Quaglio GianLuca, Lugoboni Fabio, Fornasiero Anna, Lechi Alessandro, Gerra Gilberto, Mezzelani Paolo
Medical Service for Addictive Disorders, Department of Internal Medicine, University of Verona, Italy.
Int Clin Psychopharmacol. 2005 Sep;20(5):285-7. doi: 10.1097/01.yic.0000166404.41850.b4.
Zolpidem is a hypnotic drug that is chemically distinct from benzodiazepines (BDZ). It has been suggested that it acts selectively on gamma-aminobutyric acid receptors. However, recent evidence has shown that the behavioural effects of zolpidem are generally similar to those of BDZs. Flumazenil is usually considered to be a BDZ antagonist. Nonetheless, in chronic BDZ users, it acts as a partial, bland agonist. We describe two cases of zolpidem dependence that were detoxified by the use of flumazenil infusion. BDZ dependence is usually treated with tapering of the medication. As an alternative, abrupt discontinuation of the medication and rapid detoxification using flumazenil has been used. Flumazenil may represent an alternative to detoxification treatment by employing a tapering approach, or by replacement therapy with BDZs with a long half-life, particularly where patients are hard to treat or have low compliance to treatment.
唑吡坦是一种催眠药物，其化学结构与苯二氮䓬类药物（BDZ）不同。有人认为它对γ-氨基丁酸受体具有选择性作用。然而，最近的证据表明，唑吡坦的行为效应通常与苯二氮䓬类药物相似。氟马西尼通常被认为是一种苯二氮䓬类拮抗剂。尽管如此，在长期使用苯二氮䓬类药物的患者中，它表现为一种部分、温和的激动剂。我们描述了两例通过静脉输注氟马西尼进行脱毒治疗的唑吡坦依赖病例。苯二氮䓬类药物依赖通常采用逐渐减少药物剂量的方法进行治疗。作为一种替代方法，也有人采用突然停药并使用氟马西尼进行快速脱毒的方法。氟马西尼可能是一种替代脱毒治疗的方法，可采用逐渐减量的方法，或用半衰期长的苯二氮䓬类药物进行替代治疗，特别是在患者难以治疗或对治疗依从性差的情况下。
