Reactions 1680, p292 - 2 Dec 2017
Parasomnias: case report
A female patient [age not stated] developed parasomnia
involving episodes of sleep-walking, sleep-talking, sleep-
eating and sleep-driving following combined treatment with
zolpidem and off-label quetiapine [dosages, routes and time to
reactions onset not stated].
The female patient had bipolar I disorder. She was being
treated with zolpidem for insomnia (for many years) without
parasomnia. During one hospitalisation, zolpidem treatment
was switched to quetiapine (off-label setting). She did not have
any episode of parasomnia. When she was discharged,
zolpidem was added to her quetiapine therapy. Within
2 months after starting this combination therapy, she showed
abnormal nocturnal behaviours. She would wake form her
sleep, talk to her friends for hours on the phone (sleep-talking),
walk to the kitchen to eat (sleep-walking and sleep-eating). She
even had episodes of driving out (sleep-driving). She did not
recollect any of these events.
The female patient’s zolpidem treatment was discontinued
and her parasomnia episodes resolved. Clonazepam was
added to her quetiapine treatment and her insomnia resolved.
She did not have any recurrence of parasomnia later.
Author comment: "She presented with parasomnia on a
combination of quetiapine and zolpidem." "According to the
serotonergic hypothesis of somnambulism, serotonergic
neurons can be activated, exert excitatory action on motor
neurons and precipitate somnambulism." "Zolpidem is a
GABA-A receptor agonist to treat insomnia. Many cases of
zolpidem-induced complex sleep behaviors have been
Chan C, et al. Complex sleep behaviors in patient treated with quetiapine and
zolpidem for insomnia. CNS Spectrums 21: 119-120, No. 1, 22 Feb 2016.
Available from: URL: http://doi.org/10.1017/S1092852915000905 [abstract] -
Reactions 2 Dec 2017 No. 16800114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved