[Combination therapy using sertraline with sleep deprivation and light therapy compared to sertraline monotherapy for major depressive disorder].
OBJECTIVE
Bright light therapy is effective and well tolerated in seasonal affective disorder and some studies reported an antidepressant effect of bright light also in non-seasonal depression. On the other hand, total sleep deprivation leads to a rapid and marked improvement of mood in 60% of depressed patients. Combinations of antidepressant medication with those somatic therapies are generally indicated. The aim of this study was to compare the efficacy of the combination of sertraline and partial sleep deprivation or light therapy with sertraline monotherapy in the treatment of major depression.


METHODS
Thirty-seven patients with major depressive disorder were randomly allocated into 3 treatment groups. Thirteen were treated with sertraline and late partial sleep deprivation, 13 with sertraline and bright light therapy and 11 sertraline monotherapy as a control group. Outcome measures included daily (first 15 days) and weekly Hamilton Rating Scale for Depression and biweekly Hamilton Anxiety Rating Scale.


RESULTS
Partial sleep deprivation group improved significantly and more rapidly. Accelerated treatment response was shown in sleep deprivation group that improvement was observed after the third day. Bright light and sleep deprivation combinations with sertraline were more effective than sertraline monotherapy for accompanied anxiety in depression.


CONCLUSIONS
Late partial sleep deprivation in combination with sertraline can accelerate and increase the treatment response in non-seasonal major depressive disorder.
Güdücü
Funda
F
Trakya U Tip Fak., Psikiyatri AD., Edirne.
Caliyurt
Okan
O
Vardar
Erdal
E
Tuğlu
Cengiz
C
Abay
Ercan
E
D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D010789:Phototherapy; D011594:Psychometrics; D020280:Sertraline / Q000627:therapeutic use*; D012892:Sleep Deprivation / Q000523:psychology; D016896:Treatment Outcome
D000928:Antidepressive Agents; D020280:Sertraline