I already use light and melatonin to help my patients with jet lag and to readjust their circadian rhythm,
but it won’t be long before I try triple chronotherapy for my depressed patients who don’t get better with antidepressants.
In one study of 60 hospitalized patients with bipolar depression who were taking antidepressants or lithium, 70 percent of those who did not have a history of drug resistance improved rapidly with sleep deprivation
and early morning light, and 57 percent remained well after nine months.
So now you know the fix for jet lag: Travel east and you’ll need morning light
and evening melatonin; go west and you’ll need evening light and morning melatonin.
Some 15 years ago, Dr. Francesco Benedetti, a psychiatrist in Milan, and colleagues noticed
that hospitalized bipolar patients who were assigned to rooms with views of the east were discharged earlier than those with rooms facing the west — presumably because the early morning light had an antidepressant effect.
Studies show that it is possible to make wake therapy even more powerful by incorporating two additional interventions: early morning light therapy
and what’s called sleep phase advance, in which the patient goes to bed about five to six hours earlier than usual and sleeps for about seven hours.
In another study, investigators combined chronotherapy with psychotropic medication and found
that depressed patients got better within 48 hours — much faster than antidepressants, which typically take four to six weeks to work.