A Case with Improvement of Blepharospasm by Zolpidem

Sunwoo, Mun-Kyung; Cho, Junghee; Lee, Jun Hong; Kim, Gyu Sik; Choi, Sun-Ah

doi:10.14802/jmd.11010

Cited by 4 publications

(4 citation statements)

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“…The Table includes a list of included studies and their characteristics. Most were classified under movement disorders (n = 31) or DOCs (n = 22) . For movement disorders, the most common diagnosis was dystonia (n = 10), including generalized dystonia, cervical dystonia, hand dystonia, tongue dystonia, oromandibular dystonia, blepharospasm, segmental axial dystonia, limb dystonia, spastic dysphonic dystonia, Meige syndrome, myoclonus dystonia syndrome, and Filipino X-linked dystonia .…”

Section: Resultsmentioning

confidence: 99%

“…Most were classified under movement disorders (n = 31) or DOCs (n = 22) . For movement disorders, the most common diagnosis was dystonia (n = 10), including generalized dystonia, cervical dystonia, hand dystonia, tongue dystonia, oromandibular dystonia, blepharospasm, segmental axial dystonia, limb dystonia, spastic dysphonic dystonia, Meige syndrome, myoclonus dystonia syndrome, and Filipino X-linked dystonia . Other diagnoses included Parkinson disease (n = 6), progressive supranuclear palsy (n = 6), catatonia (n = 5), postanoxic spasticity (n = 1), tardive dyskinesia (n = 1), central pontine myelinolysis (n = 1), and drug-induced parkinsonism (n = 1) .…”

Section: Resultsmentioning

confidence: 99%

“…Most were classified under movement disorders (n = 31) 1, or DOCs (n = 22). 2, For movement disorders, the most common diagnosis was dystonia (n = 10), 8,16,18,22,[24][25][26]29,30,32 including generalized dystonia, 24,25 cervical dystonia, 24,25 hand dystonia, 24 tongue dystonia, 25 oromandibular dystonia, 22,32 blepharospasm, 18,30 segmental axial dystonia, 29 limb dystonia, 25 spastic dysphonic dystonia, 25 Meige syndrome, 8,18,24,25 myoclonus dystonia syndrome, 26 and Filipino X-linked dystonia. 16 Other diagnoses included Parkinson disease (n = 6), 1,7,10,19,28,31 progressive supranuclear palsy (n = 6), 9,11,12,14,15,23 catatonia (n = 5), 6,13,20,21,…”

Section: Neurologic Disordersmentioning

confidence: 99%

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Zolpidem for the Treatment of Neurologic Disorders

et al. 2017

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IMPORTANCE Given its selective action on the ω1 subtype of the γ-aminobutyric acid A receptor, zolpidem tartrate presents a potential treatment mechanism for other neurologic disorders.OBJECTIVE To synthesize studies that used zolpidem to treat neurologic disorders.EVIDENCE REVIEW Eligibility criteria included any published English-language article that examined the use of zolpidem for noninsomnia neurologic disorders in humans for all dates up to March 20, 2015. Searched databases included PubMed, Scopus, Web of Science Core Collection, the Cochrane Library, EMBASE, CENTRAL, and clinicaltrials.gov. Publication bias was mitigated by searching clinicaltrials.gov for unpublished studies. Two rounds of screening were performed based on title and then abstract, and coding was performed by 2 coders. All methods followed the PRISMA Reporting Guidelines for systematic reviews of the literature.FINDINGS The initial search produced 2314 articles after removing duplicates. After exclusion based on a review of abstracts, 67 articles remained for full manuscript review. Thirty-one studies treated movement disorders, 22 treated disorders of consciousness, and 14 treated other neurologic conditions, including stroke, traumatic brain injury, encephalopathy, and dementia. Study designs included case reports (n = 28), case series (n = 8), single-patient interventional (n = 13), pretest and posttest (n = 9), randomized clinical trials (n = 9), and crossover studies (n = 5). Only 11 studies had more than 10 participants. Effects of zolpidem were wide ranging (eg, improvement on the JFK Coma Recovery Scale-Revised, the Unified Parkinson Disease Rating Scale, and the Burke-Fahn-Marsden Dystonia Rating Scale) and generally lasted 1 to 4 hours before the participant returned to baseline. Sedation was the most common adverse effect.CONCLUSIONS AND RELEVANCE Zolpidem has been observed to transiently treat a large variety of neurologic disorders, most often related to movement disorders and disorders of consciousness. Much of what is known comes from case reports and small interventional trials. These findings may represent a new treatment mechanism for these disorders.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Neurologic Disordersmentioning

