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Case Series
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| Two cases of seizures on sudden withdrawal of supra-therapeutic doses of zolpidem (selective omega I benzodiazepine receptor agonist) |
| Shri Niwash Jangir1, Rajeshwari Suthar2, Smita N Deshpande3 |
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1Senior Research Associate, Department of Psychiatry, PGIMER-Dr. RML Hospital, New Delhi, India.
2Senior Resident, Department of Obstetrics & Gynecology, ESIC Hospital, Rohini, New Delhi, India. 3Professor & Head, Department of Psychiatry, PGIMER-Dr. RML Hospital, New Delhi, India. |
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doi:10.5348/ijcri-2012-04-104-CS-1
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Address correspondence to: Dr Shri Niwash Jangir Senior Research Associate, Department of Psychiatry PGIMER - Dr. RML Hospital New Delhi-110001 India Phone: +91-9968236021 Fax: +91-23365532, +91-23342122 Email: dr_snjangir@yahoo.co.in |
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| How to cite this article: |
| Jangir SN, Suthar R, Deshpande SN. Two cases of seizures on sudden withdrawal of supra-therapeutic doses of zolpidem - A selective omega I benzodiazepine receptor agonist. International Journal of Case Reports and Images 2012;3(4):1–4. |
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Abstract
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Introduction:
Zolpidem, a non-benzodiazepine hypnotic, reportedly with little abuse potential, is widely prescribed in clinical practice for the treatment of insomnia. Zolpidem abuse has begun to be reported in the literature, but serious withdrawal symptoms such as seizures rarely so. We present two cases of zolpidem-withdrawal seizures.
Case Series: Two young patients started consuming zolpidem for insomnia secondary to psychiatric illness. They escalated the dose of zolpidem in order to maintain relaxation and pleasurable effect of the drug and eventually presented to casualty with withdrawal seizures. Conclusion: Rate of onset of drug effects and short half-life are thought to be critical determinants of reinforcing effects of a drug. Based on the pharmacokinetic data of the studies comparing zolpidem with alprazolam or diazepam, the reinforcing effect and dependence potential of the former was not expected to differ significantly from those of other benzodiazepines. Thus abuse potential of zolpidem was initially underestimated. Our two cases add to the growing evidence that zolpidem has significant risk of dependence especially for patients with comorbid psychiatric illness. Therefore, primary care physicians should prescribe zolpidem judiciously with the same caution as exercised for all benzodiazepine hypnotics. | |
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Key Words:
Dependence, Withdrawal seizure, Zolpidem, Benzodiazepine
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Author Contributions:
Shri Niwash Jangir - Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article and approval of the version to be published Rajeshwari Suthar - Acquisition of data, Analysis and interpretation of data, Critical revision of the article and approval of the version to be published Smita N Deshpande - Drafting the article, Critical revision of the |
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Guarantor of submission:
The corresponding author is the guarantor of submission. |
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Source of support:
None |
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Conflict of interest:
Authors declare no conflict of interest. |
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Copyright:
© Shri Niwash Jangir et. al. 2012; This article is distributed the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.) |
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