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 reported." 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] - USA 803284795 0114-9954/17/1680-0001/$14.95 Adis © 2017 Springer International Publishing AG. All rights reserved Reactions 2 Dec 2017 No. 1680
Reactions Weekly – Springer Journals
Published: Dec 2, 2017
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