Severe Chronic Abuse of Zolpidem in Refractory Insomnia

J Clin Sleep Med. 2018 Jul 15;14(7):1257-1259. doi: 10.5664/jcsm.7240.

Abstract

Zolpidem is an imidazopyridine nonbenzodiazepine hypnotic drug with a high affinity to the α1 subunit of the gamma amino butyric acid A receptor It is the first pharmacological option in the short-term management of sleep-onset insomnia. Initially considered a safer drug compared to benzodiazepines because of lower liability for abuse and dependence, recently, an increasing body of reports has questioned zolpidem's proneness to misuse. In this report, we describe a case of serious zolpidem abuse requiring pharmacological washout during hospitalization because of previous withdrawal seizures in a patient with chronic sleep-onset and maintenance insomnia.

Keywords: abuse; actigraphy; electroencephalography; insomnia; power spectrum; video polysomnography; zolpidem.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anticonvulsants / therapeutic use*
  • Chronic Disease
  • Clonazepam / therapeutic use
  • Female
  • Hospitalization
  • Humans
  • Levetiracetam / therapeutic use
  • Pregabalin / therapeutic use
  • Seizures / drug therapy
  • Seizures / etiology*
  • Selective Serotonin Reuptake Inhibitors / therapeutic use
  • Sertraline / therapeutic use
  • Sleep Aids, Pharmaceutical / adverse effects
  • Sleep Aids, Pharmaceutical / therapeutic use
  • Sleep Initiation and Maintenance Disorders / drug therapy*
  • Substance-Related Disorders / complications*
  • Substance-Related Disorders / drug therapy*
  • Zolpidem / adverse effects*
  • Zolpidem / therapeutic use

Substances

  • Anticonvulsants
  • Serotonin Uptake Inhibitors
  • Sleep Aids, Pharmaceutical
  • Levetiracetam
  • Pregabalin
  • Clonazepam
  • Zolpidem
  • Sertraline