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Trial of Zolpidem, Eszopiclone, and Other GABA Agonists in a Patient with Progressive Supranuclear Palsy.

Chang AY, Weirich E - Case Rep Med (2014)

Bottom Line: Zolpidem, a gamma aminobutyric acid (GABA) agonist specific to the α-1 receptor subtype, has been reported to show improvements in symptoms of PSP patients, including motor dysfunction, dysarthria, and ocular disturbances.We observed a 73-year-old woman with a six-year history of PSP, who, upon administration of a single 12.5 mg dose of sustained-release zolpidem, exhibited marked enhancements in speech, facial expressions, and fine motor skills for five hours.These results were reproduced upon subsequent clinic visits.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Stanford University Medical Center, 300 Pasteur Drive, Palo Alto, CA 94305, USA.

ABSTRACT
Progressive supranuclear palsy (PSP) is a progressive, debilitating neurodegenerative disease of the Parkinson-plus family of syndromes. Unfortunately, there are no pharmacologic treatments for this condition, as most sufferers of the classic variant respond poorly to Parkinson medications such as levodopa. Zolpidem, a gamma aminobutyric acid (GABA) agonist specific to the α-1 receptor subtype, has been reported to show improvements in symptoms of PSP patients, including motor dysfunction, dysarthria, and ocular disturbances. We observed a 73-year-old woman with a six-year history of PSP, who, upon administration of a single 12.5 mg dose of sustained-release zolpidem, exhibited marked enhancements in speech, facial expressions, and fine motor skills for five hours. These results were reproduced upon subsequent clinic visits. In an effort to find a sustainable medication that maximized these beneficial effects while minimizing side effects and addressing some of her comorbid neuropsychological conditions, a trial of five other GABA receptor agonists was performed with the patient's consent, while she and her caregivers were blinded to the specific medications. She and her caretakers subsequently reported improvements, especially visual, while on eszopiclone, and, to a lesser degree, temazepam and flurazepam.

No MeSH data available.


Related in: MedlinePlus

Writing/drawing samples from patient. A writing sample and attempt at copying the Folstein MMSE intersecting pentagon figure. The left panel shows an attempt at both in the absence of medication. The right panel shows subsequent improvement when taking zolpidem CR. The original figure from the Folstein document is reproduced above.
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Related In: Results  -  Collection


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fig1: Writing/drawing samples from patient. A writing sample and attempt at copying the Folstein MMSE intersecting pentagon figure. The left panel shows an attempt at both in the absence of medication. The right panel shows subsequent improvement when taking zolpidem CR. The original figure from the Folstein document is reproduced above.

Mentions: The patient was able to speak in intelligible complete sentences with a full vocabulary and normal content, though her speech was still slightly slurred. Facial expressiveness was greatly expanded (e.g., visible changes during thinking, laughing, frustration, smiling, and whispering). Fine motor control was improved, as demonstrated in her quality of writing and figure drawing (Figure 1). She also noted greater motivation to converse, write, and move herself. She denied feelings of somnolence or confusion, instead expressing that she felt more alert and active.


Trial of Zolpidem, Eszopiclone, and Other GABA Agonists in a Patient with Progressive Supranuclear Palsy.

Chang AY, Weirich E - Case Rep Med (2014)

Writing/drawing samples from patient. A writing sample and attempt at copying the Folstein MMSE intersecting pentagon figure. The left panel shows an attempt at both in the absence of medication. The right panel shows subsequent improvement when taking zolpidem CR. The original figure from the Folstein document is reproduced above.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4209775&req=5

fig1: Writing/drawing samples from patient. A writing sample and attempt at copying the Folstein MMSE intersecting pentagon figure. The left panel shows an attempt at both in the absence of medication. The right panel shows subsequent improvement when taking zolpidem CR. The original figure from the Folstein document is reproduced above.
Mentions: The patient was able to speak in intelligible complete sentences with a full vocabulary and normal content, though her speech was still slightly slurred. Facial expressiveness was greatly expanded (e.g., visible changes during thinking, laughing, frustration, smiling, and whispering). Fine motor control was improved, as demonstrated in her quality of writing and figure drawing (Figure 1). She also noted greater motivation to converse, write, and move herself. She denied feelings of somnolence or confusion, instead expressing that she felt more alert and active.

Bottom Line: Zolpidem, a gamma aminobutyric acid (GABA) agonist specific to the α-1 receptor subtype, has been reported to show improvements in symptoms of PSP patients, including motor dysfunction, dysarthria, and ocular disturbances.We observed a 73-year-old woman with a six-year history of PSP, who, upon administration of a single 12.5 mg dose of sustained-release zolpidem, exhibited marked enhancements in speech, facial expressions, and fine motor skills for five hours.These results were reproduced upon subsequent clinic visits.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Stanford University Medical Center, 300 Pasteur Drive, Palo Alto, CA 94305, USA.

ABSTRACT
Progressive supranuclear palsy (PSP) is a progressive, debilitating neurodegenerative disease of the Parkinson-plus family of syndromes. Unfortunately, there are no pharmacologic treatments for this condition, as most sufferers of the classic variant respond poorly to Parkinson medications such as levodopa. Zolpidem, a gamma aminobutyric acid (GABA) agonist specific to the α-1 receptor subtype, has been reported to show improvements in symptoms of PSP patients, including motor dysfunction, dysarthria, and ocular disturbances. We observed a 73-year-old woman with a six-year history of PSP, who, upon administration of a single 12.5 mg dose of sustained-release zolpidem, exhibited marked enhancements in speech, facial expressions, and fine motor skills for five hours. These results were reproduced upon subsequent clinic visits. In an effort to find a sustainable medication that maximized these beneficial effects while minimizing side effects and addressing some of her comorbid neuropsychological conditions, a trial of five other GABA receptor agonists was performed with the patient's consent, while she and her caregivers were blinded to the specific medications. She and her caretakers subsequently reported improvements, especially visual, while on eszopiclone, and, to a lesser degree, temazepam and flurazepam.

No MeSH data available.


Related in: MedlinePlus