By Anna Wirz-Justice, F. Benedetti, M. Terman
Read Online or Download Chronotherapeutics for Affective Disorders: A Clinician's Manual for Light and Wake Therapy PDF
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Extra resources for Chronotherapeutics for Affective Disorders: A Clinician's Manual for Light and Wake Therapy
In some patients, a 30-min session at 10,000 lx upon awakening will be effective within days, while others will require dose increments. In adjusting dose, the clinician must look for side effects including autonomic hyperactivation, headache and nausea. In bipolar 1 depression, light therapy is never administered without a mood stabiliser, but the clinician must remain alert to manic switches or mixed states. The method has been widely used as monotherapy in outpatients, but is more commonly combined with standard antidepressant medication in both inpatients and outpatients.
The melatonin assay remains primarily a research tool, even though such a kit has been developed and is already used in sleep medicine (fig. 16). 73; fig. 20). Healthy subjects without depression show a similar relationship. One thus can schedule morning light exposure at individually determined circadian times by estimating the time of melatonin onset from the MEQ score, a strategy that facilitates circadian rhythm phase advances and antidepressant response (fig. 21). Given the spread of DLMOs around the regression line (fig.
However, after the first wake therapy she experienced rapid and complete amelioration of the depressive syndrome leading to perceived euthymia in the early morning. The first recovery sleep was followed by a partial but definite depressive relapse. The second wake therapy led again to perceived euthymia, without relapse after recovery sleep, a benefit sustained after the third wake therapy. Euthymia persisted over the following days and the patient was discharged. 75 mEq/l. Nine years later, the patient is still euthymic.