Trial of Zolpidem, Eszopiclone, and Other GABA Agonists in a Patient with Progressive Supranuclear Palsy

Table 2

Impressions and effects of medication trials.

Trial day	Name of medication	Dose	Effects (comments)	MMSE	PSP
0	Alprazolam	3 mg	No improvements, some sedation.	—	—
1	Zolpidem CR	12.5 mg	Excellent. Good speech, strong desire to converse.	—	58
3	Eszopiclone	3 mg	Speech improved, though not as much as on zolpidem. Double vision markedly improved. Effects extinguished more quickly than zolpidem.	27	—
4	No medications		—	23	—
6	Zolpidem CR	2 × 6.25 mg	Best day. Good speech.	28	—
8	Tizanidine	4 mg	None.	27	61
10	Temazapam	7.5 mg	Speech improved slightly. Effects diminished quickly (1.5 hrs) and patient experienced sedation.	28	—
11	No medications		—	25	—
12	Zolpidem CR	12.5 mg	Speech improved for five hours.	—	—
14	Flurazepam	30 mg	Speech improved slightly, but effects diminished quickly and patient experienced confusion.	27/27; (Scored out of 27)	—
15	No medications	—	—	25	62
17	Triazolam	0.25 mg	Speech improved slightly. Effects diminished quickly and patient experienced some sedation.	27	—

Table describing the patient’s response to the various medications. MMSE: Folstein’s minimental status exam, scored out of 28 points; higher score denotes higher cognitive function. PSP: progressive supranuclear palsy rating scale (Foundation for PSP, CBD and Related Brain Disease), scored out of 100 points; lower score denotes better symptoms and higher functional status.