Neuropsychiatric Disease and Treatment (May 2018)

Low dose of aripiprazole advanced sleep rhythm and reduced nocturnal sleep time in the patients with delayed sleep phase syndrome: an open-labeled clinical observation

  • Omori Y,
  • Kanbayashi T,
  • Sagawa Y,
  • Imanishi A,
  • Tsutsui K,
  • Takahashi Y,
  • Takeshima M,
  • Takaki M,
  • Nishino S,
  • Shimizu T

Journal volume & issue
Vol. Volume 14
pp. 1281 – 1286

Abstract

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Yuki Omori,1 Takashi Kanbayashi,1,2 Yohei Sagawa,1 Aya Imanishi,1 Ko Tsutsui,1 Yuya Takahashi,1 Masahiro Takeshima,1 Manabu Takaki,3 Seiji Nishino,4 Tetsuo Shimizu1,2 1Department of Neuropsychiatry, Akita University Graduate School of Medicine, Akita, Japan; 2International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Japan; 3Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Okayama, Japan; 4Department of Psychiatry and Behavioral Sciences, Sleep and Circadian Neurobiology Laboratory & Center for Narcolepsy, Stanford University School of Medicine, Stanford, CA, USA Objectives: Delayed sleep phase syndrome (DSPS) is a chronic dysfunction of circadian rhythm of the subject that impairs functioning in social, occupational, or other spheres. High rate of depression is found among DSPS patients. Aripiprazole (APZ), a second-generation antipsychotic, is effective in treatment of depression as well as schizophrenia. Recently, few case reports show the effectiveness of APZ in treating DSPS and non-24-hour sleep–wake rhythm disorder. Therefore, we tried to treat DSPS with depression using APZ.Methods: Twelve subjects (including four women) aged 19–64 years were included. The subjects were prescribed initially 0.5–3 mg of APZ once a day with subsequent dose adjustments.Results: Sleep onset, midpoint of sleep, and sleep offset were significantly advanced by 1.1, 1.8, and 2.5 hours, respectively. Unexpectedly, sleep duration became significantly shorter by 1.3 hours after treatment. Their depressive moods showed an unremarkable change.Conclusion: Low dose of APZ advanced the sleep rhythm and reduced nocturnal sleep time in the subjects with DSPS. Since it is not easy for physicians to treat prolonged sleep duration often associated with DSPS, this medication would become a new therapeutic option for these patients. Keywords: delayed sleep phase syndrome, aripiprazole, total sleep time

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