Xiao Zhang, a sophomore, started to use Sinos because of insomnia, but ended up in the addiction ward because of Sinos addiction. With the accelerated pace of modern life and the increase of environmental stressors, the number of patients who come to see a doctor due to anxiety and sleep disorders has increased significantly, and the addiction to sedatives and hypnotics has gradually attracted the attention of relevant personnel. Zolpidem tartrate (trade name: Sinos), as a sleeping aid, can significantly shorten the sleeping time, increase the slow-wave sleep, improve the sleep efficiency and quality, and at the same time, it has little influence on daytime function and is well tolerated, so it has become one of the most commonly used sleeping aid drugs in clinic. Although related articles reported that zolpidem was less addictive and safer to use than benzodiazepines, clinical practice found that improper use of sinos could still lead to addiction.
Xiao Zhang was admitted to the hospital because of "difficulty in falling asleep, repeatedly taking a large amount of zolpidem for more than 3 years". In April 216, when I was preparing for the college entrance examination, I felt great pressure, and it was difficult to fall asleep. Sometimes I couldn't sleep for two consecutive nights, and my daytime sleepiness affected my studies. After February, I went to the outpatient department of a specialized hospital to diagnose "insomnia" and gave Sinos 5mg (half a pill) once a night to help me fall asleep. After taking the medicine, Xiao Zhang felt very good at first, and fell asleep quickly. Two months later, he found that the original half pill could no longer solve the sleep problem. Because he was too nervous to see a doctor, Xiao Zhang took the initiative to increase the dose, and gradually increased the dose from the original half pill to more than 3 pills a day within two years. If he used it intermittently, he could basically ensure normal sleep at night and had no obvious drowsiness during the day. However, he felt memory loss for a long time, which had a significant impact on his study. Once he tried to reduce the dosage, he would have nausea and insomnia. In order to get enough Sinos, Xiao Zhang often wandered around hospitals to prescribe drugs, or bought them online at a high price. After his parents found out, he took him to the Addiction Department of Shanghai Mental Health Center.
Xiao Zhang's current situation meets the diagnostic criteria of hypnotic dependence 1: 1. He has a large number of long-term medication history; 2. Sweating, palpitation, hand trembling, insomnia, nausea, etc. after stopping or reducing the drug; 3. Long-term drug use has an impact on their social * * * and learning ability; 4. Medical diseases or other mental disorders cannot be used to explain the above performance.
Xiao Zhang simply can't imagine that he took sleeping AIDS to solve the problem of insomnia, and he didn't take addictive drugs such as diazepam. How could he rely on it? With such doubts, let's take a look at the drug zolpidem: zolpidem is an imidazole pyridine hypnotic drug related to benzodiazepines, which selectively acts on GABA-BZ-ω1 subtype receptors in the brain, significantly increasing the opening frequency of nitrogen ion channels, effectively inhibiting neuronal excitation and playing a role in sedation and hypnosis. The description of zolpidem dependence in the manual is as follows: the use of zolpidem sedatives/hypnotics can lead to physical and mental dependence. The risk of dependence increases with the increase of dose and treatment time; The risk may be higher in patients with mental disorders and/or alcohol or drug dependence. These patients should be carefully monitored when using sleeping pills. Once you stop using it after dependence, there will be withdrawal reactions, which may include headache, muscle pain, extreme anxiety and tension, restlessness, confusion and irritability, and insomnia. In severe cases, loss of reality, disintegration of personality, auditory allergy, numbness and tingling of limbs, allergy to light, sound and physical contact, hallucinations or seizures may occur. Clinically, it is easier for patients to use a variety of benzodiazepines in combination for a long time to increase the corresponding risks.
Xiao Zhang realized that he was really addicted, and hoped to improve his sleep and reduce the pain of stopping zolpidem by actively cooperating with the doctor. At the same time, he also raised the question, how to use zolpidem correctly for people with insomnia?
the treatment time of zolpidem should be as short as possible, the shortest is several days, and the longest is no more than 4 weeks, including the gradual reduction period. It is not recommended to use zolpidem for a long time. It is suggested that patients use the following methods: < P > 1. For occasional insomnia (such as during travel), treat it for 2-5 days;
2. treat temporary insomnia (such as insomnia caused by negative stress events) for 2 ~ 3 weeks;
patients who take it for a short time do not need to stop taking it gradually. Long-term heavy use of patients should be gradually reduced under the guidance of a doctor to avoid sudden withdrawal.
Sleep problems are not trivial. It is very important to seek medical attention in time. Taking drugs is risky, so you should be careful when taking drugs. The use of sedatives and hypnotics must go to professional institutions and be used correctly and reasonably under the guidance of professionals to avoid addiction caused by improper use.
This article is scientifically checked by Du Jiang, deputy chief physician of Shanghai Mental Health Center.
Contribution of "Reaching for Medical Care"