A small clinical study of clarithromycin for the sleep disorder hypersomnia shows that the antibiotic can combat patients’ subjective experience of sleepiness, but it does not seem to improve reaction time measured in a video-game-type vigilance task.
The effects of clarithromycin in hypersomnia were first observed by Emory doctors when a pioneering patient (Anna Sumner, whose story is told in this Emory Medicine article) unexpectedly experienced sleeplessness when taking it for a respiratory infection.
The results of the study were published online by Annals of Neurology on June 10.
Lynn Marie Trotti, MD, David Rye, MD, PhD and colleagues from the Department of Neurology and Emory Sleep Center conducted the study, which involved 23 patients.
Advantages of clarithromycin:
- It’s inexpensive and widely available.
- It’s an option for people dealing with hypersomnia for whom other medications, such as modafinil, are not helpful or tolerable.
- It represents an alternative to flumazenil, the benzodiazepine antidote that has been shown to help some hypersomnia patients. Flumazenil used to be very scarce, and shortages occur (Hypersomnia Foundation/American Society of Health System Pharmacists).
Disadvantages of clarithromycin:
- It’s an antibiotic, so it probably changes intestinal bacteria.
- Chronic use could promote the growth of antibiotic-resistant bacteria.
- Most patients reported an altered sense of taste or smell. Some describe this as a metallic mouth sensation.