title: Three cases of zolpidem dependence treated with fluoxetine: the serotonin hypothesis.
abstract: Zolpidem is an imidazopyridine hypnotic that is believed to act selectively at alpha(1) subunit-containing gamma-aminobutyric acid type A (GABA(A)) receptors and thus to have minimal abuse and dependence potential. We present three cases of zolpidem abuse and dependence in which the drug was used not for sedation but for stimulation and anxiolysis. All of the patients were treated with fluoxetine (a selective serotonin reuptake inhibitor) and managed to discontinue the abuse and remain abstinent from the drug. The efficacy of this kind of medication on the abuse of a GABAergic agonist, in this case dependence on zolpidem, leads to a serotonergic and GABAergic system interaction hypothesis.
authors.affiliation: Department of Psychiatry, Eginition Hospital, University of Athens, 72-74 Vas. Sophias Ave, 11528 Athens, Greece. drugfree@hol.gr
authors.forename: Ioannis A
authors.initials: IA
authors.lastname: Liappas
authors.forename: Petros N
authors.initials: PN
authors.lastname: Malitas
authors.forename: Nikolaos P
authors.initials: NP
authors.lastname: Dimopoulos
authors.forename: Olympia E
authors.initials: OE
authors.lastname: Gitsa
authors.forename: Alexandros I
authors.initials: AI
authors.lastname: Liappas
authors.forename: Chrisoula K
authors.initials: CK
authors.lastname: Nikolaou
authors.forename: Georgios N
authors.initials: GN
authors.lastname: Christodoulou
mesh_terms: D000328:Adult; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use*; D018755:GABA Agonists / Q000009:adverse effects*; D006801:Humans; D008297:Male; D011725:Pyridines / Q000009:adverse effects*; D012701:Serotonin / Q000378:metabolism*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D019966:Substance-Related Disorders / Q000188:drug therapy* / Q000209:etiology; D016896:Treatment Outcome; D000077334:Zolpidem; D005680:gamma-Aminobutyric Acid / Q000378:metabolism
chemical_list: D005473:Fluoxetine; D018755:GABA Agonists; D011725:Pyridines; D012701:Serotonin; D017367:Selective Serotonin Reuptake Inhibitors; D000077334:Zolpidem; D005680:gamma-Aminobutyric Acid