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Iatrogenic Zolpidem Dependence
Manjeet S. Bhatia, M.B.B.S., M.D.; Gurdeet S. Kohli, M.B.B.S., D.T.C.D.
The Journal of Neuropsychiatry and Clinical Neurosciences 2014;26:E38. doi:10.1176/appi.neuropsych.13040094
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The authors report no financial relationships with commercial interests.

University College of Medical Sciences and GTB Hospital, Delhi, India

Joy Nursing Home, Delhi, India

Send correspondence to Dr. Bhatia; e-mail: manbhatia1@rediffmail.com

Copyright © 2014 by the American Psychiatric Association


To the Editor: Iatrogenic benzodiazepine abuse is emerging as a common mental health problem in neuro-psychiatric practice. Zolpidem, which selectively binds to γ-aminobutyric acid type A (GABA-A) receptors, was launched for the treatment of insomnia with the hope that it produces no dependence. However, animal studies,1 reviews,2 and case reports3,4 demonstrate that zolpidem can result in tolerance and dependence. We report a case of bipolar mood disorder with iatrogenic zolpidem dependence.

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Griffiths  RR;  Sannerud  CA;  Ator  NA  et al:  Zolpidem behavioral pharmacology in baboons: self-injection, discrimination, tolerance and withdrawal.  J Pharmacol Exp Ther 1992; 260:1199–1208
Victorri-Vigneau  C;  Dailly  E;  Veyrac  G  et al:  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; 64:198–209
[CrossRef] | [PubMed]
Ye  Y;  Chang  H;  Chen  C:  Zolpidem dependence, withdrawal seizure and comorbidity following different outcomes: two case reports and a review of the literature.  J Med Sci 2008; 28:263–267
Spyridi  S;  Diakogiannis  I;  Nimatoudis  J  et al:  Zolpidem dependence in a geriatric patient: a case report.  J Am Geriatr Soc 2009; 57:1962–1963
[CrossRef] | [PubMed]
Fava  M;  Asnis  GM;  Shrivastava  RK  et al:  Improved insomnia symptoms and sleep-related next-day functioning in patients with comorbid major depressive disorder and insomnia following concomitant zolpidem extended-release 12.5 mg and escitalopram treatment: a randomized controlled trial.  J Clin Psychiatry 2011; 72:914–928
[CrossRef] | [PubMed]
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