UNASSIGNED: A 25-year-old woman complained of night snacking with partial/complete amnesia and sleepwalking for 1 year. She had a diagnosis of major depressive disorder at age 20 and was on paroxetine and brotizolam for depression and insomnia. At 24 years of age, she experienced her second depressive episode, then her amnestic nocturnal eating became prominent. Even after improvement in depressive symptoms, she experienced uncontrollable nocturnal eating episodes every 2 days, resulting in weight gain of over 10 kg. After a partial amnestic eating episode following an awakening from stage N2 sleep was confirmed through video polysomnography, she was diagnosed with SRED. Considering her strong desire to resolve involuntary eating, we instructed her to discontinue brotizolam and start suvorexant. Subsequently, her nocturnal eating completely disappeared. She experienced rebound insomnia, which improved within 1 month. She was then continued on 10 mg of suvorexant and has not experienced nocturnal eating for 2 years.
UNASSIGNED: This case highlights the importance of discontinuing benzodiazepines in the treatment of SRED, but also suggests the potential benefit of orexin receptor antagonists in the treatment of SRED. The efficacy of orexin receptor antagonists in idiopathic SRED should be tested in future studies.
一名25岁的妇女抱怨夜间吃零食,伴有部分/完全健忘症和梦游1年。她在20岁时被诊断为重度抑郁症,并因抑郁症和失眠而服用帕罗西汀和溴替唑仑。在24岁的时候,她经历了第二次抑郁,然后她的健忘的夜间饮食变得突出。即使在抑郁症状改善后,她每两天经历一次无法控制的夜间进食事件,导致体重增加超过10公斤。通过视频多导睡眠图确认了N2阶段睡眠苏醒后的部分遗忘进食事件,她被诊断出患有SRED。考虑到她想要解决非自愿进食的强烈愿望,我们指示她停止Brotizolam开始Suvorexant.随后,她的夜间饮食完全消失了。她经历了反弹失眠,在1个月内有所改善。然后,她继续服用10mgsuvorexant,并且已经两年没有夜间进食了。
■此案例突出了停用苯二氮卓类药物在SRED治疗中的重要性,但也表明食欲素受体拮抗剂在治疗SRED中的潜在益处。食欲素受体拮抗剂在特发性SRED中的功效应在未来的研究中进行测试。