Modafinil and zolpidem use by emergency medicine residents.
OBJECTIVE
The objective was to assess the prevalence and patterns of modafinil and zolpidem use among emergency medicine (EM) residents and describe side effects resulting from use.


METHODS
A voluntary, anonymous survey was distributed in February 2006 to EM residents nationally in the context of the national American Board of Emergency Medicine in-training examination. Data regarding frequency and timing of modafinil and zolpidem use were collected, as well as demographic information, reasons for use, side effects, and perceived dependence.


RESULTS
A total of 133 of 134 residency programs distributed the surveys (99%). The response rate was 56% of the total number of EM residents who took the in-training examination (2,397/4,281). Past modafinil use was reported by 2.4% (57/2,372) of EM residents, with 66.7% (38/57) of those using modafinil having initiated their use during residency. Past zolpidem use was reported by 21.8% (516/2,367) of EM residents, with 15.3% (362/2,367) reporting use in the past year and 9.3% (221/2,367) in the past month. A total of 324 of 516 (62.8%) of zolpidem users initiated use during residency. Side effects were commonly reported by modafinil users (31.0%)-most frequent were palpitations, insomnia, agitation, and restlessness. Zolpidem users reported side effects (22.6%) including drowsiness, dizziness, headache, hallucinations, depression/mood lability, and amnesia.


CONCLUSIONS
Zolpidem use is common among EM residents, with most users initiating use during residency. Modafinil use is relatively uncommon, although most residents using have also initiated use during residency. Side effects are commonly reported for both of these agents, and long-term safety remains unclear.
McBeth
Brian D
BD
From the Department of Emergency Medicine, Regions Hospital (BDM, FKA, EJM, TJF, BRA), St. Paul, MN; the Department of Emergency Medicine, Temple University Medical Center (RMN), Philadelphia, PA; the Department of Emergency Medicine, Hennepin County Medical Center (LJL), Minneapolis, MN. Dr. McBeth is currently with the San Francisco General Hospital, San Francisco, CA. Dr. Mason is currently with the Sacred Heart Hospital, Eau Claire, WI. Dr. Asplin is currently with the Mayo Clinic, Rochester, MN.
McNamara
Robert M
RM
From the Department of Emergency Medicine, Regions Hospital (BDM, FKA, EJM, TJF, BRA), St. Paul, MN; the Department of Emergency Medicine, Temple University Medical Center (RMN), Philadelphia, PA; the Department of Emergency Medicine, Hennepin County Medical Center (LJL), Minneapolis, MN. Dr. McBeth is currently with the San Francisco General Hospital, San Francisco, CA. Dr. Mason is currently with the Sacred Heart Hospital, Eau Claire, WI. Dr. Asplin is currently with the Mayo Clinic, Rochester, MN.
Ankel
Felix K
FK
From the Department of Emergency Medicine, Regions Hospital (BDM, FKA, EJM, TJF, BRA), St. Paul, MN; the Department of Emergency Medicine, Temple University Medical Center (RMN), Philadelphia, PA; the Department of Emergency Medicine, Hennepin County Medical Center (LJL), Minneapolis, MN. Dr. McBeth is currently with the San Francisco General Hospital, San Francisco, CA. Dr. Mason is currently with the Sacred Heart Hospital, Eau Claire, WI. Dr. Asplin is currently with the Mayo Clinic, Rochester, MN.
Mason
Emily J
EJ
From the Department of Emergency Medicine, Regions Hospital (BDM, FKA, EJM, TJF, BRA), St. Paul, MN; the Department of Emergency Medicine, Temple University Medical Center (RMN), Philadelphia, PA; the Department of Emergency Medicine, Hennepin County Medical Center (LJL), Minneapolis, MN. Dr. McBeth is currently with the San Francisco General Hospital, San Francisco, CA. Dr. Mason is currently with the Sacred Heart Hospital, Eau Claire, WI. Dr. Asplin is currently with the Mayo Clinic, Rochester, MN.
Ling
Louis J
LJ
From the Department of Emergency Medicine, Regions Hospital (BDM, FKA, EJM, TJF, BRA), St. Paul, MN; the Department of Emergency Medicine, Temple University Medical Center (RMN), Philadelphia, PA; the Department of Emergency Medicine, Hennepin County Medical Center (LJL), Minneapolis, MN. Dr. McBeth is currently with the San Francisco General Hospital, San Francisco, CA. Dr. Mason is currently with the Sacred Heart Hospital, Eau Claire, WI. Dr. Asplin is currently with the Mayo Clinic, Rochester, MN.
Flottemesch
Thomas J
TJ
From the Department of Emergency Medicine, Regions Hospital (BDM, FKA, EJM, TJF, BRA), St. Paul, MN; the Department of Emergency Medicine, Temple University Medical Center (RMN), Philadelphia, PA; the Department of Emergency Medicine, Hennepin County Medical Center (LJL), Minneapolis, MN. Dr. McBeth is currently with the San Francisco General Hospital, San Francisco, CA. Dr. Mason is currently with the Sacred Heart Hospital, Eau Claire, WI. Dr. Asplin is currently with the Mayo Clinic, Rochester, MN.
Asplin
Brent R
BR
From the Department of Emergency Medicine, Regions Hospital (BDM, FKA, EJM, TJF, BRA), St. Paul, MN; the Department of Emergency Medicine, Temple University Medical Center (RMN), Philadelphia, PA; the Department of Emergency Medicine, Hennepin County Medical Center (LJL), Minneapolis, MN. Dr. McBeth is currently with the San Francisco General Hospital, San Francisco, CA. Dr. Mason is currently with the Sacred Heart Hospital, Eau Claire, WI. Dr. Asplin is currently with the Mayo Clinic, Rochester, MN.
D000328:Adult; D017109:Akathisia, Drug-Induced / Q000209:etiology; D000647:Amnesia / Q000139:chemically induced; D000855:Anorexia / Q000139:chemically induced; D001559:Benzhydryl Compounds / Q000008:administration & dosage*; D000697:Central Nervous System Stimulants / Q000008:administration & dosage; D002983:Clinical Competence / Q000706:statistics & numerical data; D003863:Depression / Q000139:chemically induced; D004244:Dizziness / Q000139:chemically induced; D004334:Drug Administration Schedule; D004363:Drug Utilization / Q000706:statistics & numerical data; D004635:Emergency Medicine / Q000706:statistics & numerical data*; D005260:Female; D006212:Hallucinations / Q000139:chemically induced; D006261:Headache / Q000139:chemically induced; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D007396:Internship and Residency / Q000706:statistics & numerical data*; D008297:Male; D000077408:Modafinil; D009325:Nausea / Q000139:chemically induced; D010561:Personnel Staffing and Scheduling; D010815:Physician Impairment / Q000706:statistics & numerical data*; D011159:Population Surveillance; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D015995:Prevalence; D011725:Pyridines / Q000008:administration & dosage*; D020178:Sleep Disorders, Circadian Rhythm / Q000188:drug therapy*; D007319:Sleep Initiation and Maintenance Disorders / Q000139:chemically induced; D012894:Sleep Stages / Q000187:drug effects; D014481:United States / Q000453:epidemiology; D014940:Work Schedule Tolerance; D055815:Young Adult; D000077334:Zolpidem
D001559:Benzhydryl Compounds; D000697:Central Nervous System Stimulants; D006993:Hypnotics and Sedatives; D011725:Pyridines; D000077334:Zolpidem; D000077408:Modafinil