Chronotherapeutics for Affective Disorders: A Clinician's Manual for Light and Wake Therapy

By Levitan, Robert D. | Canadian Journal of Psychiatry, December 2010 | Go to article overview

Chronotherapeutics for Affective Disorders: A Clinician's Manual for Light and Wake Therapy


Levitan, Robert D., Canadian Journal of Psychiatry


Chronotherapeutics for Affective Disorders: A Clinician's Manual for Light and Wake Therapy Anna Wirz- Justice, Francesco Benedetti, Michael Terman. Basel (CH): Karger; 2009. 116 p. US$48.00

Reviewer rating: Excellent

It can be said that most patients with a mood disorder exhibit one or more disturbances in their biological and (or) social rhythms. Despite this, most clinicians, particularly in North America, are not well versed in the field of chronobiology. As a result, most clinicians are somewhat hesitant to implement chronobiologically based protocols such as light treatment and wake therapy.

Wirz- Justice, Benedetti, and Terman, world-leading experts in this field, address this problem head-on with this first edition publication on the chronotherapy of mood disorders.

The manual begins with a well thought out foreword section that puts this work into a broader context. As mentioned by the authors, the overall intention is for each reader to use the manual as a reference book based on their own needs and interests. The authors acknowledge that chronotherapeutics is a relatively new paradigm for most clinicians, and that significant loose ends need to be filled in before a second edition becomes available. This point should be kept in mind as one progresses to later sections, as the evidence base for at least some of the protocols is still in its early stages.

The first chapter provides a general overview of biological rhythms and circadian timing, followed by a brief introduction to chronotherapeutics, per se. While some readers may want to skip this overview and learn about the treatment protocols themselves, readers who are new to the area will want to review these basic principles as a first step.

The next 2 chapters provide more details on the various chronotherapeutic strategies that have been implemented to date, using both detailed case reports and data from actual clinical trials where available. The case reports are well balanced and believable, demonstrating both the therapeutic potential of chronotherapy and the precautions needed in certain high-risk populations, such as people with mixed bipolar states. …

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