Sleeping Pill May Help With Nerve Disorder

Temporary improvement seen in some patients with potentially fatal disease

WEDNESDAY, July 28, 2004 (HealthDayNews) -- A widely used sleeping pill appears to offer temporary help for people with a relentless degenerative nerve disease, researchers report.

There currently is no drug treatment for the condition, called spinocerebellar ataxia 2, doctors from England and South Africa report in the July 29 issue of the New England Journal of Medicine. But four of five patients with the disease showed some improvement within an hour after taking zolpidem, a sleeping pill whose brand name is Ambien, the researchers report.

There is a large family of ataxias disorders, which are mainly inherited and cause deterioration of parts of the nervous system that results in loss of balance and coordination, weakness in the arms and legs, slurred speech and other problems. The deterioration can't be stopped, and most patients die about 20 years after the onset of the disease, according to the National Ataxia Foundation.

Hereditary and sporadic ataxias combined affect an estimated 150,000 Americans, according to the National Institute of Neurological Disorders and Stroke.

All five patients described in the report are members of the same South African family, meaning they have inherited the same genetic flaw that causes the disease. They range in age from 24 to 49. In each case, the improvement after drug treatment was only moderate and temporary.

For example, symptoms of the oldest patient, a 49-year-old man, "improved moderately," says the report by Drs. Ralf Clauss of Royal Surrey County Hospital in England, Mike Sathekge of the Medical University of Southern Africa in Pretoria and Wally Nel, who is in private practice in South Africa.

The symptoms of another patient -- a 24-year-old woman who was diagnosed with the condition two years ago -- were "slightly improved," the report said. But a 22-year-old woman diagnosed four years ago showed no improvement.

The researchers said they tested zolpidem because of reports that it has provided improvement for other central nervous system problems, including brain injuries.

Dr. Tetsuo Ashizawa is chairman of neurology at the University of Texas Medical Branch in Galveston, and an authority on ataxia. "This paper intrigues patients with ataxia and neurologists who treat them," he said. But, he was quick to point out weaknesses in the report.

"The authors did not use validated scales for evaluation of ataxia," Ashizawa said. "Thus, the study did not provide convincing scientific evidence for efficacy of the drug."

But he called the study's observation "interesting" because there are no effective treatments for ataxia, although the tranquillizer buspirone (BuSpar) has been found to relieve some symptoms in patients in a controlled study.

Both buspirone and zolpidem have sedative and tranquillizing action, "which may have contributed to the apparent efficacy," Ashizawa said. Carefully controlled studies of zolpidem in ataxia patients "may be of interest," he concluded.

More information

The National Ataxia Foundation has more about the disease.

SOURCES: Tetsuo Ashizawa, M.D., chairman, neurology, University of Texas Medical Branch, Galveston; July 29, 2004, New England Journal of Medicine
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