Circadian rhythm and sleep management is proving key in the effective treatment of major depressive disorder and bipolar disorder¹. The techniques provide a potent nonpharmacologic adjunct or alternative to standard medication regimens, ECT and psychotherapy. The methods promise faster inpatient and outpatient improvement, higher remission rate with fewer residual symptoms, and shorter hospital stays². It is both cost effective and in the patient’s interest.

Implementation of chronotherapeutics requires a commitment to innovation on the hospital ward, and staff training in the three central procedures: light therapy, wake therapy (sleep deprivation) and sleep phase advance therapy. The acute protocol requires six days or less, usually shortly after hospital admission, although it is also appropriate during extended hospitalization in treatment-resistant cases.

Chronotherapeutics Consultants was established in 2005 to assist hospitals and the managed care industry in launching these procedures on site. The first treatment manual for chronotherapeutics³ has been published in 2009, providing a hands-on basis for unterstanding and implementing the techniques. To complement this reading, we provide staff seminars, protocol guidelines and case consultation. We also host visits to a hospital ward where the procedures are in place, and provide recommended light treatment apparatus.

Psychiatrists and institutions are invited to contact us for further information: cc@cet.org.

¹ Wirz-Justice A, Benedetti F, Berger M, Lam RW, Martiny K, Terman M & Wu JC (2005) Chronotherapeutics (light and wake therapy) in affective disorders. Psychological Medicine, 35: 939-944.

² Benedetti F, Barbini B, Colombo C & Smeraldi E (2007) Chronotherapeutics in a psychiatric ward. Sleep Medicine Reviews, 11: 509–522.

³ Wirz-Justice A, Benedetti F & Terman M (2009) Chronotherapeutics for Affective Disorders. A Clinician’s Manual for Light and Wake Therapy. Basel: S.Karger AG.