About Chronotherapy

How long does the diagnostic assessment take?
This depends on a variety of clinical factors for each patient. Our typical evaluation takes between three to four sessions with additional time required for questionnaire completion.

What is the cost of triple chronotherapy?
Please contact our office for questions about our fees.

Do all your patients get triple chronotherapy?
Absolutely not. Treatments are recommended on the basis of a person's specific diagnostic picture. When we do prescribe wake therapy, we always use it in conjunction with bright light therapy and sleep phase advance. This protocol is based on research findings of greater effectiveness when the three treatments are combined. We will frequently use bright light therapy, dawn simulation or melatonin as single, stand-alone treatments.

Is Wake Therapy done with one person at a time?
It can either be done individually or in small groups. Many patients find it helpful to have other individuals present during their long hours of wakefulness.

If Wake Therapy is so effective, why isn't it used more frequently in the U.S.?
Fascinating, complicated question with many answers.

First, there is no pharmaceutical industry support for research involving chronotherapy. This reduces the resources available for scientific study of this area, the number of publications, and the overall profile in the psychiatric community.

Second, chronotherapy is not reimbursed by Medicare or other private insurance companies in the U.S. at this time.

Third, until recently, individuals seeking wake therapy required inpatient hospitalization.

Fourth, the notion of staying awake for an extended period in order to switch out of depression is counterintuitive, and may sound difficult or overly taxing before it is experienced.

Fifth, wake therapy is the ultimate low-tech treatment. Many people are attracted to therapies that use advanced devices such as TMS.

Last, the level of research on wake therapy has been spare, and of inconsistent quality despite its dramatic clinical results.

Why can't I try staying awake on my own?
First, we feel that depression is a serious condition that warrants professional care. Treating oneself just isn't a good idea.

Second, wake therapy, like any other antidepressant treatment, has side-effects. In particular, approximately 7% of patients undergoing Wake Therapy develop hypomanic or manic symptoms. When carefully monitored and detected early, these are relatively easy to manage. Attempting to do this on one's own would be hazardous.

Last, most pointedly, staying up for prolonged periods on one's own while depressed can be extremely challenging. Falling asleep or dozing is hard to avoid. Doing this in a comfortable environment with numerous activities to engage in and staff who provide continual support is a critical part of this process.

What is the relationship between your practice and the Center for Environmental Therapeutics?
We collaborate with C.E.T. We have worked together to design elements of our chronotherapy program. The Directors of C.E.T., Dr's Francesco Benedetti, Dan Oren, Michael Terman, and Anna Wirz-Justice are providing ongoing support and guidance as we introduce this unique program to the United States.

Please feel free to contact us with any other questions you may have.