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[镇静催眠药物的合理使用与滥用]

[Appropriate Use and Abuse of Sedative-Hypnotic Drugs].

作者信息

Zheng Jun-Wei, Meng Shi-Qiu, Liu Wang-Yue, Chang Xiang-Wen, Shi Jie

机构信息

National Institute on Drug Dependence, Peking University, Beijing 100191, China.

School of Basic Medical Sciences, Peking University, Beijing 100191, China.

出版信息

Sichuan Da Xue Xue Bao Yi Xue Ban. 2023 Mar;54(2):231-239. doi: 10.12182/20230260302.

Abstract

The incidence of insomnia has been increasing in recent years. In addition, due to the impact of the COVID-19 pandemic, more and more people are experiencing a variety of insomniac problems, including having difficulty in sleep initation, waking up too early, and short sleep duration. Chronic insomnia may seriously affect patients' life and work, increase their risks of developing physical and mental illnesses, and cause crushing social and economic burdens. Sedative-hypnotics, including benzodiazepine agonists, melatonin receptor agonists, orexin receptor antagonists, and antidepressants with hypnotic effects, are widely used to treat most patients suffering from insomnia. However, there is the phenomenon of the non-medical use and abuse of sedative-hypnotic drugs, especially benzodiazepine receptor agonists. The abuse of sedative-hypnotic drugs may lead to mental and physical dependence, cognitive impairment, depression and anxiety, as well as an increased risks of falls and death. Therefore, drug regulatory authorities in China and other countries have issued relevant policies to reinforce regulation. Herein, we reviewed the prevalent use and safety of sedative-hypnotic drugs and proposed suggestions concerning their appropriate use. Both the efficacy and safety of sedative-hypnotic drugs should be carefully considered so that patients suffering from insomnia receive thorough and prompt treatment and the problem of potential abuse of sedative-hypnotic drugs is assessed in an objective and scientific manner. We also hope to provide references for the standardized clinical use of insomnia drugs.

摘要

近年来,失眠的发病率一直在上升。此外,由于新冠疫情的影响,越来越多的人出现了各种失眠问题,包括入睡困难、过早醒来和睡眠时间短。慢性失眠可能严重影响患者的生活和工作,增加他们患身心疾病的风险,并造成沉重的社会和经济负担。镇静催眠药,包括苯二氮䓬类激动剂、褪黑素受体激动剂、食欲素受体拮抗剂以及具有催眠作用的抗抑郁药,被广泛用于治疗大多数失眠患者。然而,存在镇静催眠药非医疗使用和滥用的现象,尤其是苯二氮䓬受体激动剂。滥用镇静催眠药可能导致精神和身体依赖、认知障碍、抑郁和焦虑,以及跌倒和死亡风险增加。因此,中国和其他国家的药品监管部门已出台相关政策加强监管。在此,我们回顾了镇静催眠药的普遍使用情况和安全性,并就其合理使用提出了建议。应仔细考虑镇静催眠药的疗效和安全性,以便使失眠患者得到全面、及时的治疗,并以客观、科学的方式评估镇静催眠药潜在滥用的问题。我们也希望为失眠药物的规范化临床使用提供参考。

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[Appropriate Use and Abuse of Sedative-Hypnotic Drugs].[镇静催眠药物的合理使用与滥用]
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本文引用的文献

1
Insomnia.失眠。
Lancet. 2022 Sep 24;400(10357):1047-1060. doi: 10.1016/S0140-6736(22)00879-0. Epub 2022 Sep 14.
5
Benzodiazepine-Involved Overdose Deaths in the USA: 2000-2019.美国涉及苯二氮䓬类药物的过量死亡人数:2000-2019 年。
J Gen Intern Med. 2022 Jun;37(8):2103-2109. doi: 10.1007/s11606-021-07035-6. Epub 2022 Apr 12.

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