夜間睡眠の延長と睡眠相後退症候群に対するaripiprazoleの有効性の検討

• 神林 崇

  秋田大学大学院医学系研究科精神科学教室 筑波大学睡眠研究機構

• 大森 佑貴

  秋田大学大学院医学系研究科精神科学教室

• 今西 彩

  秋田大学大学院医学系研究科精神科学教室

• 高木 学

  岡山大学病院精神科神経科

• 佐川 洋平

  秋田大学大学院医学系研究科精神科学教室

• 筒井 幸

  秋田大学大学院医学系研究科精神科学教室

• 竹島 正浩

  秋田大学大学院医学系研究科精神科学教室

• 小野 太輔

  秋田大学大学院医学系研究科精神科学教室

• 塩見 利明

  愛知医科大学病院睡眠科・睡眠医療センター

• 清水 徹男

  秋田大学大学院医学系研究科精神科学教室 筑波大学睡眠研究機構

書誌事項

タイトル別名

• Effects of aripiprazole for prolonged nocturnal sleep and delayed sleep phase disorder

抄録

Delayed sleep phase disorder (DSPD) comprises a persistent or recurrent pattern of sleep disturbances, sleep disruption that leads to insomnia and/or excessive daytime sleepiness, and impaired functioning in social, occupational, or other spheres. Three techniques are typically used to treat DSPD : chronotherapy, phototherapy, and exogenous melatonin administration. Antipsychotics have not been reported in the treatment of DSPD, aripiprazole (APZ), which is a second generation antipsychotic, manifests a novel mechanism of action by serving as a partial agonist of D2 receptors. Depression is reported to be the most common psychopathology associated with DSPD, and APZ is reported to be effective in major depressive disorder as adjunctive therapy. Therefore, we speculated that APZ might be effective to treat DSPD, and we observed how APZ works for the treatment of DSPD. Methods : 18 subjects (including 7 women) who are 14–48–year–old (the average is 31.6) were included. The patients were prescribed 0.75–4.5mg APZ at once a day. Results : We prescribed 1.5–3.0mg/day of APZ, all subject reduced total sleep time (9.6 +/− 2.3h → 7.8 +/− 2.0h, p＝0.03), many cases got up earlier (9.1 +/− 1.9h → 6.7 +/− 1.4h, p＝0.005) in the morning and advanced their sleep phase within one week. The sleep onset was not significantly changed (23.5 +/− 2.0h → 22.9 +/− 1.9h, n.s.). Conclusion : Low dose of APZ would reduce nocturnal sleep time in the subjects who had prolonged sleep time and DSPD symptoms. The mechanism of action would be dopaminergic up regulation due to dopamine D3 agonistic activity. Since it is difficult for physicians to treat prolonged sleep time and DSPD symptoms, this medication would become a new therapeutic tool for these patients.

収録刊行物

• 神経治療学

  神経治療学 34 (4), 406-410, 2018

  日本神経治療学会

キーワード

• aripiprazole
• delayed sleep-phase syndrome (DSPD)
• depression
• hypersomnolence disorder

詳細情報

• CRID: 1390001204636548224
• NII論文ID: 130006386758
• DOI: 10.15082/jsnt.34.4_406
• ISSN: 21897824
• ISSN: 09168443
• 本文言語コード: ja
• データソース種別:
  • JaLC
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可