Is advancing circadian rhythm the mechanism of antidepressants?

Heon Jeong Lee

Research output: Contribution to journalReview articlepeer-review

10 Citations (Scopus)


Antidepressants usually require 2–8 weeks after drug administration to obtain a clinical response. In contrast, three fast-acting antidepressant treatments (sleep deprivation, electroconvulsive therapy, and ketamine) significantly reduced depressive symptoms within hours to days in a subgroup of patients with depressive disorder. This review addresses the mechanisms underlying these fast effects, with specific focus on treatment effects on circadian rhythms. Numerous recent studies have shown that circadian dysregulation may play an important role in the pathogenesis of mood disorders. These studies indicate that a common therapeutic mechanism underlying the three fast antidepressant therapies is related to circadian rhythm. Evidence suggests that depressive disorder is associated with circadian rhythm delay and that the mechanism of the antidepressant effect is a process in which the delayed circadian rhythm is restored to normal by the treatment.

Original languageEnglish
Pages (from-to)479-483
Number of pages5
JournalPsychiatry Investigation
Issue number7
Publication statusPublished - 2019 Jul

Bibliographical note

Funding Information:
This study was supported by the Korea Health 21 R&D Project funded by the National Research Foundation of Korea (2017M3A9F1031220).

Publisher Copyright:
© 2019 Korean Neuropsychiatric Association.


  • Antidepressant
  • Circadian
  • Electroconvulsive therapy
  • Ketamine
  • Sleep deprivation

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry


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