[Sleep deprivation (wakefulness therapy) as an antidepressant]

In this complete survey of publications concerning therapeutic sleep deprivation (including reports of a conference held in 1985) first the practical management and especially the advantages of sleep deprivation of the second half of the night are explained. After discussing the psychological conditions and methods of therapeutic evaluation the treatment results in endogenous depression (melancholia), the effectiveness of repetition and of combination with antidepressive pharmacotherapy, the comparison with electroconvulsive therapy and the predictors are described. Sleep deprivation is indicated in nearly every therapeutic situation, including drug-resistant melancholia, furthermore in severe neurotic depression and in depressive states of schizophrenic patients. Side effects are unimportant, and complications are almost absent. In addition psychophysiological, neuroendocrinological and biochemical investigations are reported, as far as they concern either the mechanism of action of sleep deprivation or chronobiological hypotheses of depression.