Drug makes man eat in sleep

Drug makes man eat in sleep

Preetu Nair/TNN
PANAJI: Imagine a situation where you eat throughout the night and are not even aware of it. That's what happened to a 45-year-old businessman in
Goa, whose "unexpected and bizarre" eating behaviour while sleep walking (somnambulistic state) has been reported in a medical journal.

Harish (name changed), at 100 kgs was obese and on short-term treatment for insomnia. On the tenth day of the treatment, two hours after taking his bedtime dose, his wife found him missing. A search in the house and neighbourhood ensued, and he was found in his shop, almost 2 km away, eating sweets.

Reprimanded, Harish did not seem aware of where he was nor recollect how he came to be there. Interestingly, he opened the shop's shutter in his sleep. The facts of the case were published in the International Medical Journal of Eating Disorders, published on October 29, 2008 by doctors of the pharmacology department of Goa Medical College and Hospital.

Three doctors of the pharmacology department of Goa Medical College and Hospital—Dr Padmanabh Rataboli, Dr Amit Dang and Dr Gaurav Garg—have published a rare case of drug-induced (zolpidem) "nocturnal sleep-related eating disorder" (NSRED) in a middle-aged man in the October 2008 issue of the International Medical Journal of Eating Disorders. Doctors say such behaviour is usually reported among women, which makes this case rare.

The report states that the patient was prescribed zolpidem tartrate (10 mg) once a day at bedtime for insomnia and was not on any other concomitant medication. Further, he was not alcoholic and had no recent history of weight gain and somnambulism.

The physician did not link the first episode to the “drug” and the medication was continued. However, after a repeat four nights later, the link was established and once the drug was stopped, no further episodes were reported.

"In case of suspected drug induced NSRED, the first and the foremost intervention should be to stop the offending drug. Psychiatrists and general practitioners should consider the possibility of drug-induced NSRED as one of the differential diagnosis, when they examine patients with sleeping and eating disorders," doctors state.

The pharmacologists note that Zolpidem’s ability to stimulate the frontal lobe of the brain, particularly in the semicomatose state, may be responsible for its adverse effects like sleep-walking or other activity while asleep, such as driving, making phone calls or having sex, with no memory of doing any of it.

However, such behaviour on a long-term can lead to health complications, including depression. Explaining this further, the paper states that the food consumed during such episodes is usually rich in fat and sugar content like ketchup, sweets, or canola oil, and even bizarre meals like raw chicken, sandwiches made with fistfuls of salt or sugar, dog food, soap, hand creams, buttered cigarettes or ammonia.

"When clues of their behaviour become evident, patients often feel ashamed, guilty and may develop self hatred at times. Some of them undergo psychological disruption due to unknown weight gain and a feeling of embarrassment on awakening. This may subsequently lead to depression. They are also exposed to food allergies and have increased risk of injuries (especially during preparation of food)," the report added.
20 Jan 2009,The Times of India, Goa edition