title: Improvement of a patient's circadian rhythm sleep disorders by aripiprazole was associated with stabilization of his bipolar illness.
abstract: Splitting of the behavioural activity phase has been found in nocturnal rodents with suprachiasmatic nucleus (SCN) coupling disorder. A similar phenomenon was observed in the sleep phase in the diurnal human discussed here, suggesting that there are so-called evening and morning oscillators in the SCN of humans. The present case suffered from bipolar disorder refractory to various treatments, and various circadian rhythm sleep disorders, such as delayed sleep phase, polyphasic sleep, separation of the sleep bout resembling splitting and circabidian rhythm (48 h), were found during prolonged depressive episodes with hypersomnia. Separation of sleep into evening and morning components and delayed sleep-offset (24.69-h cycle) developed when lowering and stopping the dose of aripiprazole (APZ). However, resumption of APZ improved these symptoms in 2 weeks, accompanied by improvement in the patient's depressive state. Administration of APZ may improve various circadian rhythm sleep disorders, as well as improve and prevent manic-depressive episodes, via augmentation of coupling in the SCN network.
authors.affiliation: Tashiro Clinic, Akita-heal Medical Corporation, Akita City, Akita, Japan.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Tashiro
mesh_terms: D000328:Adult; D000068180:Aripiprazole / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000150:complications* / Q000188:drug therapy* / Q000523:psychology; D002940:Circadian Rhythm / Q000187:drug effects; D006970:Disorders of Excessive Somnolence / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D012890:Sleep / Q000187:drug effects; D020178:Sleep Disorders, Circadian Rhythm / Q000150:complications* / Q000188:drug therapy* / Q000523:psychology; D013493:Suprachiasmatic Nucleus / Q000187:drug effects
chemical_list: D000068180:Aripiprazole
keywords: aripiprazole; biological oscillator; bipolar disorder; circadian rhythm sleep disorders; suprachiasmatic nucleus