Psychiatry 2 Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa.
Neurology Unit, Department of Clinical and Experimental Medicine, University Hospital of Pisa, Pisa, Italy.
Int Clin Psychopharmacol. 2023 Mar 1;38(2):117-120. doi: 10.1097/YIC.0000000000000443. Epub 2022 Nov 11.
Zolpidem is a non-benzodiazepine agent used for short-term treatment of insomnia. Several cases of dependence and withdrawal from zolpidem are reported in the literature. Furthermore, involuntary movements after prolonged zolpidem misuse have been described. In this case report, a 69-year-old Italian woman with no history of diagnosed psychiatric or neurologic diseases developed uncontrolled movements and a depressive-anxious syndrome after twelve-year zolpidem misuse. The underlying mechanisms of involuntary movements occurring after long-term zolpidem intake are unknown; yet, we suggest that zolpidem might induce an increase in dopamine release through inhibition of gamma-aminobutyric acid neurons tonically suppressing dopamine cells. Future studies on the occurrence of persistent disorders after long-term benzodiazepine or Z-drug abuse are needed and clinicians should pay attention to the risk of tardive syndromes related to zolpidem misuse, especially in the case of long-term intake of over-therapeutic dosages.
唑吡坦是一种非苯二氮䓬类药物，用于短期治疗失眠。文献中有几例因唑吡坦而产生依赖和戒断的报告。此外，长期滥用唑吡坦后还会出现不自主运动。在本病例报告中，一名 69 岁的意大利女性，无诊断性精神或神经疾病史，在滥用唑吡坦 12 年后出现了无法控制的运动和抑郁焦虑综合征。目前尚不清楚长期服用唑吡坦后出现不自主运动的潜在机制；然而，我们认为唑吡坦可能通过抑制伽马氨基丁酸神经元来增加多巴胺的释放，从而抑制多巴胺细胞。需要进一步研究长期滥用苯二氮䓬类药物或 Z 类药物后持续出现障碍的情况，临床医生应注意与滥用唑吡坦相关的迟发性综合征的风险，特别是在长期摄入超治疗剂量的情况下。
