Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China.
Chengdushi Dekang Hospital, Chengdu, China.
Medicine (Baltimore). 2024 Nov 1;103(44):e40280. doi: 10.1097/MD.0000000000040280.
Zolpidem, a non-benzodiazepine sedative-hypnotic, is considered safer for the treatment of insomnia compared to benzodiazepines. However, in recent years, there have been growing reports of Zolpidem dependence, addiction, and withdrawal symptoms. We reported a case of Zolpidem addiction and successful detoxification, reviewed similar cases in the literature, and proposed a potential mechanism underlying Zolpidem addiction.
The patient was a 46-year-old Tibetan woman who had been using Zolpidem intermittently to treat insomnia for at least 8 years. She was overweight, with a BMI of 28.04 kg/m², and had hypertension, diabetes, a 20-year smoking history, and several years of alcohol abuse, often seeking instant gratification. She voluntarily increased both the dosage and frequency of Zolpidem, experiencing euphoria, anxiolysis, and increased appetite at higher doses, which led her to gradually escalate her dosage to 280 mg per day in divided doses. However, upon stopping Zolpidem, she experienced withdrawal symptoms, including insomnia, tension, and palpitations.
She was diagnosed with a combination of hypnotic use disorder, anxiety disorder, hypertension, and diabetes.
She underwent diazepam replacement therapy, along with antianxiety medications and mindfulness-based cognitive therapy, to address Zolpidem addiction.
After 13 days of inpatient treatment, the patient successfully quit Zolpidem. During a 3-month follow-up, she returned to work and remained free from Zolpidem use.
We speculate that Zolpidem addiction is likely linked to the drug's euphoric effects and certain patient characteristics, such as sensation-seeking behavior. A comprehensive approach, involving both pharmacological and psychological interventions, is essential for an effective detoxification strategy for Zolpidem addiction.
佐匹克隆是一种非苯二氮䓬类镇静催眠药，相较于苯二氮䓬类药物，被认为在治疗失眠方面更安全。然而，近年来，佐匹克隆依赖、成瘾和戒断症状的报告越来越多。我们报告了 1 例佐匹克隆成瘾病例，并对文献中的类似病例进行了回顾，提出了佐匹克隆成瘾的潜在机制。
患者为 46 岁藏族女性，间断使用佐匹克隆治疗失眠至少 8 年。患者超重，BMI 为 28.04kg/m²，患有高血压、糖尿病、20 年吸烟史和数年的酗酒史，经常寻求即时满足感。她自愿增加佐匹克隆的剂量和频率，高剂量时会感到欣快、焦虑缓解和食欲增加，这导致她逐渐将剂量增加至 280mg/天，分剂量服用。然而，停止使用佐匹克隆时，她出现戒断症状，包括失眠、紧张和心悸。
诊断为催眠药物使用障碍、焦虑障碍、高血压和糖尿病。
给予地西泮替代治疗，同时给予抗焦虑药物和正念认知疗法，以治疗佐匹克隆成瘾。
住院治疗 13 天后，患者成功戒断佐匹克隆。在 3 个月的随访中，她恢复工作，未再使用佐匹克隆。
我们推测佐匹克隆成瘾可能与药物的欣快作用和某些患者特征有关，如寻求刺激的行为。对于佐匹克隆成瘾，药物治疗和心理干预相结合的综合治疗策略是有效的。
