Nov. 16, 1999 (Indianapolis) -- No, it's not a dream: not getting enough sleep can actually help treat depression. A review article in a recent issue of Biological Psychiatry suggests that doctors may soon be using sleep deprivation therapy to treat depression as regularly as they did some 20 years ago.

In the 1970s, a depressed insomniac discovered that getting much less sleep than he wanted surprisingly improved his mood the next day. Doctors who treated depression began using sleep deprivation as a form of therapy. But sleep deprivation's popularity was brief, and soon the evolution of highly effective antidepressant medications made it all but obsolete.

Now, however, doctors are reconsidering the often striking improvement sleep deprivation can make in a person with depression. "The remarkable transformation of often deeply depressed, psychotic, and suicidal patients in the course of a few hours into their normal ... 'selves' convinced many psychiatrists [in the 1970s] of the extraordinary importance of this phenomenon," writes Anna Wirz-Justice, PhD. "Many studies followed, resulting in widespread [agreement] that sleep deprivation can have antidepressant effects. [However, it] also turned out that subsequent sleep tends to reverse the improvement. [So the] original interest and investment in clinical research went away."

Wirz-Justice, of the Chronobiology and Sleep Laboratory at the Psychiatric University Clinic in Basel, Switzerland, notes that sleep deprivation was shown to be effective in more than half the patients treated and in many types of depression. And if one course of sleep deprivation treatment didn't help relieve depressed patients' symptoms, often a second course did.

Used alone, however, sleep deprivation's effects were both temporary and unpredictable. Lacking a way to standardize sleep deprivation treatment, most doctors soon abandoned its use in depressed patients.

So why is sleep deprivation making a comeback now? Because use of newer antidepressant drugs together with sleep deprivation treatment is proving effective for helping to prevent return of depressive symptoms after sleep deprivation and for improving depressed patients' response to their medication.

"Antidepressant medication has little influence on rates of response to sleep deprivation but may prevent relapse," says Wirz-Justice. And "there is evidence ... that ... the addition of drugs can [help] the sleep deprivation effect."