I already use light and melatonin to help my patients with jet lag and to readjust their circadian rhythm,<br />but it won’t be long before I try triple chronotherapy for my depressed patients who don’t get better with antidepressants.<br />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<br />and early morning light, and 57 percent remained well after nine months.<br />So now you know the fix for jet lag: Travel east and you’ll need morning light<br />and evening melatonin; go west and you’ll need evening light and morning melatonin.<br />Some 15 years ago, Dr. Francesco Benedetti, a psychiatrist in Milan, and colleagues noticed<br />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.<br />Studies show that it is possible to make wake therapy even more powerful by incorporating two additional interventions: early morning light therapy<br />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.<br />In another study, investigators combined chronotherapy with psychotropic medication and found<br />that depressed patients got better within 48 hours — much faster than antidepressants, which typically take four to six weeks to work.
