Risk of Parkinson’s Disease Following Zolpidem Use

Huang, Hui‐Chun; Tsai, Chon-Haw; Muo, Chih‐Hsin; Lin, Kang-Hsu; Lu, Ming-Kuei; Sung, Fung‐Chang; Kao, Chia‐Hung

doi:10.4088/jcp.13m08790

Cited by 19 publications

(8 citation statements)

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“…To increase the validity of clinical diagnoses, PD cases were identified from patients diagnosed with Parkinson's disease (ICD-9-CM: 322) in at least three outpatient visits within one year or in a one-time hospital admission. This definition was also used in studies that utilized the NHIRD [ 42 , 43 ]. The control subjects were randomly selected from beneficiaries without PD using a matching strategy for age (±5 years), sex, the year of PD diagnosis and the year of NHI program entrance for each identified case.…”

Section: Methodsmentioning

confidence: 99%

Long-term exposure to air pollution and the incidence of Parkinson’s disease: A nested case-control study

et al. 2017

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BackgroundPrevious studies revealed that chronic exposure to air pollution can significantly increase the risk of the development of Parkinson’s disease (PD), but this relationship is inconclusive as large-scale prospective studies are limited and the results are inconsistent. Therefore, the purpose of this study was to ascertain the adverse health effects of air pollution exposure in a nationwide population using a longitudinal approach.Materials and methodsWe conducted a nested case-control study using the National Health Insurance Research Dataset (NHIRD), which consisted of 1,000,000 beneficiaries in the National Health Insurance Program (NHI) in the year 2000 and their medical records from 1995 to 2013 and using public data on air pollution concentrations from monitoring stations across Taiwan released from the Environmental Protection Administration to identify people with ages ≥ 40 years living in areas with monitoring stations during 1995–1999 as study subjects. Then, we excluded subjects with PD, dementia, stroke and diabetes diagnosed before Jan. 1, 2000 and obtained 54,524 subjects to follow until Dec. 31, 2013. In this observational period, 1060 newly diagnosed PD cases were identified. 4240 controls were randomly selected from those without PD using a matching strategy for age, sex, the year of PD diagnosis and the year of entering the NHI program at a ratio of 1:4. Ten elements of air pollution were examined, and multiple logistic regression models were used to measure their risks in subsequent PD development.ResultsThe incidence of PD in adults aged ≥ 40 years was 1.9%, and the median duration for disease onset was 8.45 years. None of the chemical compounds (SO2, O3, CO, NOx, NO, NO2, THC, CH4, or NMHC) significantly affected the incidence of PD except for particulate matter. PM10 exposure showed significant effects on the likelihood of PD development (T3 level: > 65μg/m3 versus T1 level: ≤ 54μg/m3; OR = 1.35, 95% CI = 1.12–1.62, 0.001 ≤ P < 0.01). In addition, comorbid conditions such as dementia (ORs = 3.53–3.93, Ps < 0.001), stroke (ORs = 2.99–3.01, Ps < 0.001), depression (ORs = 2.51–2.64, Ps < 0.001), head injury (ORs = 1.24–1.29, 0.001 ≤ Ps < 0.01 or 0.01 ≤ Ps < 0.05), sleep disorder (OR = 1.23–1.26, 0.001 ≤ Ps < 0.01), and hypertension (ORs = 1.18–1.19, 0.01 ≤ Ps < 0.05) also significantly increased the risk for PD development.ConclusionsAlthough PM10 plays a significant role in PD development, the associated chemical/metal compounds that are capable of inducing adverse biological mechanisms still warrant further exploration. Because of a link between comorbid conditions and PM exposure, research on the causal relationship between long-term exposure to PM and the development of PD should be considered with caution because other possible modifiers or mediators, comorbid diseases in particular, may be involved.

