Total Absence of Recall of Discussion Occurred Shortly after Ingestion of 10 mg Zolpidem

 

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We report here the case of a 34-year-old woman who held a long and emotional discussion with her boyfriend about 45 min after the intake of 10 mg of zolpidem, with total absence of recall on the next day.

The woman has no significant psychiatric antecedent. She presents with a long-term primary insomnia, for the treatment of which she occasionnally takes, with satisfactory results, 10 mg of zolpidem, a drug known to provide good sleep stability in psychophysiological insomnia [3]. On one night however, she had an animated discussion for about an hour with her boyfriend after having taken the drug but did not enter sleep. The boyfriend actually proposed for her to live with him at his place in the coming future. This implied for her to leave her appartment about six months later at the due date (November) and complete the documents for this three months earlier (August). The discussion also included the choice of names for future children. According to the boyfriend, the discussion was warm and alive, the woman showing no sign of fatigue or sleepiness, rather being somewhat disinhibited.

To his surprise, the woman seemed to have absolutely no clue of the talk on the next morning but he did not tell her what the discussion was about. As he was aware of details that he could not have learned otherwise, it was interesting to test the recall during an ambulatory psychiatric session. Giving her the clue that something could happen in November did not bring any memory. Adding that this was linked to something happening in August did not either. Adding it had to do with the couple in forming did not help. Only by bringing her attention to the appartment plus the previous information did she ask whether it had to do with her moving to his place but she still had no memory of having talked about the subject earlier, it seemed to her as a fresh new idea. Also, she had no clue whatsoever about the choice of a forename for a future baby, although she liked the name that was brought up by the boyfriend, again, seeming to have no memory at all of having debated the subject.

We never had the impression of someone hiding or keeping back information and our impression was of total honesty from both the members of the couple.

This complete absence of recall points to a defect in recording or in storing information in memory shortly after intake of the drug. This contrasts to reports of only mild impairments of memory for information stored before sleep [4] [5]. This information is also interesting as benzodiazepines, especially long-acting ones such as flunitrazepam, are known to have been linked to drug-facilitated sexual assaults “date rapes” [1]. One case of date rape was described that was linked with zolpidem [2]. The present report confirms that benzodiazepine-induced anterograde amnesia can also happen with non-benzodiazepine drugs such as zolpidem, and hence, that the phenomenon is less specific than previously thought.

References

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Correspondence

O. Le BonMD, PhD 

Service de Psychiatrie

CHU Tivoli

Université Libre de Bruxelles

Av. M. Buset 34

7100 La Louvière

Belgium

Email: lebono@ulb.ac.be