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26 - Chronotherapeutics

Light therapy, wake therapy, and melatonin

from Section 4 - Specific modalities of treatment

Published online by Cambridge University Press:  05 May 2013

J. John Mann
Affiliation:
Columbia University, New York
Patrick J. McGrath
Affiliation:
Columbia University, New York
Steven P. Roose
Affiliation:
Columbia University, New York
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Summary

This chapter deals with chronotherapeutics and discusses light therapy, wake therapy, and melatonin. Light therapy is the first somatic antidepressant treatment to have been born of a biological hypothesis rather than discovered by serendipity in the course of drug testing or brain stimulation. A single cycle of triple chronotherapy can produce such rapid improvement that after a few more days of observation the patient can be discharged. Others may need a second or third cycle of wake therapy, but the expected course of acute treatment can be completed within a week. Pineal melatonin is produced on a nocturnal cycle triggered by the internal circadian clock, which in turn is synchronized to the day/night cycle by appropriately timed light exposure. The endogenous melatonin cycle is intimately connected to the day/night pattern of light exposure, and thus to light therapy.
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Publisher: Cambridge University Press
Print publication year: 2013

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