Zolpidem pharmacotherapy combined with alpha-blocker therapy for nocturia unresponsive to alpha-blocker monotherapy in men with lower urinary tract symptoms: a preliminary study.
OBJECTIVE
The aim of the present study was to determine whether administration of zolpidem, a nonbenzodiazepine sedative-hypnotic agent, at night would improve the frequency of nocturia unresponsive to alpha-blocker monotherapy in men with lower urinary tract symptoms (LUTS).


METHODS
The study inclusion criteria were: age >/=50 years, nocturia twice or more per night (International Prostate Symptom Score [IPSS] question 7) after taking alpha-blockers for more than eight weeks, and incomplete frequency-flow chart (FVC). A total of 18 patients met the criteria and constituted the study cohort. Three patients were given 0.2 mg tamsulosin once daily and others were given 4 mg terazosin once daily. All patients were additionally administered 10 mg zolpidem once at night for the eight weeks.


RESULTS
There were no serious side-effects in any patient. Nocturia decreased from a baseline median (25-75th percentiles) of 3 (3-5) to 3 (3-4.5) episodes after taking alpha-blockers (p = 0.129) and to 2 (1-3) episodes after taking zolpidem and alpha-blockers (p = 0.001) on the IPSS. After treatment, the scores of uroflowmetry values did not significantly changed. However, at eight weeks, voiding symptoms (p = 0.041) and total IPSS scores (p = 0.028) significantly decreased compared with those at baseline. Median (25-75th percentiles) quality-of-life (QoL) index changed from 5 (4-5) at baseline to 3 (3-3) after eight weeks of treatment (p = 0.005).


CONCLUSIONS
Our results indicate that zolpidem resulted in a subjective reduction in nocturia episodes when given to some men with LUTS.
Song
Yun Seob
YS
Department of Urology, Soonchunhyang School of Medicine, Seoul, Korea.
Ku
Ja Hyeon
JH
D000317:Adrenergic alpha-Antagonists / Q000008:administration & dosage*; D000368:Aged; D004305:Dose-Response Relationship, Drug; D006801:Humans; D008297:Male; D008875:Middle Aged; D011224:Prazosin / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D011446:Prospective Studies; D011470:Prostatic Hyperplasia; D011725:Pyridines / Q000008:administration & dosage / Q000627:therapeutic use*; D011788:Quality of Life; D018709:Statistics, Nonparametric; D013449:Sulfonamides / Q000008:administration & dosage / Q000627:therapeutic use; D000077409:Tamsulosin; D016896:Treatment Outcome; D014555:Urination Disorders / Q000188:drug therapy* / Q000503:physiopathology; D014563:Urodynamics / Q000502:physiology; D000077334:Zolpidem
D000317:Adrenergic alpha-Antagonists; D011725:Pyridines; D013449:Sulfonamides; D000077334:Zolpidem; C041226:Terazosin; D000077409:Tamsulosin; D011224:Prazosin