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Zolpidem pharmacotherapy combined with alpha-blocker therapy for nocturia unresponsive to alpha-blocker monotherapy in men with lower urinary tract symptoms: a preliminary study

Abstract

Aim

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).

Materials and 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).

Conclusion

Our results indicate that zolpidem resulted in a subjective reduction in nocturia episodes when given to some men with LUTS.

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Acknowledgement

This study was supported by the Korean Continence Society-Ferring grant, #KCSF 06-02.

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Correspondence to Ja Hyeon Ku.

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Song, Y.S., Ku, J.H. Zolpidem pharmacotherapy combined with alpha-blocker therapy for nocturia unresponsive to alpha-blocker monotherapy in men with lower urinary tract symptoms: a preliminary study. Int Urol Nephrol 39, 1147–1152 (2007). https://doi.org/10.1007/s11255-007-9206-x

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Keywords

  • Nocturia
  • Bladder
  • Urination disorders
  • IPSS
  • Zolpidem
  • Alpha-blocker