[Sleep deprivation as antidepressive treatment].

BACKGROUND

Sleep deprivation, i.e. keeping patients awake for approximately 35 hours, is an antidepressive treatment that is rarely used in Norway.

MATERIAL AND METHODS

Review of a selection of publications from Medline, ISI, and psychINFO. The treatment is illustrated with two clinical vignettes.

RESULTS AND INTERPRETATION

Sleep deprivation is a well documented treatment of depression. The effect is transient but can be prolonged by sleep phase advancement, concurrent pharmacological treatment, and light therapy. The effect is comparable to other standard treatments for depression, but is reported to occur within hours rather than weeks. There are few studies with follow-up results for more than two weeks and there is uncertainty regarding the mechanisms of change that are involved in sleep deprivation. Our two pilot patients experienced over 50% symptom reduction in three days. Results from these patients indicate that it may be of interest to study the course of response to sleep deprivation and three day sleep phase advancement for several weeks, and whether the treatment has the additional effect of improving sleep quality and stabilizing diurnal rhythm.