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(searched for: Zolpidem-Dependency)
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Alexandre Beraldo Ordones, Gustavo Freitas Grad, Michel Burihan Cahali, Geraldo Lorenzi Filho, Luiz Ubirajara Sennes, Pedro Rodrigues Genta
Journal of Clinical Sleep Medicine; doi:10.5664/jcsm.8334

The publisher has not yet granted permission to display this abstract.
Sciprofile linkYves Dauvilliers, Gary Zammit, Ingo Fietze, David Mayleben, Dalma Seboek Kinter, Scott Pain, Jan Hedner
Published: 5 February 2020
by Wiley
Annals of Neurology, Volume 87, pp 347-356; doi:10.1002/ana.25680

The publisher has not yet granted permission to display this abstract.
Ryuji Furihata, Jun Kizuki, Yuya Yamano, Yasuhide Mizoguchi, Suguru Nakajima, Kou Nagai, Yoshiyuki Kaneko, Koju Yamada, Sciprofile linkMasahiro Suzuki, Makoto Uchiyama
Sleep and Biological Rhythms pp 1-3; doi:10.1007/s41105-019-00250-z

The publisher has not yet granted permission to display this abstract.
K. Wróblewski, Sciprofile linkAnna Petruczynik, Sciprofile linkTomasz Tuzimski, K. Prajsnar, D. Przygodzka, G. Buszewicz, H. Karakuła-Juchnowicz, J. Róg, J. Morylowska-Topolska, M. Waksmundzka-Hajnos
Published: 31 December 2019
Open Chemistry, Volume 17, pp 1361-1373; doi:10.1515/chem-2019-0152

Abstract: Retention, separation selectivity and system efficiency of selected basic psychotropic drugs (clozapine, aripiprazole, vortioxetine and
zolpidem
) and drug metabolites (desmethylclozapine, clozapine N-oxide and dehydroaripiprazole) on Hydro RP, Phenyl-Hexyl and Polar RP columns were studied. Mobile phases containing methanol or acetonitrile as organic modifiers, acetate buffer at pH 3.5 and addition of diethylamine (DEA) as a silanol blocker were applied. Significant differences in the retention, peak shapes and systems’ efficiency of the investigated compounds were obtained
depending
on the tested chemically bonded stationary phases with various ligands. Based on the obtained results the Phenyl-Hexyl column was selected for analysis of the drugs and their metabolites in human serum and saliva samples. Solid phase extraction (SPE) was applied for sample pre-treatment. The best SPE-HPLC-DAD procedure was used for simultaneous analysis of clozapine, aripiprazole and their metabolites in body fluids. Liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) method was applied for confirmation of the presence of the investigated compounds in biological samples. The lower limit of quantification (LLOQ) of clozapine obtained using the proposed method was 10 ng/mL. The validated method for determining the presence of clozapine and its main metabolite was successfully applied in therapeutic drug monitoring.
Sciprofile linkLaura S. Castro, Leonardo J. Otuyama, Cristiane Fumo-Dos-Santos, Sergio Tufik, Dalva Poyares
Brazilian Journal of Psychiatry; doi:10.1590/1516-4446-2019-0389

Abstract: To evaluate the safety and efficacy of a 5 mg sublingual dose of
zolpidem
, compared to a 10 mg oral dose, at bedtime and "as needed" following middle-of-the-night awakenings. Participants were randomized into an oral group (oral
zolpidem
10 mg and sublingual placebo at bedtime and "as-needed") and a sublingual group (oral placebo and sublingual
zolpidem
5 mg at bedtime and "as-needed"). Participants underwent medical evaluation, polysomnography, the psychomotor vigilance test, and completed questionnaires. Of 85 patients, 67 met the criteria for insomnia (48±10 years; 79% women) and were randomized. Of these, 46 completed 92±5 days of treatment. Mild-to-moderate adverse events were reported by 25% of the participants, including headache, sleepiness, and dizziness. Both treatments decreased middle-of-the-night awakenings by an average of -3.1±2.3 days/week and increased total sleep time by 1.5 hours. Changes in sleep quality and insomnia severity scores were also favorable and comparable between groups: variation
depended
on continuation of treatment. Regarding PSG findings, sleep latency decreased more in the sublingual group than the oral group (-14±42 vs. 10±29 min; p = 0.03). The psychomotor vigilance test showed minor residual effects 30 minutes after awakening, which reversed after 2 hours. The safety and efficacy of both
zolpidem
formulations are comparable. The sublingual 5 mg dose induced sleep more rapidly. NCT01896336.
Sciprofile linkJan Rémi, Thomas Pollmächer, Kai Spiegelhalder, Claudia Trenkwalder, Peter Young
Deutsches Aerzteblatt Online, Volume 116, pp 681-688; doi:10.3238/arztebl.2019.0681

The publisher has not yet granted permission to display this abstract.
Sciprofile linkJohn Marsden, Martin White, Fizz Annand, Peter Burkinshaw, Serena Carville, Brian Eastwood, Michael Kelleher, Jonathan Knight, Rosanna O'connor, Anh Tran, et al.
Published: 3 October 2019
The Lancet Psychiatry, Volume 6, pp 935-950; doi:10.1016/S2215-0366(19)30331-1

