Interaction between chronotypes and drug response in psychiatric patients

Psychiatric disorders are common and are associated with substantial morbidity and mortality. Interestingly, there is a web of evidence suggesting complex relationship between circadian rhythms and psychiatric disorders. Among psychiatric disorders patients, approximately 30% are subsequently diagnosed as treatment resistant, defined as failure to achieve remission despite treatment with at least two different drugs. Early treatment resistant patients diagnostic markers remain unavailable albeit some clinical markers were suggested to partially predict response to specific drugs.

Considering the recent developments suggesting the involvement of chronotypes in the development of psychiatric disorders, we hypothesize that chronotypes may also be a factor in the response to drugs in general and in interaction with the timing of drug administration. We suggest that adjusting the time of dosing based on the individual chronotype of patients may increase the chances of drug response. We are currently conducting a pilot experiment testing chronotypes in psychiatric outpatients in order to explore relationship between them and measures of drug response and quality of life. Additional work is planned in the future with larger patients groups and using wearable devices.