DOI: 10.1097/JCP.0b013e3181fbbb7d
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PMID: 21057240
Issn Print: 0271-0749
Publication Date: 2010/12/01
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Excerpt
Schizophrenia is a chronic psychiatric disorder characterized by distortion of thinking and perception and by an inappropriate or blunted affect. Although sleep disorders do not pertain to the clinical core of its symptoms, it affects the quality of life of schizophrenic patients.1 Several sleep disorders have been described in patients with schizophrenia, insomnia,2 arrhythmic circadian rest-activity cycles,3 and sleep-disordered breathing.4 Pharmacological strategies to treat insomnia in schizophrenia include adding sedative antipsychotics and the use of hypnotics.5
Agomelatine, a new antidepressant with norepinephrine-dopamine disinhibition properties because of its antagonism on the 5-hydroxytryptamine 2C receptor,6 has recently been approved by the European Medicines Agency and has proved to be effective in the treatment of moderate to severe major depressive disorder.7 Agomelatine is also a potent agonist at melatonin receptors.6 Melatonin is the main pineal hormone that plays a major role in the induction and regulation of sleep.8 Schizophrenic patients with insomnia have been reported to benefit from melatonin treatment.9 Melatonin has also been used to diminish benzodiazepine intake in patients with insomnia.10
In this article, we describe the case of a patient with chronic simple schizophrenia and severe insomnia and depression that only had a partial response to high doses of benzodiazepines and sedating antipsychotics. Treatment with agomelatine permitted the patient to completely suspend benzodiazepines.
