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Neuropsychiatr Dis Treat. 2016 Dec 13;12:3199-3203. doi: 10.2147/NDT.S115648. eCollection 2016.

Non-24-hour sleep-wake syndrome improved by low-dose valproic acid: a case report.

Author information

1
Wakamiya Hospital, Koutokukai, Yoshihara, Yamagata; Department of Cellular Signaling, Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Miyagi; Department of Psychiatry and Behavioral Science, Graduate School of Medicine, Nippon Medical School, Sendagi, Tokyo.
2
Department of Cellular Signaling, Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Miyagi.
3
Department of Cellular Signaling, Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Miyagi; Sato Hospital, Koutokukai, Kunugizuka, Nanyo, Yamagata.
4
Sato Hospital, Koutokukai, Kunugizuka, Nanyo, Yamagata.
5
Laboratory of Pharmacotherapy of Life-Style Related Diseases, Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Miyagi, Japan.
6
Department of Psychiatry and Behavioral Science, Graduate School of Medicine, Nippon Medical School, Sendagi, Tokyo.

Abstract

A woman was diagnosed with non-24-hour sleep-wake syndrome and depressive symptoms. Her depressive symptoms did not respond to standard doses of several antidepressants or mood stabilizers. Furthermore, her sleep-wake cycle remained non-entrained despite treatment with a melatonin-related drug, vitamin B12, and phototherapy. Ultimately, her sleep-wake rhythm was restored to a 24-hour pattern with a low dose of valproic acid, and her depressive symptoms tended to improve as a result of synchronization without antidepressants. Low-dose valproic acid appears to be one of the effective means of entraining circadian rhythms in patients with non-24-hour sleep-wake syndrome, which in turn likely improves associated depressive symptoms.

KEYWORDS:

antidepressants; circadian rhythm sleep disorder; depression; melatonin; mood stabilizers; phototherapy; vitamin B12

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