Core Features of Psychiatric Chronotherapy
Please note: numbers used in the text indicate scientific references that are located at the bottom of each page of this website. These references can each be clicked to bring up the abstract of the article.

Wake Therapy is the most rapid antidepressant treatment in current clinical use. [1]

Compared to standard antidepressant treatments that usually require between 2 to 8 weeks to show effects, Wake Therapy produces improvement within hours.

While not as ultra-fast as Wake Therapy, the therapeutic response to light treatment is often evident after several days and is typically complete after one to three weeks. [2, 3, 4]


Wake Therapy
In over 150 studies, treating almost 4000 patients over the last 40 years, research has found an acute reduction in depression in 50 to 60% of patients. [5, 6]

Broadly active in most depressive subtypes including unipolar, bipolar, and melancholic forms.

Bright Light Therapy
Recognized by the American Psychiatric Association as a first-line treatment for Seasonal Affective Disorder. [7, 8]

Comparable effectiveness to antidepressants in non-seasonal depression. [9]

Sustained Response:
When used with one of several other chronotherapeutic interventions and/or psychiatric medications, the initial response to Wake Therapy becomes cemented, generating a sustained remission that can last for months. [10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21]

As a biological treatment, chronotherapy shares the same psychiatric risks as any other antidepressant treatment. [22]

As a non-pharmacologic therapy, it avoids the drug side-effects associated with medications.

Non-Pharmacologic Treatment:
Though chronotherapy is often used with antidepressant and/or mood-stabilizing medications, it can be used on its own, affording the option of a fully non-pharmacologic treatment.

Time-Specific Activity:
The therapeutic action of chronotherapeutic treatment depends on its time of administration. Time-sensitive treatments and chronotherapeutic principles are increasingly being used in cardiology, oncology and sleep medicine. [23, 24, 25, 26, 27, 28]


1. Wirz-Justice, A., et al., Chronotherapeutics (light and wake therapy) in affective disorders. Psychological Medicine, 2005. 35(7): p. 939-44.

2. Kripke, D.F., Light treatment for nonseasonal depression: speed, efficacy, and combined treatment. Journal of Affective Disorders, 1998. 49(2): p. 109-117.

3. Lam, R.W., et al., The Can-SAD study: a randomized controlled trial of the effectiveness of light therapy and fluoxetine in patients with winter seasonal affective disorder. American Journal of Psychiatry, 2006. 163(5): p. 805-12.

4. Terman, M., J.S. Terman, and D.C. Ross, A Controlled Trial of Timed Bright Light and Negative Air Ionization for Treatment of Winter Depression. Archives of General Psychiatry, 1998. 55(10): p. 875-882.

5. Giedke, H. and F. Schwarzler, Therapeutic use of sleep deprivation in depression. Sleep Medicine Reviews, 2002. 6(5): p. 361-77.

6. Wu, J. and W. Bunney, The biological basis of an antidepressant response to sleep deprivation and relapse: review and hypothesis. American Journal of Psychiatry, 1990. 147(1): p. 14-21.

7. Westrin, A., et al., Seasonal affective disorder: a clinical update. Annals of Clinical Psychiatry, 2007. 19(4): p. 239-46.

8. Association, A.P., Practice Guidelines for the Treatment of Psychiatric Disorders. Compendium 2006. 2006.

9. Golden, R.N., et al., The efficacy of light therapy in the treatment of mood disorders: a review and meta-analysis of the evidence. American Journal of Psychiatry, 2005. 162(4): p. 656-62.

10. Smeraldi, E., et al., Sustained Antidepressant Effect of Sleep Deprivation Combined with Pindolol in Bipolar Depression: A Placebo-Controlled Trial. Neuropsychopharmacology, 1999. 20(4): p. 380-385.

11. Benedetti, F., et al., Ongoing lithium treatment prevents relapse after total sleep deprivation. Journal of Clinical Psychopharmacology, 1999. 19(3): p. 240-5.

12. Benedetti, F., et al., Sleep phase advance and lithium to sustain the antidepressant effect of total sleep deprivation in bipolar depression: new findings supporting the internal coincidence model? Journal of Psychiatric Research, 2001. 35(6): p. 323-9.

13. Baxter, L.R., Jr., et al., Prolongation of the antidepressant response to partial sleep deprivation by lithium. Psychiatry Research, 1986. 19(1): p. 17-23.

14. Colombo, C., et al., Total sleep deprivation combined with lithium and light therapy in the treatment of bipolar depression: replication of main effects and interaction. Psychiatry Research, 2000. 95(1): p. 43-53.

15. Berger, M., et al., Sleep deprivation combined with consecutive sleep phase advance as a fast-acting therapy in depression: an open pilot trial in medicated and unmedicated patients. The American Journal Of Psychiatry, 1997. 154(6): p. 870-872.

16. Albert, R., et al., Sleep deprivation and subsequent sleep phase advance stabilizes the positive effect of sleep deprivation in depressive episodes. Der Nervenarzt, 1998. 69(1): p. 66-69.

17. Voderholzer, U., et al., Is the antidepressive effect of sleep deprivation stabilized by a three day phase advance of the sleep period? A pilot study. European Archives of Psychiatry & Clinical Neuroscience, 2003. 253(2): p. 68-72.

18. Benedetti, F., et al., Antidepressant effects of light therapy combined with sleep deprivation are influenced by a functional polymorphism within the promoter of the serotonin transporter gene. [see comment]. Biological Psychiatry, 2003. 54(7): p. 687-92.

19. Neumeister, A., et al., Bright light therapy stabilizes the antidepressant effect of partial sleep deprivation. Biological Psychiatry, 1996. 39(1): p. 16-21.

20. Loving, R.T., et al., Bright light augments antidepressant effects of medication and wake therapy. Depression & Anxiety, 2002. 16(1): p. 1-3.

21. Moscovici, L., et al., A multistage chronobiologic intervention for the treatment of depression: a pilot study. Journal of Affective Disorders, 2009. 116(3): p. 201-7.

22. Colombo, C., et al., Rate of switch from depression into mania after therapeutic sleep deprivation in bipolar depression. Psychiatry Research, 1999. 86(3): p. 267-70.

23. Abolmaali, K., et al., Circadian variation in intestinal dihydropyrimidine dehydrogenase (DPD) expression: a potential mechanism for benefits of 5FU chrono-chemotherapy. Surgery, 2009. 146(2): p. 269-73.

24. Liao, C., et al., Chronomodulated chemotherapy versus conventional chemotherapy for advanced colorectal cancer: a meta-analysis of five randomized controlled trials. International Journal of Colorectal Disease, 2010. 25(3): p. 343-50.

25. Morgan, T.O. and T.O. Morgan, Does it matter when drugs are taken? Hypertension, 2009. 54(1): p. 23-4.

26. Block, K.I., et al., Making circadian cancer therapy practical. Integrative Cancer Therapies, 2009. 8(4): p. 371-86.

27. Morgenthaler, T.I., et al., Practice parameters for the clinical evaluation and treatment of circadian rhythm sleep disorders. An American Academy of Sleep Medicine report. Sleep, 2007. 30(11): p. 1445-59.

28. Reid, K.J., et al., Circadian rhythm disorders. Seminars in Neurology, 2009. 29(4): p. 393-405.