Periodic sleep deprivation in drug-refractory depression.

For some time it has been known that total and partial sleep deprivation (in the second half of the night) produces an immediate antidepressive effect and a short-term effect of approximately 1-week duration. A 25-day trial is discussed here. 18 endogenous depressives who proved to be refractory to tricyclic antidepressive therapy were treated with periodic sleep deprivation (5 sleep deprivation treatments in the second half of the night at 5-day intervals) under continued drug therapy. The combined treatment led to a better result than would have been expected from drug therapy alone. Some of the sleep deprivation treatments effected an accelerated remission without the efficacy of treatment subsiding. In individual cases recovery occurred after one or a few partial sleep deprivation sessions. Whether in other respects sleep deprivation shortens the course of depressive phases is still unproven.