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Sleep, BDNF, and beyond: A comparative study of zolpidem and clobazam in insomnia treatment
Vishal Kumar1, Sumita Halder1, Shruti Srivastava2
1Department of Pharmacology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, Delhi, 110095, India.
Objective:
Insomnia is a prevalent sleep disorder. However, its management still remains a challenge. This study aimed to compare the effects of zolpidem and clobazam on serum brain-derived neurotrophic factor (BDNF) levels, sleep quality, and quality of life in insomnia patients.
Methods:
This randomized comparative study included 90 participants-60 patients with insomnia randomized to receive either zolpidem (n = 30) or clobazam (n = 30) for 12 weeks. Serum BDNF levels were assessed at baseline and after 12 weeks. Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and World Health Organization Quality of Life (WHOQOL) scores were assessed at baseline and every 4th week till 12 weeks.
Results:
After 12 weeks of treatment, patients receiving zolpidem and clobazam showed significantly higher serum BDNF levels compared with baseline. Zolpidem showed superior efficacy in reducing insomnia severity (ISI) and improving quality of life (WHOQOL) compared to clobazam. A negative correlation between BDNF levels and sleep quality/insomnia severity (PSQI and ISI) was observed.
Conclusion:
Both zolpidem and clobazam improved sleep quality, insomnia severity, and serum BDNF levels over 12 weeks. Although zolpidem showed a greater trend of improvement, the absence of a placebo or untreated control group and potential effects of sleep hygiene education limit firm conclusions on comparative efficacy. The observed rise in BDNF suggests a possible association with sleep regulation.
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