SYMPOSIA
SYMPOSIA
SYMPOSIA
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Symposium Title: Chronobiotics and chronotherapeutics in psychiatry<br />
The use of sleep deprivation in the treatment of depressive disorders<br />
Adem Aydın<br />
Department of Psychiatry, Yuzuncu Yıl University, Van, Turkey<br />
E-mail: adem.dr@gmail.com<br />
Bulletin of Clinical Psychopharmacology, Vol: 21, Supplement: 2, 2011 - www.psikofarmakoloji.org<br />
Abstracts of the Invited Speakers<br />
Sleep deprivation has been used for exploring functions of sleep among healthy individuals and for treating patients suffering from<br />
depressive symptoms. Sleep deprivation is a rapid, effective and brief therapeutic alternative. Two types of sleep deprivation applications<br />
have been implemented; one is deprivation of sleep for whole night and the other is partial deprivation of sleep in the second part of<br />
the night. Although various hypotheses have been developed pertaining to the treatment potential of sleep deprivation in depression,<br />
the mechanisms underlying the process are still obscure (1). Early systematic research conducted by Pflug and Tolle proposed that<br />
patients characterized by endogenous depressive symptoms receptive to sleep deprivation have deficits in their circadian systems and<br />
sleep deprivation aids at ameliorating the dysregulation in the biological rhythm (2). Sleep deprivation and REM sleep deprivation act<br />
like antidepressants and some antidepressants have suppressing effects on REM sleep. Hence the role of REM sleep on the development<br />
of depression has received more attention. The reduction of REM latency and REM intensity are prominent features in patients with<br />
depression. Sleep deprivation reverses these two effects (3).<br />
The psychological response to sleep deprivation seems to occur regardless of diagnostic category such as endogenous-reactive,<br />
psychotic, nonpsychotic, unipolar, bipolar, schizoaffective, or seasonal (4). Merely diurnal variation (soothing of affect is typical in patients<br />
with depression in the later hours of daytime) and chronobiological differences are substantial in the psychological response to sleep<br />
deprivation (5).<br />
About 50-60 percent of patients with depression are prone to reflect antidepressant influences after one-night of sleep deprivation<br />
therapy. Deceleration in symptom severity as well as amelioration in suicidal thoughts occurs. The temporary antidepressant influence of<br />
the initial application does not predict inadequacy of further applications. If applications of sleep deprivation are continued one or two<br />
times per week, it has been claimed that it is likely to provide effective prophylaxis (6).<br />
Although sleep deprivation provides a rapid psychological response and a potent influence, its application is not prominent in major<br />
depression. Sleep deprivation can be qualified as an awkward method, because the application requires constant monitoring and to<br />
ensure wakefulness of patients as well as carrying a relapse risk in fiesta. The most prominent advantage of sleep deprivation compared<br />
to other medications and ECT is that it causes rapid and apparent improvement in affect. Therefore the pros and cons of sleep deprivation<br />
should be taken into account in treatment planning.<br />
Key words: Depression, sleep deprivation, treatment<br />
References:<br />
1. Rechtschaffen A. Current perspectives on the function of sleep. Perspect Biol Med 1998;41:359-390.<br />
2. Pflug B, Tolle R. Disturbance of the 24 hour rhythm in endogenous depression and treatment of endogenous depression by sleep deprivation. Int<br />
Pharmacopsychiatry 1971;6:187-196.<br />
3. Giedke H, Schwarzler F. Therapeutic use of sleep deprivation in depression. Sleep Med Rev 2002;6:361–377.<br />
4. Wirz-Justice A. Biological rhythm disturbances in mood disorders. Int Clin Psychopharmacol 2006;21:11-5.<br />
5. Selvi Y, Gulec M, Agargun MY, Besiroglu L. Mood changes after sleep deprivation in morningness–eveningness chronotypes in healthy individuals. J Sleep Res<br />
2007;16:241–4.<br />
6. Hemmeter UM, Hemmeter-Spernal J, Krieg JC. Sleep deprivation in depression. Expert Rev Neurother 2010;10(7):1101-15.<br />
Bulletin of Clinical Psychopharmacology 2011;21(Suppl. 2):S87<br />
S87