Abstract: Antidepressants, opioids for non-cancer pain, gabapentinoids (gabapentin and pregabalin), benzodiazepines, and Z-drugs (zopiclone, zaleplon, and
zolpidem
) are commonly prescribed medicine classes associated with a risk of
dependence
or withdrawal. We aimed to review the evidence for these harms and estimate the prevalence of dispensed prescriptions, their geographical distribution, and duration of continuous receipt using all patient-linked prescription data in England. This was a mixed-methods public health review, comprising a rapid evidence assessment of articles (Jan 1, 2008, to Oct 3, 2018; with searches of MEDLINE, Embase, and PsycINFO, and the Cochrane and King's Fund libraries), an open call-for-evidence on patient experience and service evaluations, and a retrospective, patient-linked analysis of the National Health Service (NHS) Business Services Authority prescription database (April 1, 2015, to March 30, 2018) for all adults aged 18 years and over. Indirectly (sex and age) standardised rates (ISRs) were computed for all 195 NHS Clinical Commissioning Groups in England, containing 7821 general practices for the geographical analysis. We used publicly available mid-year (June 30) data on the resident adult population and investigated deprivation using the English Indices of Multiple Deprivation (IMD) quintiles (quintile 1 least deprived, quintile 5 most deprived), with each patient assigned to the IMD quintile score of their general practitioner's practice for each year. Statistical modelling (adjusted incident rate ratios [IRRs]) of the number of patients who had a prescription dispensed for each medicine class, and the number of patients in receipt of a prescription for at least 12 months, was done by sex, age group, and IMD quintile. 77 articles on the five medicine classes were identified from the literature search and call-for-evidence. 17 randomised placebo-controlled trials (6729 participants) reported antidepressant-associated withdrawal symptoms. Almost all studies were rated of very low, low, or moderate quality. The focus of qualitative and other reports was on patients' experiences of long-term antidepressant use, and typically sudden onset, severe, and protracted withdrawal symptoms when medication was stopped. Between April 1, 2017, and March 31, 2018, 11·53 million individuals (26·3% of residents in England) had a prescription dispensed for at least one medicine class: antidepressants (7·26 million [16·6%]), opioids (5·61 million [12·8%]), gabapentinoids (1·46 million [3·3%]), benzodiazepines (1·35 million [3·1%]), and Z-drugs (0·99 million [2·3%]). For three of these medicine classes, more people had a prescription dispensed in areas of higher deprivation, with adjusted IRRs (referenced to quintile 1) ranging from 1·10 to 1·24 for antidepressants, 1·20 to 1·85 for opioids, and 1·21 to 1·85 for gabapentinoids across quintiles, and higher ISRs generally concentrated in the north and east of England....
Sciprofile linkSujita Kumar Kar, Suyash Dwivedi
Published: 6 September 2019
by BMJ
General Psychiatry, Volume 32; doi:10.1136/gpsych-2019-100102

Abstract:
Zolpidem
is a short-acting non-benzodiazepine hypnotic agent, commonly recommended for short-term treatment of insomnia.
Zolpidem
has less
dependence
potential than benzodiazepines. Patients with mental illnesses often have disturbed sleep, for which
zolpidem
is often prescribed. Long-term use and self-medication (in more than recommended doses) are more likely to cause
dependence
. We report here a case of bipolar affective disorder with epilepsy, who developed
dependence
to
zolpidem
and had severe withdrawal symptoms. The management issues are also discussed with review of the literature.
Sciprofile linkMichel Sabe, H. Kashef, C. Gironi, O. Sentissi
Progress in Neuro-Psychopharmacology and Biological Psychiatry, Volume 94; doi:10.1016/j.pnpbp.2019.109643

The publisher has not yet granted permission to display this abstract.
Stephanie Patricia J. Badillo, Sciprofile linkRoland Dominic Jamora
Published: 17 July 2019
Frontiers in Neurology, Volume 10; doi:10.3389/fneur.2019.00779

Abstract: Background and Purpose: There are recent reports of
zolpidem
being effective for the treatment of a variety of movement disorders, due to its action on the gamma-aminobutyric acid A receptors in the thalamus, subthalamic nucleus, and globus pallidus, hence facilitating inhibitory pathways in the basal ganglia motor loop. Its beneficial effects have been described for Parkinson's disease and other related disorders. The objective of this study was to assess the therapeutic effects of
zolpidem
for various types of dystonia. Methods: We conducted a literature search using MEDLINE via PubMed, Cochrane Library, EMBASE, Scopus, and Google Scholar. Results: There were no randomized controlled trials. The literature included 6 case reports, 4 case series, and 1 non-randomized, non-controlled interventional trial. Overall, 49 adult participants (range 1-34 participants) with a mean age of 49.5 years were treated. Regardless of the dystonia subtype, a single dose of
zolpidem
at 10 mg causes improvement of symptoms for a mean duration of 3.4 h until patient returns to baseline. The main adverse effect noted was drowsiness, which was dose-
dependent
. Conclusion: While the current available literature suggests that
zolpidem
may be an effective pharmacologic option for treating dystonia, however the quality of evidence remains limited. Larger sample size, methodological consistency, and randomized controlled trials with long-term patient follow-ups are necessary to come up with definitive conclusion.
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