When I showed this slim and elegant book to my colleagues at our hospital – many of whom are renowned in the management of depression – the responses were mostly excitement and wonder. It is surprising that as we toil daily in our offices, clinics and wards to lessen the burden of affective disorders, very few of us are versed in the intricacies of chronotherapeutics. Mega-studies such as the STAR*D and the STEP-BD have shown us that affective disorders are quite difficult to treat, even under systematic treatment using modern psychopharmacological agents – and if these outcomes are the best we can do, it is clear that we need better treatments. The widely held clinical view of antidepressants as highly effective and specific for the treatment of all types of depressive disorders is exaggerated. This sobering conclusion calls for emphasis on novel techniques. This book is “just what we need” to start thinking differently about the treatment of affective disorders.

The book is elegant in design, filled with useful figures and tables, and reads fluently. There are 15 chapters, starting with a well-grounded introduction and then covering a wide array of topics such as “Individual chronotherapeutic elements”, “Inpatient procedures”, “Practical details of wake therapy” and finally “Chronobiology in everyday life”. As a psychogeriatrician working full-time on a closed ward I found the chapter on inpatient techniques particularly engaging. The authors carefully describe assessment and monitoring of patients’ response to the use (alone or in combination) of light therapy, single night sleep deprivation and a three-day sleep phase advance. The timing and duration of treatments is detailed, the combination with medications is described and the accompanying flowcharts offer even the beginner a precise mode of action. Variations tailored for hospitals unable to set-up the triple-wake-therapy are given and maintenance treatment recommended. It is a credit to the authors that the case-study they chose to incorporate describes a severe error in the application of wake therapy as a guide to the “Do not” we need to keep in mind when trying these techniques for the first time.

Chronotherapeutics have developed directly from basic neurobiology research. Some are recognized as the treatment of choice – as in seasonal affective disorder – while a combination of techniques can reduce residual symptoms of depression and minimize relapse. This manual is an essential read for psychiatrists, psychologists, practitioners of sleep medicine and any health professional interested in adding an impressive weapon to the armament in the fight against affective disorders.