title: Non-24-hour sleep-wake syndrome improved by low-dose valproic acid: a case report.
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.
authors.affiliation: 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.
authors.forename: Masatake
authors.initials: M
authors.lastname: Kurita
authors.affiliation: Department of Cellular Signaling, Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Miyagi.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Moriya
authors.affiliation: Department of Cellular Signaling, Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Miyagi; Sato Hospital, Koutokukai, Kunugizuka, Nanyo, Yamagata.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Nishino
authors.affiliation: Sato Hospital, Koutokukai, Kunugizuka, Nanyo, Yamagata.
authors.forename: Eishin
authors.initials: E
authors.lastname: Hirata
authors.affiliation: Laboratory of Pharmacotherapy of Life-Style Related Diseases, Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Miyagi, Japan.
authors.forename: Noriyasu
authors.initials: N
authors.lastname: Hirasawa
authors.affiliation: Department of Psychiatry and Behavioral Science, Graduate School of Medicine, Nippon Medical School, Sendagi, Tokyo.
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Okubo
authors.affiliation: Sato Hospital, Koutokukai, Kunugizuka, Nanyo, Yamagata.
authors.forename: Tadahiro
authors.initials: T
authors.lastname: Sato
keywords: antidepressants; circadian rhythm sleep disorder; depression; melatonin; mood stabilizers; phototherapy; vitamin B12