Paroxysmal Tonic Spasm in a Patient with the Sudden Zolpidem Withdrawal: A Case Report

Zolpidem is an imidazopyridine derivative and a non-benzodiazepine hypnotic drug. There are several case reports of zolpidem abuse or dependence and zolpidem withdrawal. This study reports a case of paroxysmal tonic spasm (PTS) after abrupt withdrawal of high dose zolpidem. The case was a 21-year- old male patient with complaints of acute involuntary and painful spasms of all extremities after the sudden withdrawal of taking supratherapeutic zolpidem. In his medical records, He had the history of insomnia and psychiatric disorder . The patient's symptoms improved with intravenous injection of 10 mg diazepam slowly and zolpidem was tapered gradually. This case report indicates that zolpidem has a dependency and abusage properties. To the best of our knowledge , this is the first report of zolpidem withdrawal with PTS.