To the Editor.—
Sleep deprivation produces a prompt, acute antidepressant response in about half of all bipolar and unipolar depressed patients given this treatment.1 The response is shortlived, however, lasting only one or two days in most cases. Sleep deprivation has shown little promise as a clinically useful treatment for depression, though when added to treatment with a tricyclic antidepressant this may result in a somewhat quicker response than with a tricyclic antidepressant alone.2 An initial fortuitous experience with one of our inpatients led me to investigate whether lithium carbonate can sustain the acute antidepressant effect of sleep deprivation, making it clinically useful.
Patients and Methods.—
Twenty-two patients were treated with sleep deprivation and lithium carbonate. Twelve of these patients had an acute antidepressant response. Two patients were deprived of sleep by being kept awake for 38 hours.3 The rest were given partial sleep deprivation, which consists