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LETTER TO EDITOR
Year : 2015  |  Volume : 37  |  Issue : 4  |  Page : 476-477  

Sleep-walking with zolpidem: Need for continued postmarketing surveillance


1 Department of Pharmacology, Pondicherry Institute of Medical Sciences, Puducherry, India
2 Department of Emergency Medicine Services, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India

Date of Web Publication29-Oct-2015

Correspondence Address:
Ajitha Sharma
Department of Pharmacology, Pondicherry Institute of Medical Sciences, Puducherry
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0253-7176.168617

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How to cite this article:
Sharma A, Prakasha S R. Sleep-walking with zolpidem: Need for continued postmarketing surveillance. Indian J Psychol Med 2015;37:476-7

How to cite this URL:
Sharma A, Prakasha S R. Sleep-walking with zolpidem: Need for continued postmarketing surveillance. Indian J Psychol Med [serial online] 2015 [cited 2020 Jan 20];37:476-7. Available from: http://www.ijpm.info/text.asp?2015/37/4/476/168617

Sir,

We read with great interest the report on zolpidem causing sleep-walking by Singh et al. [1] A few reports on this rare adverse effect of zolpidem have been described from various parts of the world, as mentioned by the authors. In addition, we came across a few more similar case reports. [2],[3] Zolpidem is a non-benzodiazepine hypnotic agent, acting on α1 subunit of the benzodiazepine (BZD) receptor which is a part of the gamma-aminobutyric acid type A (GABA A ) receptor-chloride channel complex. The proposed hypothesis regarding mechanism for zolpidem induced somnambulism is desensitization of GABA receptors located on serotonergic neurons. [4] Though there are scattered reports of somnambulism with zolpidem, the incidence is yet to be determined.

In a postmarketing surveillance study, sleep-walking was seen in 7 out of 1972 patients (0.3%). [5] Furthermore, there were few reports of zolpidem causing other parasomnias like sleep-driving and sleep-eating, which could be a source of danger to the patient, as well as others. The Food and Drug Administration issued a request to drug manufacturers to include these warnings in the labels of drugs approved for the treatment of insomnia in December 2006. [6] In spite of these warnings, it is pertinent that zolpidem intake should be carefully scrutinized, and any somnambulism noted be reported so as to determine the incidence of this potentially dangerous adverse effect. Postmarketing surveillance plays a crucial role to this effect and hence the need for a dynamic, relentless monitoring of adverse drug reactions.

 
   References Top

1.
Singh H, Thangaraju P, Natt NK. Sleep-walking a rarest side effect of zolpidem. Indian J Psychol Med 2015;37:105-6.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.
Sharma A, Dewan VK. A case report of zolpidem-induced somnambulism. Prim Care Companion J Clin Psychiatry 2005;7:74.  Back to cited text no. 2
    
3.
Hoque R, Chesson AL Jr. Zolpidem-induced sleepwalking, sleep related eating disorder, and sleep-driving: Fluorine-18-lourodeoxyglucose positron emission tomography analysis, and a literature review of other unexpected clinical effects of zolpidem. J Clin Sleep Med 2009;5:471-6.  Back to cited text no. 3
    
4.
Juszczak GR. Desensitization of GABAergic receptors as a mechanism of zolpidem-induced somnambulism. Med Hypotheses 2011;77:230-3.  Back to cited text no. 4
    
5.
Ganzoni E, Santoni JP, Chevillard V, Sébille M, Mathy B. Zolpidem in insomnia: A 3-year post-marketing surveillance study in Switzerland. J Int Med Res 1995;23:61-73.  Back to cited text no. 5
    
6.
Zammit G. Comparative tolerability of newer agents for insomnia. Drug Saf 2009;32:735-48.  Back to cited text no. 6
    




 

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