–48 hours), noninvasive antidepressant treatment. First proposed by Schulte1 and Pflug and Tolle,2 SDT has been administered to more than 2000 patients worldwide. One night of enforced sleep loss significantly decreases depressive symptoms in approximately 40%–60% of depressed patients and can be administered as an adjunctive treatment to ongoing medications.3
Predictors of response to combined wake and light therapy in treatment-resistant inpatients with depression
Published in Chronobiology International, 2018
Mette Kragh, Erik Roj Larsen, Klaus Martiny, Dorthe Norden Møller, Camilla Schultz Wihlborg, Tove Lindhardt, Poul Videbech
This study demonstrated that 41% of the patients responded to the treatment by the end of the wake therapy sessions. However, markedly higher response and remission rates were seen in a study by Martiny et al. as they found a response rate of 75% and a remission rate of 59% at Day 5 (Martiny et al. 2013). By comparison, the numbers were 41% and 19% in our study at a comparable day (the day after the last wake therapy). These differences are probably caused by differences in study populations as the participants in the study by Martiny and colleagues were less treatment-resistant compared with our patients. In their study, treatment resistance was thus found in 62.3% of the patients with a mean treatment resistance score of 6.4. In contrast, all our patients were treatment-resistant with a mean score of 7.1. Furthermore, the patients in the study by Martiny et al. received less medication. In our study, 41% of the patients received quetiapine during the study period, whereas only one patient (3%) in their study did. Research has suggested antipsychotic drugs could abolish the effect of wake therapy (Martiny 2016) and therefore the smaller effect found in our study could potentially be due to more extensive use of quetiapine. However, we were not able to find any significant differences in effect when comparing patients receiving quetiapine with those that did not.
Short-term effects of wake- and bright light therapy on sleep in depressed youth
Published in Chronobiology International, 2018
Inken Kirschbaum, Joana Straub, Stephanie Gest, Martin Holtmann, Tanja Legenbauer
However, those effects decline in the second week, in which sleep parameters did not differ between groups anymore. Thus, in line with the study of Gest et al. (2015), WT had no additional effect on BLT compared to BLT only with with respect to sleep parameters concerning objective and subjective sleep parameters (Hypothesis 2). Since it is well known from literature (Wirz-Justice et al., 2009) that WT is frequently followed by recovery sleep, which leads to relapses in turn, one night of WT might have been too little to result in longer lasting positive effects. Therefore, repeated nights of WT (e.g., one night of WT in the first and another night of WT in the second week) might be more promising (Martiny et al., 2015). A second possibility to prevent from relapsing might be a short phase advance of sleep over 3 days following a single night of wake therapy (Wirz-Justice et al., 2005). Third, one single night of sleep deprivation might inhibit, rather than stabilize, the positive response to BLT and as a consequence of that its antidepressant effect. Fourth, it might be concluded that WT is not as effective in adolescents as it is in adults, possibly due to the developmental changes in chronotype from child- to adulthood (Roenneberg et al., 2004; s. introduction). Thus, further research is urgently needed to examine the role of WT in the treatment of depressed adolescents.