confidence: 99%

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Zolpidem for the Treatment of Neurologic Disorders

et al. 2017

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“…A case report of a patient with Meige syndrome, initially unresponsive to botulinum toxin A, baclofen, and trihexyphenidyl, showed complete resolution of symptoms within 1 h of intake of zolpidem 12.5 mg, with symptom free periods lasting for 4 h (14). A patient with blepharospasm refractory to botulinum toxin injections showed much improvement of symptoms within 30 min after taking zolpidem 10 mg, with effects lasting for 5 h (16).…”

Section: Resultsmentioning

confidence: 99%

Zolpidem for the Treatment of Dystonia

Badillo

Jamora

2019

Front. Neurol.

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Background and Purpose: There are recent reports of zolpidem being effective for the treatment of a variety of movement disorders, due to its action on the gamma-aminobutyric acid A receptors in the thalamus, subthalamic nucleus, and globus pallidus, hence facilitating inhibitory pathways in the basal ganglia motor loop. Its beneficial effects have been described for Parkinson's disease and other related disorders. The objective of this study was to assess the therapeutic effects of zolpidem for various types of dystonia. Methods: We conducted a literature search using MEDLINE via PubMed, Cochrane Library, EMBASE, Scopus, and Google Scholar. Results: There were no randomized controlled trials. The literature included 6 case reports, 4 case series, and 1 non-randomized, non-controlled interventional trial. Overall, 49 adult participants (range 1–34 participants) with a mean age of 49.5 years were treated. Regardless of the dystonia subtype, a single dose of zolpidem at 10 mg causes improvement of symptoms for a mean duration of 3.4 h until patient returns to baseline. The main adverse effect noted was drowsiness, which was dose-dependent. Conclusion: While the current available literature suggests that zolpidem may be an effective pharmacologic option for treating dystonia, however the quality of evidence remains limited. Larger sample size, methodological consistency, and randomized controlled trials with long-term patient follow-ups are necessary to come up with definitive conclusion.

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Can a Positive Allosteric Modulation of GABAergic Receptors Improve Motor Symptoms in Patients with Parkinson’s Disease? The Potential Role of Zolpidem in the Treatment of Parkinson’s Disease

Daniele

Greco

Logroscino

et al. 2016

Parkinson's Disease

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At present, patients with advanced Parkinson's disease (PD) are unsatisfactorily controlled by currently used anti-Parkinsonian dopaminergic drugs. Various studies suggest that therapeutic strategies based on nondopaminergic drugs might be helpful in PD. Zolpidem, an imidazopyridine widely used as sleep inducer, shows high affinity only for GABAA receptors containing the α-1 subunit and facilitates GABAergic neurotransmission through a positive allosteric modulation of GABAA receptors. Various observations, although preliminary, consistently suggest that in PD patients zolpidem may induce beneficial (and sometimes remarkable) effects on motor symptoms even after single doses and may also improve dyskinesias. Since a high density of zolpidem binding sites is in the two main output structures of the basal ganglia which are abnormally overactive in PD (internal globus pallidus, GPi, and substantia nigra pars reticulata, SNr), it was hypothesized that in PD patients zolpidem may induce through GABAA receptors an inhibition of GPi and SNr (and, possibly, of the subthalamic nucleus also), resulting in an increased activity of motor cortical areas (such as supplementary motor area), which may give rise to improvement of motor symptoms of PD. Randomized clinical trials are needed in order to assess the efficacy, safety, and tolerability of zolpidem in treating motor symptoms of PD.

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A Case with Improvement of Blepharospasm by Zolpidem

Cited by 4 publications

References 10 publications

Zolpidem for the Treatment of Neurologic Disorders

Zolpidem for the Treatment of Neurologic Disorders

Zolpidem for the Treatment of Dystonia

Can a Positive Allosteric Modulation of GABAergic Receptors Improve Motor Symptoms in Patients with Parkinson’s Disease? The Potential Role of Zolpidem in the Treatment of Parkinson’s Disease

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