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Meta-Analysis of the Effectiveness and Safety of Shugan Jieyu Capsules for the Treatment of Insomnia
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Prescribing Patterns in Fatal Intoxications Involving Zopiclone and Alprazolam: An Observational Register-Based

Lova Tralla1,2, Sara Gustavsson2, Carl Söderberg2

  • 1Division of Clinical Chemistry and Pharmacology, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.

Basic & Clinical Pharmacology & Toxicology
|June 4, 2026
PubMed
Summary
This summary is machine-generated.

Fatal intoxications involving zopiclone are frequently linked to prescribed use, unlike alprazolam. Understanding these differences in prescribed drug use is crucial for developing targeted prevention strategies for drug-related deaths.

Keywords:
alprazolamfatal intoxicationsforensic toxicologypharmacoepidemiologyzopiclone

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Area of Science:

  • Forensic Toxicology
  • Public Health
  • Pharmacovigilance

Background:

  • Zopiclone is a growing contributor to fatal drug intoxications in Sweden.
  • Prescription patterns and misuse characteristics of zopiclone require further investigation.
  • Alprazolam has a more established profile of misuse.

Purpose of the Study:

  • To compare fatal intoxications involving zopiclone and alprazolam.
  • To describe characteristics of prescribed zopiclone and alprazolam use in fatal cases.
  • To identify factors associated with prescribed drug use in fatal intoxications.

Main Methods:

  • Analysis of fatal intoxications (2012-2020) positive for zopiclone or alprazolam.
  • Utilized Swedish Cause of Death Register and forensic medicine database.
  • Cross-referenced with national registers for prescription data and health/sociodemographic information.

Main Results:

  • 84% of zopiclone fatal intoxications involved prescribed users, versus 22% for alprazolam.
  • Prescribed use for both drugs was associated with female sex, suicide, and age over 46.
  • Psychiatric contact and prior self-harm linked to prescribed zopiclone, but not alprazolam.

Conclusions:

  • Fatal intoxications with zopiclone and alprazolam exhibit distinct characteristics.
  • Shared factors were identified for prescribed use, but substance-specific prevention is needed.
  • Targeted strategies are essential for mitigating risks associated with prescribed zopiclone and alprazolam.