Zolpidem valproic acid

An interaction of zolpidem with valproic acid has been reported. 

A 47-year-old white man with a history of bipolar disorder, who was taking citalopram 40 mg/day and zolpidem 5 mg at bedtime, developed manic symptoms and was given valproic acid (50). Soon after this, he had episodes of somnambulism, which stopped when valproic acid was withdrawn. On rechallenge with valproic acid, the somnambulism returned. 

This appears to be the first report in which the interaction of valproic acid with zolpidem led to somnambulism. 

Sattar SP, Ramaswamy S, Bhatia SC, Petty F. Somnambulism due to probable interaction of valproic acid and zolpidem. Ann Pharmacother 2003 37 1429-33. 

Biperiden Zolpidem Oomipramine Trihexyphenidyl Amoxapine Hydroxyzine HCl Lorazepam Nortriptyline Diphenhydramine BusfJirone Clonidine Prazepam Clozapine Benztropine Pemoline Flurazepam Valproic acid Valproic acid Trazodone Dextroamphetamine... 

Barbiturates phenobarbital, secobarbital Benzodiazepines alprazolam, diazepam, lorazepam, triazolam Others buspirone, zolpidem BZ receptor antagonist flumazenil Carbamazepine, ethosuximide, valproic acid, phenytoin, clonazepam, diazepam, lorazepam, gabapentin... 

A 47-year-old woman with multiple medical problems stabilised on warfarin (and also taking azathioprine, captopril, furosemide, insulin, capto-pril, prednisone, levothyroxine, valproic acid and zolpidem) had all her teeth removed under general anaesthetic. Sixteen days later she needed a dental abscess drained and was given oral clindamycin 300 mg four times daily with ibuprofen 600 mg for any discomfort. On day 17 she needed a suture to stop some bleeding and her INR was found to be 3.5. By day 20 she had developed more severe oral bleeding, which needed emergency room treatment. Her INR was found to have risen to 13 and her haemat-ocrit decreased to 18%. She was treated successfully with a blood transfusion and vitamin K. ... 

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