[Abuse of and dependence on zolpidem: a report of seven cases].
Zolpidem is an hypnotic drug that belongs to the imidazopyridine family. Its chemical structure is different from that of benzodiazepines though both type of drugs bind specifically to the same site of the GABA-A macromolecular complex: the omega 1 benzodiazepine receptor. This mechanism of action could be responsible for the predominantly hypnotic properties of zolpidem and its reduced liability to induce dependence in comparison with benzodiazepines. Yet, several cases of zolpidem abuse and dependence have been published recently. We report seven cases, from which three are detailed, of zolpidem abuse and/or dependence. These patients did not suffer from sedative effects of this drug despite important doses. We even noticed stimulating and euphorising effects in two of these patients, an effect that may explain at least in part the dependence to zolpidem. We will discuss the clinical similarities existing between zolpidem and benzodiazepines' effects. Furthermore we will discuss a molecular genetic hypothesis that may explain the differential effect of a specific benzodiazepine ligand on its receptors.
Courtet
P
P
Service Universitaire de Psychiatrie Adultes, Hôpital La Colombière, INSERM CJF 97-02, Montpellier.
Pignay
V
V
Castelnau
D
D
Boulenger
J P
JP
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives; D008297:Male; D008875:Middle Aged; D011725:Pyridines; D019966:Substance-Related Disorders / Q000175:diagnosis*; D000077334:Zolpidem
D006993:Hypnotics and Sedatives; D011725:Pyridines; D000077334:Zolpidem