Improvement of blepharospasm with Zolpidem

Garretto, Nélida; Bueri, J. A.; Rey, Roberto; Arakaki, Tomoko; Nano, Gabriela; Mancuso, Marcela

doi:10.1002/mds.20085

Cited by 24 publications

(21 citation statements)

References 8 publications

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“…Subsequent perfusion testing with radiolabelled isotopes showed improved areas of hypoactivity with improved perfusion after zolpidem [8]. Further case reports have been pupblished in blepharospasm, spinocerebellar ataxia and aphasia after stroke where SPECT imaging showed a 40% increase in regional blood flow in Broca's area, left middle frontal and supramarginal gyri and bilateral orbitofrontal cortex [9][10][11]. Zopiclone, a drug in the same class, has also been reported to have the same effect [12].…”

Section: Discussionmentioning

confidence: 94%

Zolpidem in a minimally conscious state

et al. 2008

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Section: Discussionmentioning

confidence: 94%

Zolpidem in a minimally conscious state

et al. 2008

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“…Although there are several options to treat dystonia, its medical treatment is notoriously difficult and often unsuccessful. Zolpidem, an imidazopyridine agonist with a high affinity to benzodiazepine subtype receptor BZ1 (ω1; Holm and Goa, 2000), is reported to improve basal ganglia disease including Parkinson’s disease (Daniele et al, 1997) and various types of dystonia (Evidente, 2002; Garretto et al, 2004; An et al, 2008; Park et al, 2009) Despite these case reports, zolpidem has not been tested in a large number of patients with various subtypes of dystonia. Here we report two dystonia patients who improved remarkably by oral zolpidem therapy, and assessed treatment outcome of zolpidem in 34 medically intractable patients suffering from miscellaneous types of dystonia, in order to determine what subtypes of dystonia are good candidates for zolpidem trial.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of zolpidem for dystonia: a study among different subtypes

et al. 2012

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Although there are some newly developed options to treat dystonia, its medical treatment is not always satisfactory. Zolpidem, an imidazopyridine agonist with a high affinity on benzodiazepine subtype receptor BZ1 (ω1), was found to improve clinical symptoms of dystonia in a limited number of case reports. To investigate what subtype of dystonia is responsive to the therapy, we conducted an open label study to assess the efficacy of zolpidem (5–20 mg) in 34 patients suffering from miscellaneous types of dystonia using the Burke–Fahn–Marsden Dystonia Rating Scale (BFMDRS). Patients were entered into the study if they had been refractory to other medications as evaluated by BFMDRS (no change in the previous two successive visits). After zolpidem therapy, the scores in the patients as a whole were decreased from 7.2 ± 7.9 to 5.5 ± 5.0 (P = 0.042). Patients with generalized dystonia, Meige syndrome/blepharospasm, and hand dystonia improved in the scale by 27.8, 17.8, and 31.0%, respectively, whereas no improvement was found in cervical dystonia patients. Overall response rate among patients were comparable to that of trihexyphenidyl. Zolpidem may be a therapeutic option for generalized dystonia, Meige syndrome, and hand dystonia including musician’s. Drowsiness was the dose-limiting factor.

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“…A recent study on subjective effects of zolpidem sheds light on this issue where 10 mg was rated to be unpleasant while 20 mg was rated as “likable” and giving a “high.”[5] Similar to this case, activation instead of somnolence is reported when zolpidem is used at high doses such as 40 mg/day for blepharospasm. [6] There can be multiple pharmacokinetic and pharmacodynamic explanations of these unexpected effects and side effects. A plausible pharmacokinetic explanation is that short half-life agents have higher abuse potential.…”

Section: Discussionmentioning

confidence: 99%

High-dose zolpidem dependence - Psychostimulant effects? A case report and literature review

et al. 2016

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Zolpidem, an imidazoline nonbenzodiazepine sedative drug, is used widely. Initial reports showed minimal abuse potential. However, multiple reports have appeared of dose escalation and abuse. Subjective effects of high-dose zolpidem are not known. In light of accumulating evidence of abuse potential, we hereby report a case of high-dose dependence and a review of relevant literature. A 33-year-old male presented with 5 years of daily use of 600–1700 mg of zolpidem tartrate. He reported subjective effects of euphoria, intense craving, and inability to stop use. Loss of receptor specificity, pharmacokinetic factors, and different receptor distributions can explain paradoxical stimulatory effects of high-dose zolpidem. Further studies are required to characterize subjective effects of high-dose zolpidem.

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Improvement of blepharospasm with Zolpidem

Abstract: Zolpidem (ZLP) is an imidazopyridine that binds to GABA receptors. We report on improvement of blepharospasm in 3 patients treated with ZLP. The GABAergic action of this drug on the output structures of the basal ganglia could explain the improvement of blepharospasm in these patients.

Cited by 24 publications

References 8 publications

Zolpidem in a minimally conscious state

Zolpidem in a minimally conscious state

Efficacy of zolpidem for dystonia: a study among different subtypes

High-dose zolpidem dependence - Psychostimulant effects? A case report and literature review

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