What is the role of zolpidem in the treatment of ischemic stroke?
Label:chem
Topic
Zolpidem is a selective positive allosteric modulator (PAM) of α1-GABA-A receptors, primarily used as a sleep-inducing agent. Clinical reports have shown symptomatic improvement in stroke patients following zolpidem administration, suggesting its potential neuroprotective efficacy in ischemic stroke.
Answer
Zolpidem significantly reduces infarct volume, lowers glutamate levels, and improves motor recovery when administered early (within 1.5 hours) post-reperfusion. It enhances phasic GABAergic signaling via α1-GABA-A receptors, reduces NKCC1 mRNA expression, and suppresses the frequency of cortical spreading depolarizations (CSDs), which are key propagators of secondary neuronal injury. These findings suggest that zolpidem is a promising candidate for drug repurposing in stroke treatment, targeting both early neuroprotection and longer-term functional recovery.
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