Case report, 5/19: A case of zolpidem dependence with extremely high daily doses

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Journal: Asia Pacific Psychiatry

 

Title: "A case of zolpidem dependence with extremely high daily doses."

 

Abstract

The human population has been witnessing an increase in the number of diseases which are a consequence of progressively increasing physical and mental stress. Insomnia is one such condition whose prevalence is rising all over the world. Apart from the conventional behavioral interventions and use of benzodiazepines, the use of non-benzodiazepine drugs has seen a surge in recent times. The various adverse effects associated with benzodiazepines, dependence potential being one of them, led to an ever increasing use of non-benzodiazepine sedatives like zolpidem and zopiclone all over the world. But with their continuous and ever increasing use, it is seen that even these drugs carry dependence potential. Numerous cases of zolpidem abuse have been reported in literature until now. Here, we are presenting the case of a zolpidem-dependent patient who consumed it in quantities of 2400 mg/day, a quantity not reported anywhere in literature and around 240 times more than its usual prescribed daily dosage.

 

https://www.ncbi.nlm.nih.gov/pubmed/31044518

[Guest [NM...]]

Journal: Asia Pacific Psychiatry

 

Title: "A case of zolpidem dependence with extremely high daily doses."

 

Abstract

The human population has been witnessing an increase in the number of diseases which are a consequence of progressively increasing physical and mental stress. Insomnia is one such condition whose prevalence is rising all over the world. Apart from the conventional behavioral interventions and use of benzodiazepines, the use of non-benzodiazepine drugs has seen a surge in recent times. The various adverse effects associated with benzodiazepines, dependence potential being one of them, led to an ever increasing use of non-benzodiazepine sedatives like zolpidem and zopiclone all over the world. But with their continuous and ever increasing use, it is seen that even these drugs carry dependence potential. Numerous cases of zolpidem abuse have been reported in literature until now. Here, we are presenting the case of a zolpidem-dependent patient who consumed it in quantities of 2400 mg/day, a quantity not reported anywhere in literature and around 240 times more than its usual prescribed daily dosage.

 

https://www.ncbi.nlm.nih.gov/pubmed/31044518

 

😳😳😳😳😳

[[Fi...]]

Journal: Asia Pacific Psychiatry

 

Title: "A case of zolpidem dependence with extremely high daily doses."

 

Abstract

The human population has been witnessing an increase in the number of diseases which are a consequence of progressively increasing physical and mental stress. Insomnia is one such condition whose prevalence is rising all over the world. Apart from the conventional behavioral interventions and use of benzodiazepines, the use of non-benzodiazepine drugs has seen a surge in recent times. The various adverse effects associated with benzodiazepines, dependence potential being one of them, led to an ever increasing use of non-benzodiazepine sedatives like zolpidem and zopiclone all over the world. But with their continuous and ever increasing use, it is seen that even these drugs carry dependence potential. Numerous cases of zolpidem abuse have been reported in literature until now. Here, we are presenting the case of a zolpidem-dependent patient who consumed it in quantities of 2400 mg/day, a quantity not reported anywhere in literature and around 240 times more than its usual prescribed daily dosage.

 

https://www.ncbi.nlm.nih.gov/pubmed/31044518

 

That is indeed an EXTREMELY high dose.

 

I can't imagine a reputable U.S. doctor prescribing that dosage or a reputable U.S. pharmacist filling an Rx with instructions to consume that daily dosage.

 

I wonder, what are the details & conclusion to this "Asia Pacific Psychiatry" story? ... unfortunately the abstract doesn't tell us.

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That is indeed an EXTREMELY high dose.

 

I can't imagine a reputable U.S. doctor prescribing that dosage or a reputable U.S. pharmacist filling an Rx with instructions to consume that daily dosage.

 

I wonder, what are the details & conclusion to this "Asia Pacific Psychiatry" story? ... unfortunately the abstract doesn't tell us.

 

This was a case report from India.

 

In the article they point out, "Cases of zolpidem dependence in dosages of up to 600‐1700 mg/day have been reported in literature (Morinan & Keaney, 2010)."

 

Regarding where he got the drug:

"Zolpidem is not an over the counter drug in India and patient refused to disclose the source of drug. (He was not coerced into disclosing his source on ethical grounds though it is suspected that he had easy access to the drug through a local shop.)"

 

They apparently switched him to clonazepam 4mg and then had to up that to 8mg for the withdrawal symptoms to subside: "His irritability subsided within 10 days of admission."

 

They also state, "It is possible that, in the high doses that our patient used, zolpidem abandons its selectivity for BZ1 receptors and demonstrates all the actions of classic benzodiazepines. (Liappas et al., 2003)."