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Improvement in daytime sleepiness with clarithromycin in patients with GABA-related hypersomnia: Clinical experience.
- Source :
-
Journal of psychopharmacology (Oxford, England) [J Psychopharmacol] 2014 Jul; Vol. 28 (7), pp. 697-702. Date of Electronic Publication: 2013 Dec 03. - Publication Year :
- 2014
-
Abstract
- The macrolide antibiotic clarithromycin can enhance central nervous system excitability, possibly by antagonism of GABA-A receptors. Enhancement of GABA signaling has recently been demonstrated in a significant proportion of patients with central nervous system hypersomnias, so we sought to determine whether clarithromycin might provide symptomatic benefit in these patients. We performed a retrospective review of all patients treated with clarithromycin for hypersomnia, in whom cerebrospinal fluid enhanced GABA-A receptor activity in vitro in excess of controls, excluding those with hypocretin deficiency or definite cataplexy. Subjective reports of benefit and objective measures of psychomotor vigilance were collected to assess clarithromycin's effects. Clinical and demographic characteristics were compared in responders and non-responders. In total, 53 patients (38 women, mean age 35.2 (SD 12.8 years)) were prescribed clarithromycin. Of these, 34 (64%) reported improvement in daytime sleepiness, while 10 (19%) did not tolerate its side effects, and nine (17%) found it tolerable but without symptomatic benefit. In those who reported subjective benefit, objective corroboration of improved vigilance was evident on the psychomotor vigilance task. Twenty patients (38%) elected to continue clarithromycin therapy. Clarithromycin responders were significantly younger than non-responders. Clarithromycin may be useful in the treatment of hypersomnia associated with enhancement of GABA-A receptor function. Further evaluation of this novel therapy is needed.<br /> (© The Author(s) 2013.)
- Subjects :
- Adult
Clarithromycin adverse effects
Disorders of Excessive Somnolence cerebrospinal fluid
Disorders of Excessive Somnolence diagnosis
Disorders of Excessive Somnolence physiopathology
Female
HEK293 Cells
Humans
Male
Middle Aged
Psychomotor Performance drug effects
Receptors, GABA-A genetics
Retrospective Studies
Time Factors
Transfection
Treatment Outcome
Wakefulness-Promoting Agents adverse effects
Young Adult
Clarithromycin therapeutic use
Disorders of Excessive Somnolence drug therapy
Receptors, GABA-A metabolism
Sleep drug effects
Wakefulness drug effects
Wakefulness-Promoting Agents therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1461-7285
- Volume :
- 28
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Journal of psychopharmacology (Oxford, England)
- Publication Type :
- Academic Journal
- Accession number :
- 24306133
- Full Text :
- https://doi.org/10.1177/0269881113515062