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고용량 졸피뎀 의존 및 디아제팜을 사용한 금단증상의 해독 증례

High-Dose Zolpidem Dependence and Detoxification from Withdrawal Symptoms Using Diazepam

최정원|박한선|고석만|이상진
대한신경정신의학회 (Korean Neuropsychiatric Association)|2012.05|신경정신의학 (JOURNAL OF THE KOREAN NEUROPSYCHIATRIC ASSOCIATION)|제51권 제3호|pp. 134-138

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참고문헌

키워드

해독중독AddictionWithdrawal의존졸피뎀ZolpidemDependence금단디아제팜DetoxificationDiazepam
주제분류정신과학

초록

졸피뎀은 벤조디아제핀 계열의 약물에 비해서, 비교적 남용가능성이 적은 안전한 수면제로서 많이 처방되고 있는 실정이지만 국내에서는 전문의약품으로 분류되어 만성적인 과량 복용이 현실적으로 쉽지 않아 임상의들의 관심이 적은 편이다. 그러나 본 증례와 같이 고용량을 장기간 사용할 경우의존성과 금단 증상을 유발할 수 있으며, 그 치료방법에 대한임상적인 경험도 축적되지 않은 편이다. 따라서 그 진단과 치료에 있어서 임상의들의 세심한 주의가 필요하다고 하겠다.

Abstract

Zolpidem is a nonbenzodiazepine hypnotic for the treatment of insomnia, and known as a relatively-safe medication. However, there have been several case reports of zolpidem abuse aand dependence these days. Even though some withdrawal symptoms like seizures can occur, there has not been any standard detoxification method until now. A high dose of zolpidem has similar pharmacological properties as the rest of the benzodiazepines, even though the usual dose of zolpidem has a selectivity to the type 1 benzodiazepine receptors. We report a rare case of high-dose addiction and successful detoxification by cross-titration with diazepam.

참고문헌 (29)

  1. American Psychiatric A, "American Psychiatric Association. Task Force on D-I. Diagnostic and statistical manual of mental disorders:DSM-IV-TR" (2000), American Psychiatric Publishing,Inc
  2. Joseph TD, "Pharmacotherapy: A Pathophysiologic Approach", pp.1083~1098 (2008), Mc Graw Hill Medical
  3. Doble A, "New insights into the mechanism of action of hypnotics", J Psychopharmacol, 13, pp.11~20 (1999)
  4. Follesa P, "Changes in GABA(A) receptor gene expression induced by withdrawal of, but not by long-term exposure to, zaleplon or zolpidem", Neuropharmacology, 42, pp.191~198 (2002)
  5. Hwang TJ, "Risk predictors for hypnosedative-related complex sleep behaviors: a retrospective, crosssectional pilot study", J Clin Psychiatry, 71, pp.1331~1335 (2010)
  6. Liappas IA, "Zolpidem dependence case series: possible neurobiological mechanisms and clinical management", J Psychopharmacol, 17, pp.131~135 (2003)
  7. Tripodianakis J, "Zolpidem-related epileptic seizures: a case report", Eur Psychiatry, 18, pp.140~141 (2003)
  8. Alexander B, "Detoxification from benzodiazepines: schedules and strategies", J Subst Abuse Treat, 8, pp.9~17 (1991)
  9. Ashton H, "The diagnosis and management of benzodiazepine dependence", Curr Opin Psychiatry, 18, pp.249~255 (2005)
  10. Wagner J, "Beyond benzodiazepines: alternative pharmacologic agents for the treatment of insomnia", Ann Pharmacother, 32, pp.680~691 (1998)
  11. Rush CR, "Behavioral pharmacology of zolpidem relative to benzodiazepines:a review", Pharmacol Biochem Behav, 61, pp.253~269 (1998)
  12. Darcourt G, "The safety and tolerability of zolpidem--an update", J Psychopharmacol, 13, pp.81~93 (1999)
  13. Lobo BL, "Zolpidem: distinct from triazolam?", Ann Pharmacother, 31, pp.625~632 (1997)
  14. Sellers EM, "Alprazolam and benzodiazepine dependence", J Clin Psychiatry, 54(Suppl), pp.64~75 (1993)
  15. Curtis JL, "Sleep disorders, In Pharmacotherapy:A pathophysiologic approach", pp.1323~1334 (2002), McGraw-Hill
  16. Hajak G, "Safety and tolerance of zolpidem in the treatment of disturbed sleep: a post-marketing surveillance of 16944 cases", Int Clin Psychopharmacol, 13, pp.157~167 (1998)
  17. Hajak G, "Abuse and dependence potential for the non-benzodiazepine hypnotics zolpidem and zopiclone: a review of case reports and epidemiological data", Addiction, 98, pp.1371~1378 (2003)
  18. Aragona M, "Abuse, dependence, and epileptic seizures after zolpidem withdrawal: review and case report", Clin Neuropharmacol, 23, pp.281~283 (2000)
  19. Gilbert DL, "Seizure after withdrawal from supratherapeutic doses of zolpidem tartrate, a selective omega I benzodiazepine receptor agonist", J Pain Symptom Manage, 14, pp.118~120 (1997)
  20. Sethi PK, "Zolpidem at supratherapeutic doses can cause drug abuse, dependence and withdrawal seizure", J Assoc Physicians India, 53, pp.139~140 (2005)
  21. Harrison M, "Diazepam tapering in detoxification for high-dose benzodiazepine abuse", Clin Pharmacol Ther, 36, pp.527~533 (1984)
  22. Barrero-Hernandez FJ, "Epileptic seizures as a sign of abstinence from chronic consumption of zolpidem", Rev Neurol, 34, pp.253~256 (2002)
  23. Suh JH, "Clinical characteristics of acute zolpidem intoxication", J Korean Soc Clin Toxicol, 6, pp.91~98 (2008)
  24. Chen SC, "Detoxification of high-dose zolpidem using cross-titration with an adequate equivalent dose of diazepam", Gen Hosp Psychiatry, 34, pp.210.e5~210.e7 (2012)
  25. Madrak LN, "Zolpidem abuse", Am J Psychiatry, 158, pp.1330~1331 (2001)
  26. Svitek J, "Extensive craving in high dose zolpidem dependency", Prog Neuropsychopharmacol Biol Psychiatry, 32, pp.591~592 (2008)
  27. Chu BC, "Seizures after supratherapeutic doses of zolpidem withdrawal: a case report", Taiwanese Psychiatry Taiwanese Psychiatry, 22, pp.148~152 (2008)
  28. Rappa LR, "Detoxification from high-dose zolpidem using diazepam", Ann Pharmacother, 38, pp.590~594 (2004)
  29. Jana AK, "A case of zolpidem dependence successfully detoxified with clonazepam", Am J Addict, 17, pp.343~344 (2008)

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