Effect of add-on ramelteon therapy on sleep and circadian rhythm disruption in patients with schizophrenia: A randomized controlled trial

Mishra, Archana; Maiti, Rituparna; Mishra, Biswa Ranjan; Jena, Monalisa; Nath, Santanu; Sahu, Pallabi

doi:10.1016/j.euroneuro.2019.11.008

Cited by 14 publications

(17 citation statements)

References 28 publications

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“…However, studies which have looked at the effect of melatonin on the psychotic symptoms in patients, although limited, show conflicting results. A reduction in symptom severity has been reported with addon treatment of both melatonin (Modabbernia et al, 2014) and the melatonin receptor agonist, ramelteon (Mishra et al, 2020). In contrast, Romo-Nava et al (2014) did not detect any improvement resulting from melatonin administration over placebo, although this study also included patients with bipolar disorder.…”

Section: Causal Role Of Sleep and Circadian Rhythm Disruptionmentioning

confidence: 66%

Disrupted Sleep and Circadian Rhythms in Schizophrenia and Their Interaction With Dopamine Signaling

Ashton

Jagannath

2020

Front. Neurosci.

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Section: Causal Role Of Sleep and Circadian Rhythm Disruptionmentioning

confidence: 66%

Disrupted Sleep and Circadian Rhythms in Schizophrenia and Their Interaction With Dopamine Signaling

Ashton

Jagannath

2020

Front. Neurosci.

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“…Z-compounds also at higher doses showed a negative linear correlation between the doses of z-compound and melatonin concentration, suggesting the possibility of suppression at higher doses or with chronic administration [46]. So, in this clinical scenario, add-on melatonin or add-on melatonin agonist may be helpful in ameliorating sleep and circadian disturbances [47].…”

Section: Discussionmentioning

confidence: 91%

Effect of Haloperidol and Risperidone on Serum Melatonin and GAP-43 in Patients with Schizophrenia: A Prospective Cohort Study

Maiti

Mishra

Jena

et al. 2021

Clin Psychopharmacol Neurosci

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Objective Serum melatonin, a biomarker of circadian rhythm, can upregulate Growth-associated protein 43 (GAP-43) which is involved in neural regeneration and plasticity. The present study was conducted to investigate the adequacy of the first-line antipsychotic drugs to improve sleep and circadian rhythm disruptions by assessing the effect of haloperidol and risperidone on serum melatonin and GAP-43 in schizophrenia. Methods In this cohort study, 100 schizophrenic patients were recruited, and clinical evaluations were done using the Positive and Negative Syndrome Scale (PANSS) and the Pittsburgh sleep quality index (PSQI). The patients with predominantly positive symptoms taking haloperidol (Group I) and patients with predominantly negative symptoms taking risperidone (Group II) were admitted and serum melatonin, arylalkylamine N-acetyltransferase, GAP-43 and urinary melatonin were estimated. After 8 weeks, all clinical and biochemical parameters were repeated. Results Serum melatonin (200 hours) was significantly decreased in both haloperidol (2.42; 95% confidence interval [95% CI] 0.67−4.17; p = 0.008) and risperidone group (3.40; 95% CI 0.54−6.25; p = 0.021). Urinary melatonin was significantly decreased in both haloperidol ( p = 0.005) and risperidone group ( p = 0.014). PSQI score was significantly increased in both haloperidol ( p = 0.001) and risperidone group ( p = 0.003). Serum GAP-43 was significantly decreased in both haloperidol and risperidone group ( p < 0.001). PANSS decreased significantly in both the groups and there was a significant negative correlation between serum melatonin at 200 hours and PANSS (r = −0.5) at baseline. Conclusion Monotherapy with haloperidol and risperidone can achieve symptomatic improvement but cannot improve sleep and circadian rhythm disturbances in schizophrenia.

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“…Because participation in employment and rehabilitation programs can be social zeitgebers, it is unclear whether participation in social activities affects circadian rhythm disruptions or whether circadian rhythm disruptions prevent participation in social activities. Although the causal relationship remains unclear, therapeutic interventions with add-on melatonin agonists, which have been shown to be effective for better sleep-wake behavior and the alleviation of psychopathological symptoms in patients with schizophrenia [53][54][55], may enable patients to participate in social activities.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Circadian Rhythm Sleep-Wake Disorder in Outpatients with Schizophrenia and Its Association with Psychopathological Characteristics and Psychosocial Functioning

Matsui

Inada

Kuriyama

et al. 2021

JCM

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The prevalence of circadian rhythm sleep-wake disorder (CRSWD) among patients with schizophrenia is not clear. The effect of comorbid CRSWD on such patients has also not been fully evaluated yet. Outpatients with schizophrenia in the maintenance phase who visited Tokyo Women’s Medical University Hospital between April 2018 and March 2019 participated in this study. The Brief Psychiatric Rating Scale (BPRS), the Clinical Global Impressions–Severity Illness Scale (CGI-S), Global Assessment of Functioning (GAF), World Health Organization Disability Assessment Schedule II, Insomnia Severity Index (ISI), and Morningness–Eveningness Questionnaire (MEQ) were administered, and the patient responses with and without CRSWD were compared. Of the 105 patients with schizophrenia, 19 (18.1%) had CRSWD. There were trends toward higher BPRS and lower GAF scores in the CRSWD group than in the non-CRSWD group, although these did not reach statistical significance following a false discovery rate correction. Among the BPRS subitems, the anxiety scores were significantly higher in the CRSWD group than in the non-CRSWD group (p < 0.01). CRSWD was highly prevalent among patients with schizophrenia in the maintenance phase. Comorbidities of CRSWD may affect psychopathological characteristics and psychosocial functioning.

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Effect of add-on ramelteon therapy on sleep and circadian rhythm disruption in patients with schizophrenia: A randomized controlled trial

Cited by 14 publications

References 28 publications

Disrupted Sleep and Circadian Rhythms in Schizophrenia and Their Interaction With Dopamine Signaling

Disrupted Sleep and Circadian Rhythms in Schizophrenia and Their Interaction With Dopamine Signaling

Effect of Haloperidol and Risperidone on Serum Melatonin and GAP-43 in Patients with Schizophrenia: A Prospective Cohort Study

Prevalence of Circadian Rhythm Sleep-Wake Disorder in Outpatients with Schizophrenia and Its Association with Psychopathological Characteristics and Psychosocial Functioning

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