Case study of circadian rhythm sleep disorder following haloperidol treatment: Reversal by risperidone and melatonin

Liat Ayalon, Haggai Hermesh, Yaron Dagan

Research output: Contribution to journalArticlepeer-review

32 Scopus citations

Abstract

A patient with Gilles de la Tourette syndrome treated with haloperidol, ingested once daily after awakening from sleep, exhibited an irregular sleep-wake pattern with a free-running component of approximately 48 h. Transfer to risperidone, ingested once daily after awakening from sleep, was beneficial resulting in a sleep-wake cycle more synchronized at the appropriate phase to the external zeitgebers, and fewer nocturnal disturbances. The circadian sleep-wake schedule was fully synchronized when the patient had been subsequently treated with melatonin at 21:00h, before intended nocturnal sleep, in addition to risperidone in the morning. Restoration of the sleep-wake circadian pattern was accompanied by the patient's subjective report of significant improvement in his quality of life, social interactions, and occupational status. This observation suggests that circadian rhythm sleep disorders can be related to the typical neuroleptic haloperidol and restored by the atypical neuroleptic risperidone. Similar findings reported in patients suffering from other disorders support the hypothesis that the described disruption of the sleep-wake schedule is medication rather than illness-related. Therefore, it is very important to realize that circadian rhythm sleep disorders may be a side effect of neuroleptics.

Original languageEnglish
Pages (from-to)947-959
Number of pages13
JournalChronobiology International
Volume19
Issue number5
DOIs
StatePublished - Sep 2002
Externally publishedYes

Keywords

  • Circadian rhythm sleep disorders
  • Haloperidol
  • Iatrogenic side effects of medications
  • Melatonin
  • Risperidone
  • Wrist actigraphy

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