Phase advance is an actimetric correlate of antidepressant response to sleep deprivation and light therapy in bipolar depression

Francesco Benedetti, Sara Dallaspezia, Mara Cigala Fulgosi, Barbara Barbini, Cristina Colombo, Enrico Smeraldi

Research output: Contribution to journalArticle

Abstract

The combination of total sleep deprivation (TSD) and light therapy (LT) in bipolar depression causes rapid antidepressant effects, and its mechanism of action has been hypothesized to involve the enhancement of all of the monoaminergic systems targeted by antidepressant drugs (serotonin, dopamine, norepinephrine). It is still unknown if the clinical effects are paralleled by changes in biological rhythms. In a before/after design of a study of biological correlates of response, 39 inpatients affected by Type I Bipolar Disorder whose current depressive episode was without psychotic features were treated for one week with repeated TSD combined with morning LT. Wrist actigraphy was recorded throughout the study. Two-thirds of the patients responded to treatment (50% reduction in Hamilton Depression score). Responders showed an increase in daytime activity, phase-advance of the activity-rest rhythm of 57 min compared to the pre-treatment baseline, and reduced nighttime sleep. Non-responders did not show significant changes in the parameters of their activity-rest rhythm. Phase advance of the activity-rest rhythm is an actimetric correlate of the antidepressant response to TSD and LT in bipolar depression. Results are consistent with the known effects of sleep-wake manipulations and neurotransmitter function on the suprachiasmatic nucleus.

Original languageEnglish
Pages (from-to)921-937
Number of pages17
JournalChronobiology International
Volume24
Issue number5
DOIs
Publication statusPublished - Sep 2007

Keywords

  • Antidepressant treatment
  • Bipolar disorder
  • Light therapy
  • Phase advance
  • Sleep deprivation

ASJC Scopus subject areas

  • Agricultural and Biological Sciences (miscellaneous)
  • Physiology
  • Physiology (medical)

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