title: [Abrupt shift to zolpidem, a new imidazopyridine hypnotic, in insomniac patients previously treated with benzodiazepine hypnotics].
abstract: Zolpidem is a new imidazopyridine hypnotic with a pharmacological profile substantially different from benzodiazepines. In this observational multicenter study the possibility of shifting to zolpidem (10 mg at N1, 15 or 20 after N1) insomniac patients previously taking (for at least 15 days and not longer than 3 months) standard posology of triazolam (0.125-0.25 mg), lorazepam (1 mg) or lormetazepam (1 mg) was assessed. For ethical reasons the patients were mandatorily to be insomniacs despite their taking hypnotics or not tolerating them. Patients enrolled were 299 of whom 276 evaluable (139 males and 136 females; mean age 48.67 +/- 14.64, range 18-83). Study duration was 7 nights with visits at N0 (baseline), N1 (after 1st night), N3 (after 3rd night) and N7 (final evaluation); on each visit the Saint Mary Hospital Sleep Questionnaire and the benzodiazepine withdrawal symptom's rating scale were administered; moreover, after N7, investigators were asked a judgement of feasibility of such a shift. In 229 (83.5%) out of 274 patients such a shift to zolpidem was considered successfully (no occurrence of symptoms and/or signs of previously taken hypnotic withdrawal); in the remaining 45 patients, just 17 (6.2%) seemed to be real unsuccessful cases (reactions mild and transient, anyhow). In conclusion abrupt shift to zolpidem appeared to be largely feasible in the patients studied.
authors.affiliation: Clinica Psichiatrica I, Università di Pisa.
authors.forename: A
authors.initials: A
authors.lastname: Ciapparelli
authors.forename: C
authors.initials: C
authors.lastname: Colombo
authors.forename: G
authors.initials: G
authors.lastname: Cuccato
authors.forename: A
authors.initials: A
authors.lastname: Levi-Minzi
authors.forename: A
authors.initials: A
authors.lastname: Lorizio
authors.forename: M
authors.initials: M
authors.lastname: Maggioni
authors.forename: G
authors.initials: G
authors.lastname: Siciliano
authors.forename: R
authors.initials: R
authors.lastname: Silvestri
authors.forename: F
authors.initials: F
authors.lastname: Biondi
authors.forename: G L
authors.initials: GL
authors.lastname: Casadei
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D001569:Benzodiazepines; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011725:Pyridines / Q000627:therapeutic use*; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy*; D000077334:Zolpidem
chemical_list: D014151:Anti-Anxiety Agents; D006993:Hypnotics and Sedatives; D011725:Pyridines; D001569:Benzodiazepines; D000077334:Zolpidem
vernacular_title: Passaggio ex-abrupto a zolpidem, nuovo ipnotico imidazopiridinico, in pazienti insonni già in trattamento con ipnotici benzodiazepinici.