Text 15907, 97 rader
Skriven 2007-02-06 17:36:20 av mike (1:379/45)
Ärende: Sleep medication linked to bizarre behaviour
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From: mike <mike@barkto.com>


http://www.newscientist.com/article/dn11115.html

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New evidence has linked a commonly prescribed sleep medication with bizarre
behaviours, including a case in which a woman painted her front door in her
sleep.

UK and Australian health agencies have released information about 240 cases of
odd occurrences, including sleepwalking, amnesia and hallucinations among
people taking the drug zolpidem.

While doctors say that zolpidem can offer much-needed relief for people with
sleep disorders, they caution that these newly reported cases should prompt a
closer look at its possible side effects.

Zolpidem, sold under the brand names Ambien, Stilnoct and Stilnox, is widely
prescribed to treat insomnia and other disorders such as sleep apnea. Various
forms of the drug, made by French pharmaceutical giant Sanofi-Aventis, were
prescribed 674,500 times in 2005 in the UK.

A newly published report from Australia’s Federal Health Department describes
104 cases of hallucinations and 62 cases of amnesia experienced by people
taking zolpidem since marketing of the drug began there in 2000. The health
department report also mentioned 16 cases of strange sleepwalking by people
taking the medication. Midnight snack

In one of these sleepwalking cases a patient woke with a paintbrush in her hand
after painting the front door to her house. Another case involved a woman who
gained 23 kilograms over seven months while taking zolpidem. “It was only when
she was discovered in front of an open refrigerator while asleep that the
problem was resolved,ö according to the report.

The UK’s Medicines and Healthcare products Regulatory Agency, meanwhile, has
recorded 68 cases of adverse reactions to zolpidem from 2001 to 2005.

The newly reported cases in the UK and Australia add to a growing list of
bizarre sleepwalking episodes linked to the drug in other countries, including
reports of people sleep-driving while on the medication. In one case, a
transatlantic flight had to be diverted after a passenger caused havoc after
taking zolpidem. Hypnotic effects

There is no biological pathway that has been proven to connect zolpidem with
these behaviours. The drug is a benzodiazepine-like hypnotic that promotes deep
sleep by interacting with brain receptors for a chemical called
gamma-aminobutyric acid. While parts of the brain become less active during
deep sleep, the body can still move, making sleepwalking a possibility.

The product information for prescribers advises that psychiatric adverse
effects, including hallucinations, sleepwalking and nightmares, are more likely
in the elderly, and treatment should be stopped if they occur.

Patient advocacy groups say they would like government health agencies and drug
companies to take a closer look at the possible risks associated with sleep
medicines. They stress that strange sleepwalking and sleep-driving behaviours
can have risky consequences.

“When people do something in which they’re not in full control it’s always a
danger,ö says Vera Sharav of the New York-based Alliance for Human Research
Protection, a US network that advocates responsible and ethical medical
research practices. Tried and tested

“The more reports that come out about the potential side effects of the drug,
the more research needs to be done to understand if these are real side
effects,ö says sleep researcher Kenneth Wright at the University of Colorado in
Boulder, US.

Millions of people have taken the drug without experiencing any strange side
effects, points out Richard Millman, a professor of medicine at Brown Medical
School and director of the Sleep Disorders Center of Lifespan Hospitals in
Providence, Rhode Island, US. He says that unlike older types of sleep
medications, zolpidem does not carry as great a risk of addiction.

And Wright notes that some of the reports of “sleep-drivingö linked to zolpidem
can be easily explained: some patients have wrongly taken the drug right before
leaving work in hopes that the medicine will kick in by the time they reach
home. Doctors stress that the medication should be taken just before going to
bed.

The US Food and Drug Administration says it is continuing to "actively
investigate" and collect information about cases linking zolpidem to unusual
side effects.

The Ambien label currently lists strange behaviour as a “special concernö for
people taking the drug. “It’s a possible rare adverse event,ö says
Sanofi-Aventis spokesperson Melissa Feltmann, adding that the strange
sleepwalking behaviours “may not necessarily be caused by the drugö but instead
result from an underlying disorder. She says that “the safety profile [of
zolpidem] is well establishedö. The drug received approval in the US in 1993.
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