Zolpidem increases GABA in depressed volunteers maintained on SSRIs

Licata, Stephanie C.; Jensen, J. Eric; Conn, Nina A.; Winer, Jeffrey P.; Lukas, Scott E.

doi:10.1016/j.pscychresns.2014.05.009

Cited by 13 publications

(7 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Kripke (2007) reported in a meta-analysis of randomized, controlled trial studies on hypnotics, including zolpidem, that the incidence of depression was significantly higher in the hypnotics groups than in the placebo groups (2.0% vs. 0.9%). In addition, in recent randomized, controlled trials of a single 10 mg dose of zolpidem (Licata, Jensen, Conn, Winer, & Lukas, 2014;Licata et al, 2009) the zolpidem groups reported significantly higher dysphoric symptoms than did the control groups, in both healthy and depressed volunteers. However, in the current study, the association between zolpidem use and suicide remained significant after controlling for psychiatric disorders, which is consistent with the previous Taiwanese study (Sun et al, 2016).…”

Section: Discussionmentioning

confidence: 95%

Zolpidem Use and Suicide Death in South Korea: A Population‐Based Case–Control Study

Choi

Sung

Nam

et al. 2019

Suicide & Life Threat Behav

View full text Add to dashboard Cite

Objective To investigate whether zolpidem use is associated with suicide death in adults. Method We conducted a case–control study using the National Health Insurance Service‐National Sample Cohort (NHIS‐NSC) database. Cases were adults with a suicide record (ICD‐10 codes; X‐60‐X84, Y87.0) between January 1, 2004 and December 31, 2013. 10 Controls were matched to each case by age, sex, index year, region, income level, and health insurance type. Zolpidem use during 2 years before suicide was quantified. Adjusted odd ratios (aORs) with 95% confidence intervals (CIs) were estimated using conditional logistic regression. Results The percentage of zolpidem users was significantly higher in cases (451 of 1,928 [23.4%]) than in controls (832 of 18,404 [4.5%]). After controlling for potential confounders, zolpidem use was significantly associated with suicide (aORs, 2.09; 95% CI, 1.74–2.52). Dose–response relationships were observed (for trend, p < .0001). Consistent findings were observed when analyses were restricted to suicide death (aORs, 2.08; 95% CI, 1.73–2.51) and nonmedication poisoning suicide death cases (aORs, 2.10; 95% CI, 1.74–2.53). Conclusions We found a significant and positive association between zolpidem use and suicide. Zolpidem should be prescribed cautiously and with due caution of increased suicide risk.

show abstract

Section: Discussionmentioning

confidence: 95%

Zolpidem Use and Suicide Death in South Korea: A Population‐Based Case–Control Study

Choi

Sung

Nam

et al. 2019

Suicide & Life Threat Behav

View full text Add to dashboard Cite

show abstract

“…Although the results of studies assessing valproate monotherapy for depression are not conclusive, and the use of benzodiazepines is restricted by their addictive potential, it is important to consider other therapeutic alternatives with a mechanism of action on GABAergic pathways as single-agent or coadjuvant therapy. That is, the case of repetitive transcranial magnetic stimulation, which has been shown to be effective for the treatment of depression and to be involved in GABA/glutamate systems modulation 92 , and in that of drugs that modulate the same system such as ketamine 92 and zolpidem 93 . In the same token, assessing the antidepressant therapeutic potential of neuroactive steroids 94 might enable the proposal of novel treatment strategies for patients with depression or for particular groups of depressed patients such as women with postpartum depression or during peri menopause and patients with treatment-resistant de pression.…”

Section: Discussionmentioning

confidence: 99%

The role of gamma-aminobutyric acid in female depression

Flores‐Ramos¹,

Salinas²,

Carvajal-Lohr³

et al. 2023

GMM

View full text Add to dashboard Cite

Depression is a common psychiatric disorder and a leading cause of disability worldwide. Multiple and diverse factors are involved in its cause although biologic factors are prominent. The present study reviews the evidence about the role that gamma-aminobutyric acid (GABA) plays in the complex pathogenesis of depression, particularly in women. The implication of GABA is based mainly from animal models, whereas clinical studies in depressed patients show alterations of GABA levels in plasma and cerebrospinal fluid. Neuroimaging studies using spectroscopy indicate also decreased GABA levels in different brain areas which in turn may normalize after antidepressant therapy, and these findings translate into clinical response. It has been observed that depression has a higher prevalence among women which suggests a link between depression and hormonal changes. Similarly, gonadal hormones have a regulatory effect on the hypothalamic-pituitary-adrenal axis through GABA receptors making women more vulnerable to suffer stress and depression. Therefore, the implication of GABA in the neurobiology of depression should be explored to search for new therapeutic strategies.

show abstract

“…The binding of zolpidem in healthy controls, in which the glutamatergic/GABAergic balance is not impaired, leads to cortical inhibition. Conversely, an increased GABA/tCr ratio has been reported in the thalamus and anterior cingulate of patients with major depressive disorder after zolpidem administration [28]. Hence, the effect of zolpidem seems to be influenced by changes in receptor configurations and how the glutamatergic/GABAergic balance is affected by neuropsychiatric disorders.…”

Section: Discussionmentioning

confidence: 99%

Multimodal neurometabolic investigation of the effects of zolpidem on leukoencephalopathy‐related apathy

Delorme¹,

Adanyeguh

Bendetowicz

et al. 2020

Euro J of Neurology

View full text Add to dashboard Cite

Background and purpose: The symptomatic effect of zolpidem on apathy has been reported in neurological disorders such as strokes and post-anoxic brain injuries, but not in white-matter disease of the brain. Methods: A 38-year-old patient presenting with severe apathy related to a genetic leukoencephalopathy but showing marked improvement of apathy after taking 10 mg of zolpidem was studied. To understand what may mediate such a clinical effect, a multimodal neurometabolic approach using 18 F fluorodeoxyglucose positron emission tomography (FDG-PET) and a dedicated magnetic resonance spectroscopy (MRS) sequence for gamma aminobutyric acid (GABA) and glutamine + glutamate metabolism was undertaken. Results: Pre-zolpidem FDG-PET showed hypometabolism in the orbitofrontal cortex, dorsolateral cortex and basal ganglia compared to healthy controls. Post-zolpidem, FDG-PET displayed increased metabolism in the orbitofrontal cortex together with improvement in the emotional and auto-activation domains of apathy. There was no improvement in the cognitive domain of apathy, and no change in metabolism in the dorsolateral frontal cortex. Postzolpidem, MRS showed increased GABA and glutamine + glutamate levels in the frontal cortex and pallidum. Conclusion: Our multimodal neurometabolic study suggests that the effects of zolpidem on apathy are related to increased metabolism in the orbitofrontal cortex and basal ganglia secondary to GABA modulation. Zolpidem may improve apathy in other white-matter disorders.

show abstract

Zolpidem increases GABA in depressed volunteers maintained on SSRIs

Cited by 13 publications

References 37 publications

Zolpidem Use and Suicide Death in South Korea: A Population‐Based Case–Control Study

Zolpidem Use and Suicide Death in South Korea: A Population‐Based Case–Control Study

The role of gamma-aminobutyric acid in female depression

Multimodal neurometabolic investigation of the effects of zolpidem on leukoencephalopathy‐related apathy

Contact Info

Product

Resources

About