The chronotherapeutic treatment of bipolar disorders: A systematic review and practice recommendations from the ISBD task force on chronotherapy and chronobiology

Research output: Contribution to journalReview articleContributedpeer-review

Contributors

  • John F. Gottlieb - , Northwestern University, Chicago Psychiatry Associates (Author)
  • Francesco Benedetti - , Vita-Salute San Raffaele University (Author)
  • Pierre A. Geoffroy - , Université Paris Cité (Author)
  • Tone E.G. Henriksen - , University of Bergen, Western Norway Regional Health Authority (Author)
  • Raymond W. Lam - , University of British Columbia (Author)
  • Greg Murray - , Swinburne University of Technology (Author)
  • James Phelps - , Samaritan Mental Health (Author)
  • Dorothy Sit - , Northwestern University (Author)
  • Holly A. Swartz - , University of Pittsburgh (Author)
  • Marie Crowe - , University of Otago (Author)
  • Bruno Etain - , Université Paris Cité (Author)
  • Ellen Frank - , University of Pittsburgh (Author)
  • Namni Goel - , University of Pennsylvania (Author)
  • Bartholomeus C.M. Haarman - , University of Groningen (Author)
  • Maree Inder - , University of Otago (Author)
  • Håvard Kallestad - , Norwegian University of Science and Technology (Author)
  • Seong Jae Kim - , Doeun Hospital (Author)
  • Klaus Martiny - , University of Copenhagen (Author)
  • Ybe Meesters - , University of Groningen (Author)
  • Richard Porter - , University of Otago, Canterbury District Health Board (Author)
  • Rixt F. Riemersma-van der Lek - , University of Groningen (Author)
  • Philipp S. Ritter - , Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus Dresden (Author)
  • Peter F.J. Schulte - , Mental Health Services Noord-Holland-Noord (Author)
  • Jan Scott - , Newcastle University (Author)
  • Joseph C. Wu - , University of California at Irvine (Author)
  • Xin Yu - , Peking University (Author)
  • Shenghao Chen - , Northwestern University (Author)

Abstract

Aims: To systematically review the literature on the efficacy and tolerability of the major chronotherapeutic treatments of bipolar disorders (BD)—bright light therapy (LT), dark therapy (DT), treatments utilizing sleep deprivation (SD), melatonergic agonists (MA), interpersonal social rhythm therapy (IPSRT), and cognitive behavioral therapy adapted for BD (CBTI-BP)—and propose treatment recommendations based on a synthesis of the evidence. Methods: PRISMA-based systematic review of the literature. Results: The acute antidepressant (AD) efficacy of LT was supported by several open-label studies, three randomized controlled trials (RCTs), and one pseudorandomized controlled trial. SD showed rapid, acute AD response rates of 43.9%, 59.3%, and 59.4% in eight case series, 11 uncontrolled, studies, and one RCT, respectively. Adjunctive DT obtained significant, rapid anti-manic results in one RCT and one controlled study. The seven studies on MA yielded very limited data on acute antidepressant activity, conflicting evidence of both antimanic and maintenance efficacy, and support from two case series of improved sleep in both acute and euthymic states. IPSRT monotherapy for bipolar II depression had acute response rates of 41%, 67%, and 67.4% in two open studies and one RCT, respectively; as adjunctive therapy for bipolar depression in one RCT, and efficacy in reducing relapse in two RCTs. Among euthymic BD subjects with insomnia, a single RCT found CBTI-BP effective in delaying manic relapse and improving sleep. Chronotherapies were generally safe and well-tolerated. Conclusions: The outcome literature on the adjunctive use of chronotherapeutic treatments for BP is variable, with evidence bases that differ in size, study quality, level of evidence, and non-standardized treatment protocols. Evidence-informed practice recommendations are offered.

Details

Original languageEnglish
Pages (from-to)741-773
Number of pages33
JournalBipolar disorders
Volume21
Issue number8
Publication statusPublished - 1 Dec 2019
Peer-reviewedYes

External IDs

PubMed 31609530
ORCID /0000-0003-4286-5830/work/149796257

Keywords

Sustainable Development Goals

Keywords

  • bipolar, Chronotherapy, circadian, cognitive behavioral therapy for insomnia adapted for bipolar disorder, dark therapy, interpersonal social rhythm therapy, light therapy, melatonergic agonist, melatonin, sleep deprivation