Abstract
A 39-year-old married woman was referred to a psychiatry outpatient clinic for treatment of major depressive disorder (MDD). The dose of zolpidem she had been taking had increased to more than 500 mg/day and, therefore, she was hospitalized with the aim of zolpidem detoxification. On admission, her serum zolpidem level was 1550 ng/mL, and this dropped to less than one (ng/mL) within 50 h. However, after discontinuation of zolpidem, she experienced withdrawal symptoms. Though a few cases of high-dose zolpidem abuse have been reported in Japan, physicians should be aware that zolpidem has the potential for abuse and dependence.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Holm KJ, Goa KL. Zolpidem: an update of its pharmacology, therapeutic efficacy and tolerability in the treatment of insomnia. Drugs. 2000;59(4):865–89.
Victorri-Vigneau C, Dailly E, Veyrac G, Jolliet P. Evidence of zolpidem abuse and dependence: results of the French Centre for Evaluation and Information on Pharmacodependence (CEIP) network survey. Br J Clin Pharmacol. 2007;64(2):198–209.
Swainston Harrison T, Keating GM. Zolpidem: a review of its use in the management of insomnia. CNS Drugs. 2005;19(1):65–89.
Chattopadhyay AC, Shukla L, Kandasamy A, Benegal V. High-dose zolpidem dependence—Psychostimulant effects? A case report and literature review. Industrial psychiatry journal. 2016;25(2):222–4.
Ohshima H, Kotorii N, Takii M, Hiejima H, Habukawa M, Kuwahara H, et al. Polysomnographic sleep disturbances due to high-dose zolpidem use: a case report. J Clin Sleep Med. 2018;14(11):1949–52.
Heydari M, Isfeedvajani MS. Zolpidem dependence, abuse and withdrawal: a case report. J Res Med Sci. 2013;18(11):1006–7.
Rush CR, Baker RW, Wright K. Acute behavioral effects and abuse potential of trazodone, zolpidem and triazolam in humans. Psychopharmacology. 1999;144(3):220–33.
Licata SC, Jensen JE, Conn NA, Winer JP, Lukas SE. Zolpidem increases GABA in depressed volunteers maintained on SSRIs. Psychiatry Res. 2014;224(1):28–33.
Kralic JE, O’Buckley TK, Khisti RT, Hodge CW, Homanics GE, Morrow AL. GABA(A) receptor alpha-1 subunit deletion alters receptor subtype assembly, pharmacological and behavioral responses to benzodiazepines and zolpidem. Neuropharmacology. 2002;43(4):685–94.
Sanna E, Busonero F, Talani G, Carta M, Massa F, Peis M, et al. Comparison of the effects of zaleplon, zolpidem, and triazolam at various GABA(A) receptor subtypes. Eur J Pharmacol. 2002;451(2):103–10.
Acknowledgements
The authors are grateful to the patient for allowing us to publish this case report.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict interest.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Furihata, R., Kizuki, J., Yamano, Y. et al. High-dose zolpidem abuse in a patient with insomnia comorbid with major depressive disorder. Sleep Biol. Rhythms 18, 155–157 (2020). https://doi.org/10.1007/s41105-019-00250-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s41105-019-00250-z