Abstract Details

Title Zolpidem Improves Tardive Dyskinesia with and without Akathisia

Topic Movement Disorders

Presentation(s) P07 - (-)

Poster/Presentation
Number 205

Objective

Background BACKGROUND: TD is a group of delayed-onset, iatrogenic movement disorders caused by dopamine-receptor blocking agents. TD frequently persists after eliminating offending drugs, and is often resistant to pharmacological treatment. Zolpidem is a nonbenzodiazepine-related hypnotic drug that binds to the omega site of the GABA-benzodiazepine receptor complex found in high density in basal ganglia. Zolpidem was previously reported to be effective in a variety of movement disorders including Parkinson's disease, myoclonus-dystonia syndrome, primary dystonia, progressive supranuclear palsy, and ataxia. One animal study concluded that zolpidem exhibits neuroprotective and anti-oxidant qualities and therefore can prevent and treat TD.There were no human studies or reports of zolpidem effectiveness in TD.

Design/Methods DESIGN/METHODS: Patients with TD who reported improvement of the symptoms with zolpidem were identified from our video database from 9/2006 through 10/2012. Patients' videos before and after administration of a single dose of zolpidem were compared.

Results RESULTS: Patient 1. 67 year-old woman was treated with neuroleptics for multiple personality disorder with psychosis and developed TD with oro-bucco-lingual stereotypy, craniocervical dystonia, dystonic respiratory dysregulation, resistant to conventional medications. All symptoms markedly improved after a single dose of 15 mg of zolpidem. Patient 2. 25 year-old woman with recurrent psychotic episodes treated with neuroleptics, developed generalized TD, tardive craniocervical dystonia and severe akathisia, unresponsive to tetrabenazine. All symptoms dramatically improved after 10 mg of zolpidem. Both patients continued having good benefit from zolpidem administered a few times daily without side effects of drowsiness.

Conclusions CONCLUSIONS: Zolpidem can be safe and effective alternative treatment of TD with and without akathisia, resistant to other medications. A placebo-controlled study is needed to further investigate the effectiveness of zolpidem in TD.

Authors/Disclosures
Olga Waln, MD (Methodist Neurological Institute) PRESENTER	Dr. Waln has nothing to disclose.
Douglas L. Arnold, MD, FAAN (Montreal Neurological Institute, McGill Univ)	Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for BMS. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Frequency Therapeutics. Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Merck. Dr. Arnold has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Novartis. Dr. Arnold has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. Dr. Arnold has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sanofi. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Shionogi. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Xfacto communications. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eli Lilly. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EMD Serono. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biohaven. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Find therapeutics. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for GSK. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Idorsia. Dr. Arnold has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Kiniksa. Dr. Arnold has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Clario.
Joseph Jankovic, MD, FAAN (Baylor College of Medicine)	Dr. Jankovic has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Revance. Dr. Jankovic has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Revance, Allergan. The institution of Dr. Jankovic has received research support from Baylor College of Medicine. Dr. Jankovic has received research support from Abbvie. The institution of Dr. Jankovic has received research support from Abbvie.

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