Objective: To explore the association between zolpidem use and risk of Parkinson’s disorder.

Background: Zolpidem is commonly prescribed for the treatment of sleep disorder. Epidemiological studies presenting conflicting evidence between the zolpidem use and the risk of developing Parkinson’s Disorder (PD).

Methods:

An extensive literature search was carried out in electronic databases (Pubmed, Embase and Cochrane central) from inception to 30^th, November 2016. Keywords used were “zolpidem” AND “Parkinson’s disorder” to retrieve the relevant article. Articles were screened for inclusion on the basis title and abstract by two independent reviewers. Quality assessment of included studies was done by using Newcastle-Ottawa Scale (NOS). Cochrane Q (p >0.10) or I² test (>50%) was used to assess the heterogeneity. Depending on the heterogeneity random effect or fixed effect model was used.  All analyses were performed using Review Manager software version 5.3 (RevMan 5.3) .

Results:

Two cohort studies including 116,524 participants of which 45,132 patients belong to the zolpidem user group were included. Characteristics of the included studies were shown in Table.1. Both the included studies were from Taiwan and of high quality judged by the score attainment on NOS (Table.2). Fixed effect model was used as no heterogeneity was observed. The overall relative risk of zolpidem versus non-zolpidem use was 2.585 (95% CI, 2.302 – 2.903). Thus the overall risk of PD in patients receiving zolpidem was 158% greater than the non-zolpidem user (Fig.1). 

Conclusions:

Zolpidem use increases the risk of Parkinson’s disease. However, to confirm this association and make the evidence robust more observational and well designed randomized controlled trial is needed.

References: Yang YW, Hsieh TF, Yu CH, Huang YS, Lee CC, Tsai TH. Zolpidem and the risk of Parkinson’s disease: a nationwide population-based study. Journal of psychiatric research. 2014;58:84-8.

Huang HC, Tsai CH, Muo CH, Lin KH, Lu MK, Sung FC, Kao CH. Risk of Parkinson’s disease following zolpidem use: a retrospective, population-based cohort study. The Journal of clinical psychiatry. 2015;76(1):104-10.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/risk-of-parkinsons-disease-in-zolpidem-user-a-systematic-review-and-meta-analysis/