Effect of aripiprazole on non-24-hour sleep–wake rhythm disorder comorbid with major depressive disorder: a case report
Kentaro Matsui,1,2 Yoshikazu Takaesu,2,3 Takeshi Inoue,3 Ken Inada,1 Katsuji Nishimura1 1Department of Psychiatry, Tokyo Women’s Medical University, 2Japan Somnology Center, Neuropsychiatric Research Institute, 3Department of Psychiatry, Tokyo Medical University, Tokyo, Japan Background:...
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Dove Medical Press
2017
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oai:doaj.org-article:622bf5337420400e9db12bb713ebf1882021-12-02T04:58:10ZEffect of aripiprazole on non-24-hour sleep–wake rhythm disorder comorbid with major depressive disorder: a case report1178-2021https://doaj.org/article/622bf5337420400e9db12bb713ebf1882017-05-01T00:00:00Zhttps://www.dovepress.com/effect-of-aripiprazole-on-non-24-hour-sleep-wake-rhythm-disorder-comor-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Kentaro Matsui,1,2 Yoshikazu Takaesu,2,3 Takeshi Inoue,3 Ken Inada,1 Katsuji Nishimura1 1Department of Psychiatry, Tokyo Women’s Medical University, 2Japan Somnology Center, Neuropsychiatric Research Institute, 3Department of Psychiatry, Tokyo Medical University, Tokyo, Japan Background: Patients with non-24-hour sleep–wake rhythm disorder (N24SWD) exhibit a sleep pattern that is asynchronous with the external light–dark cycle, typically involving a cycling, relapsing–remitting pattern of sleep disturbances, including nighttime insomnia and daytime sleepiness. Here, we report the case of a patient with N24SWD comorbid with major depressive disorder, who was successfully treated with a low dose of aripiprazole.Case presentation: A 47-year-old female presented with an 8-year complaint of difficulty falling asleep and waking up in the morning. The patient was diagnosed with major depressive disorder at the age of 35 years and was treated with various antidepressants since that time. At the age of 40 years, the patient’s sleep–wake cycle began to extend without exacerbation of depressive symptoms. The patient was diagnosed with N24SWD at the age of 43 years. Ramelteon 8 mg/d and then melatonin 1 mg/d were administered, but these did not provide effective treatment. In January 2016, after treatment with aripiprazole 3 mg/d in the morning for 4 weeks, the patient’s sleep–wake cycle became markedly synchronized to the environmental light–dark cycle. Her sleep–wake cycle remained synchronized when the same dose of aripiprazole was administered for at least 6 months.Conclusion: Treatment-refractory asynchrony of the sleep–wake cycle in an N24SWD patient with depression was successfully treated with aripiprazole. Although the detailed mechanism of action is unclear, aripiprazole may be an appropriate treatment for patients with circadian rhythm sleep–wake disorders. Keywords: circadian rhythm sleep–wake disorder, non-24-hour sleep–wake rhythm disorder, melatonin, long sleep duration, antipsychoticMatsui KTakaesu YInoue TInada KNishimura KDove Medical Pressarticlecircadian rhythm sleep-wake disordernon-24-hour sleep-wake rhythm disorderaripiprazolelong sleep durationdepressionNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 13, Pp 1367-1371 (2017) |
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DOAJ |
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EN |
| topic |
circadian rhythm sleep-wake disorder non-24-hour sleep-wake rhythm disorder aripiprazole long sleep duration depression Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 |
| spellingShingle |
circadian rhythm sleep-wake disorder non-24-hour sleep-wake rhythm disorder aripiprazole long sleep duration depression Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Matsui K Takaesu Y Inoue T Inada K Nishimura K Effect of aripiprazole on non-24-hour sleep–wake rhythm disorder comorbid with major depressive disorder: a case report |
| description |
Kentaro Matsui,1,2 Yoshikazu Takaesu,2,3 Takeshi Inoue,3 Ken Inada,1 Katsuji Nishimura1 1Department of Psychiatry, Tokyo Women’s Medical University, 2Japan Somnology Center, Neuropsychiatric Research Institute, 3Department of Psychiatry, Tokyo Medical University, Tokyo, Japan Background: Patients with non-24-hour sleep–wake rhythm disorder (N24SWD) exhibit a sleep pattern that is asynchronous with the external light–dark cycle, typically involving a cycling, relapsing–remitting pattern of sleep disturbances, including nighttime insomnia and daytime sleepiness. Here, we report the case of a patient with N24SWD comorbid with major depressive disorder, who was successfully treated with a low dose of aripiprazole.Case presentation: A 47-year-old female presented with an 8-year complaint of difficulty falling asleep and waking up in the morning. The patient was diagnosed with major depressive disorder at the age of 35 years and was treated with various antidepressants since that time. At the age of 40 years, the patient’s sleep–wake cycle began to extend without exacerbation of depressive symptoms. The patient was diagnosed with N24SWD at the age of 43 years. Ramelteon 8 mg/d and then melatonin 1 mg/d were administered, but these did not provide effective treatment. In January 2016, after treatment with aripiprazole 3 mg/d in the morning for 4 weeks, the patient’s sleep–wake cycle became markedly synchronized to the environmental light–dark cycle. Her sleep–wake cycle remained synchronized when the same dose of aripiprazole was administered for at least 6 months.Conclusion: Treatment-refractory asynchrony of the sleep–wake cycle in an N24SWD patient with depression was successfully treated with aripiprazole. Although the detailed mechanism of action is unclear, aripiprazole may be an appropriate treatment for patients with circadian rhythm sleep–wake disorders. Keywords: circadian rhythm sleep–wake disorder, non-24-hour sleep–wake rhythm disorder, melatonin, long sleep duration, antipsychotic |
| format |
article |
| author |
Matsui K Takaesu Y Inoue T Inada K Nishimura K |
| author_facet |
Matsui K Takaesu Y Inoue T Inada K Nishimura K |
| author_sort |
Matsui K |
| title |
Effect of aripiprazole on non-24-hour sleep–wake rhythm disorder comorbid with major depressive disorder: a case report |
| title_short |
Effect of aripiprazole on non-24-hour sleep–wake rhythm disorder comorbid with major depressive disorder: a case report |
| title_full |
Effect of aripiprazole on non-24-hour sleep–wake rhythm disorder comorbid with major depressive disorder: a case report |
| title_fullStr |
Effect of aripiprazole on non-24-hour sleep–wake rhythm disorder comorbid with major depressive disorder: a case report |
| title_full_unstemmed |
Effect of aripiprazole on non-24-hour sleep–wake rhythm disorder comorbid with major depressive disorder: a case report |
| title_sort |
effect of aripiprazole on non-24-hour sleep–wake rhythm disorder comorbid with major depressive disorder: a case report |
| publisher |
Dove Medical Press |
| publishDate |
2017 |
| url |
https://doaj.org/article/622bf5337420400e9db12bb713ebf188 |
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