Non-24-hour sleep-wake syndrome improved by low-dose valproic acid: a case report

Neuropsychiatr Dis Treat. 2016 Dec 13:12:3199-3203. doi: 10.2147/NDT.S115648. eCollection 2016.


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.

Keywords: antidepressants; circadian rhythm sleep disorder; depression; melatonin; mood stabilizers; phototherapy; vitamin B12.

Publication types

  • Case Reports