S06-01 - Chronotherapeutics: Fulfilling the unmet needs for faster, better, and longer-lasting antidepressant response

Abstract

Chronotherapeutics (light, darkness, sleep manipulations, melatonin) offer a new synthesis of non-pharmacologic interventions designed to accelerate remission in patients with depression and bipolar disorder. Combinations of light and wake therapy achieve fast results and, by reducing residual symptoms, also minimise relapse over many months. In addition, chronotherapeutics seem to be a major facilitator of drug response, and, in combination with antidepressants, a promising method to stabilise patients over the long term. The above treatments fulfil the unmet needs for a new antidepressant drug - short latency of action, fewer residual symptoms, lack of side effects, shorter hospital stays, and less relapse, as well as WHO criteria for interventions that are effective, affordable and sustainable. Yet, despite the growing evidence for their efficacy, and more than thirty years of implementation, it is surprising how limited their use still remains. Is it an image problem (alternative medicine, too simple) or a marketing problem (not patentable, therefore not profitable)? One important factor is lack of insurance reimbursement, because of not being a listed treatment (because they do not go through official clinical trial registration at federal regulatory agencies). Perhaps it is the patients who will spearhead the transition, together with a younger generation of psychiatrists curious to find biologically active alternatives to medication.See: the nonprofit, multilingual patients’ website www.cet.org and clinicians’ website www.chronotherapeutics.org