Zolpidem is the most widely prescribed ( and most costly) hypnotic agent worldwide.It act on the GABA system. Previous reports suggest that it produce unexpected neuropsychiatric effects in patients with Parkinson’s disease. However, large population based studies were not available to conclude on this observation.Taiwanese researchers lead by Yu-Wan Yang did a population-based study using the National Health Insurance Research Database in Taiwan to investigate the association between zolpidem and PD in patients with sleep disturbance.
Around 100,000 patients treated for sleep disturbance were included in this analysis. Nearly 60,000 received Zolpidem.They were compared against 42,000 who did not receive zolpidem for their sleep disturbance.
At the end of the follow up period (7 years), 522 (1.2%) in the zolpidem group and 287 (0.5%) in the control group developed Parkinson’s disease. Higher use of zolpidem was associated with higher incidence of Parkinson’s disease.
This is the first study to show a dose response relationship between zolpidem and risk of Parkinson’s disease. The large data base and the near complete follow up rate makes the conclusions more reliable.Previous observations of Zolpidem’s benefit in aphasia and its ability to improve brain perfusion etc need further assessment in light of these findings.
Conclusion: Zolpidem can increase the risk of Parkinson’s Disease. Clinicians need to weigh such risks before prescribing this medication.
Summary of the article:
Yang YW, Hsieh TF, Yu CH, Huang YS, Lee CC, Tsai TH. J Psychiatr Res. 2014 Nov;58:84-8