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Zolpidem dependency and withdrawal seizure: a case report study
Seyed Alireza Haji Seyed Javadi1, Farid Hajiali2, Marjan Nassiri-Asl3
1Department of Psychiatry, Faculty of Medicine, Qazvin University of Medical Sciences, Qazvin, IR Iran.
Iranian Red Crescent Medical Journal
|March 13, 2015
Summary
Zolpidem dependency and withdrawal seizures can occur at lower doses than previously reported. Physicians should monitor patients closely for these adverse effects, even at sub-therapeutic Zolpidem dosages.
Area of Science:
- Pharmacology
- Neurology
- Clinical Medicine
Background:
- Zolpidem is a non-benzodiazepine hypnotic used for short-term insomnia treatment.
- It was believed to lack the dependency and withdrawal potential of traditional benzodiazepines.
- Recent reports suggest Zolpidem abuse and dependency are possible.
Observation:
- A case of a 30-year-old woman with chronic insomnia and dysthymic disorder is presented.
- She irregularly used escalating doses of Zolpidem, reaching 100-150 mg daily.
- After 16 hours of abstinence, she experienced two episodes of generalized tonic-clonic seizures.
Findings:
- The patient developed Zolpidem dependency and withdrawal seizures at a daily dosage below previously documented thresholds.
- This case indicates that Zolpidem-induced dependency and seizures can occur at lower doses than reported in literature.
- The lowest reported dose causing dependency was previously 160 mg daily.
Implications:
- Physicians must be vigilant about the potential for Zolpidem dependency and withdrawal seizures, irrespective of dosage.
- Lower-than-expected dosages of Zolpidem may still precipitate adverse events like seizures.
- Increased clinical awareness is crucial for managing patients on Zolpidem to prevent dependency and withdrawal complications.
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