Department of Psychiatry, School of Medicine, Chungnam National University, Daejeon, South Korea.
Department of Psychiatry, Sejong Chungnam National University Hospital, Sejong, South Korea.
Sci Rep. 2020 Mar 17;10(1):4875. doi: 10.1038/s41598-020-61694-9.
There have been concerns about abuse and unnecessary chronic administration of zolpidem, and zolpidem's relation to suicide risk. To investigate the temporal association of zolpidem with the risk of suicide, we conducted a 12-year, population-based, retrospective cohort study on the National Health Insurance Service-National Sample Cohort (NHIS-NSC), South Korea. Data were collected from 2002 to 2013 from the NHIS-NSC, and data cleaning was performed for 1,125,691 subjects. Cox proportional hazards regression analysis was used to investigate the correlation over time between zolpidem medication and suicide. Over intervals commencing after 80 months of observation, the adjusted hazard ratio of suicides associated with the use of the zolpidem was 2.01 (95% CI: 1.58-2.56; p < 0.001). The mean cumulative number of days of zolpidem prescription was significantly longer in the suicide group than in the non-suicide group after log-transformation (p = 0.005). Cases of chronic use of zolpidem (over six months or one year) were significantly more common in the suicide group compared to the non-suicide group (p = 0.002 and 0.005, respectively). Subjects who received zolpidem medication had a significantly higher risk of suicide after at least 80 months of observation, suggesting a long-term increased suicide risk associated with insomnia exposed to zolpidem medication.
人们一直担心唑吡坦被滥用和不必要地长期使用，以及它与自杀风险的关系。为了研究唑吡坦与自杀风险的时间关联，我们在韩国国家健康保险服务-国家样本队列（NHIS-NSC）中进行了一项为期 12 年的基于人群的回顾性队列研究。数据收集自 2002 年至 2013 年的 NHIS-NSC，并对 1125691 名受试者进行了数据清理。采用 Cox 比例风险回归分析来研究唑吡坦用药与自杀之间随时间的相关性。在观察 80 个月后开始的间隔内，与使用唑吡坦相关的自杀调整后危害比为 2.01（95%CI：1.58-2.56；p<0.001）。在对数转换后，自杀组的唑吡坦处方平均累计天数明显长于非自杀组（p=0.005）。与非自杀组相比，慢性使用唑吡坦（超过六个月或一年）的病例在自杀组中更为常见（p=0.002 和 0.005）。至少观察 80 个月后，接受唑吡坦治疗的患者自杀风险显著升高，表明与唑吡坦治疗相关的失眠症长期增加了自杀风险。