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Section: Methodsmentioning

confidence: 99%

Long-term exposure to air pollution and the incidence of Parkinson’s disease: A nested case-control study

et al. 2017

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Section: Concluding Remarks and Perspectivesmentioning

confidence: 99%

“…The safety of a long-term treatment with zolpidem in patients with PD has been recently questioned by two recent retrospective observational studies, which analyzed a large Taiwan National Health Insurance database [ 74 , 75 ]. These studies suggested that the overall incidence of PD was significantly greater among a group of subjects with a history of assumption of zolpidem for more than 3 months as sleep-inducer, as compared to a group of subjects without a history of assumption of zolpidem [ 74 , 75 ]. In the first study [ 74 ], the group of subjects who received zolpidem had a higher cumulative rate of PD than the group of subjects who did not receive zolpidem during a 5-year follow-up period, while in the second study [ 75 ] after 5 years of observation the incidence of PD did not differ between the two groups.…”

Section: Concluding Remarks and Perspectivesmentioning

confidence: 99%

Can a Positive Allosteric Modulation of GABAergic Receptors Improve Motor Symptoms in Patients with Parkinson’s Disease? The Potential Role of Zolpidem in the Treatment of Parkinson’s Disease

Daniele

Greco

Logroscino

et al. 2016

Parkinson's Disease

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At present, patients with advanced Parkinson's disease (PD) are unsatisfactorily controlled by currently used anti-Parkinsonian dopaminergic drugs. Various studies suggest that therapeutic strategies based on nondopaminergic drugs might be helpful in PD. Zolpidem, an imidazopyridine widely used as sleep inducer, shows high affinity only for GABAA receptors containing the α-1 subunit and facilitates GABAergic neurotransmission through a positive allosteric modulation of GABAA receptors. Various observations, although preliminary, consistently suggest that in PD patients zolpidem may induce beneficial (and sometimes remarkable) effects on motor symptoms even after single doses and may also improve dyskinesias. Since a high density of zolpidem binding sites is in the two main output structures of the basal ganglia which are abnormally overactive in PD (internal globus pallidus, GPi, and substantia nigra pars reticulata, SNr), it was hypothesized that in PD patients zolpidem may induce through GABAA receptors an inhibition of GPi and SNr (and, possibly, of the subthalamic nucleus also), resulting in an increased activity of motor cortical areas (such as supplementary motor area), which may give rise to improvement of motor symptoms of PD. Randomized clinical trials are needed in order to assess the efficacy, safety, and tolerability of zolpidem in treating motor symptoms of PD.

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“…In addition, we have published related studies according to the same diagnoses and ICD-9 codes. 26 – 29 …”

Section: Methodsmentioning

confidence: 99%

Increased Risk of Parkinson Disease in Patients With Carbon Monoxide Intoxication

et al. 2015

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The present study evaluated the association of carbon monoxide intoxication (COI) with Parkinson disease (PD).A total of 9012 adults newly diagnosed with COI were enrolled in this study as the COI cohort. The control (non-COI) cohort, comprising 36,048 participants, was matched for each COI patient according to age, sex, and the year of hospitalization. We calculated the hazard ratios (HR) and 95% confidence intervals by using a Cox proportional hazards regression model.The overall incidence of PD (per 10,000 person-year) in the COI and non-COI cohorts was 27.4 and 2.53, respectively. After adjustment for age, sex, and comorbidities, the COI patients exhibited a 9.08-fold increased risk for PD. The COI patients without comorbidity exhibited a significantly higher risk of PD (adjusted HR = 15.8) than did the COI patients without comorbidity (adjusted HR = 4.15). Patients with COI and receiving hyperbaric oxygen therapy exhibited a 14.3-fold increased risk of PD; the adjusted HR of patients who did not receive hyperbaric oxygen treatment was increased 7.97-fold.The risk of PD increased in the COI patients and the significance increased in young people. COI is a crucial factor leading to PD.

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Risk of Parkinson’s Disease Following Zolpidem Use

Abstract: Zolpidem use might unmask preclinical Parkinson's disease, especially in patients with depression. However, large population-based, unbiased, randomized trials are warranted to confirm this finding.

Cited by 19 publications

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Long-term exposure to air pollution and the incidence of Parkinson’s disease: A nested case-control study

Long-term exposure to air pollution and the incidence of Parkinson’s disease: A nested case-control study

Can a Positive Allosteric Modulation of GABAergic Receptors Improve Motor Symptoms in Patients with Parkinson’s Disease? The Potential Role of Zolpidem in the Treatment of Parkinson’s Disease

Increased Risk of Parkinson Disease in Patients With Carbon Monoxide Intoxication

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