title: Toxicology and characteristics of deaths involving zolpidem in New South Wales, Australia 2001-2010.
abstract: All cases presenting to the New South Wales Department of Forensic Medicine between January 1, 2001 and September 31, 2010 in which zolpidem was detected, were retrieved. A total of 91 cases were identified. The mean age was 49.4 years, 65.9% were male, and 61.5% were suicides. Zolpidem was a factor contributing to death in 35 (37.3%) cases, of which 31 (34.1%) involved zolpidem toxicity. The median blood zolpidem concentration was 0.20 mg/L (range 0.05-3.50 mg/L), with no significant gender difference. Drug toxicity cases involving zolpidem had significantly higher median blood zolpidem concentrations than other cases (0.50 vs. 0.10 mg/L). In 83.5% of cases, psychoactive substances other than zolpidem were detected, most commonly antidepressants (46.2%), benzodiazepines (35.2%), opioids (26.4%), and alcohol (39.6%). In summary, zolpidem was a factor contributing to death in a large proportion of cases, predominately involving drug toxicity and suicide.
authors.affiliation: National Drug and Alcohol Research Centre, University of New South Wales, NSW, Sydney, Australia. s.darke@unsw.edu.au
authors.forename: Shane
authors.initials: S
authors.lastname: Darke
authors.forename: Mark
authors.initials: M
authors.lastname: Deady
authors.forename: Johan
authors.initials: J
authors.lastname: Duflou
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000097:blood; D001315:Australia / Q000453:epidemiology; D001569:Benzodiazepines / Q000097:blood; D002423:Cause of Death; D002492:Central Nervous System Depressants / Q000097:blood; D000431:Ethanol / Q000097:blood; D005260:Female; D053593:Forensic Toxicology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects* / Q000032:analysis / Q000506:poisoning*; D008099:Liver / Q000737:chemistry; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000097:blood; D011725:Pyridines / Q000009:adverse effects* / Q000032:analysis / Q000506:poisoning*; D013405:Suicide / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000401:mortality; D055815:Young Adult; D000077334:Zolpidem
chemical_list: D000928:Antidepressive Agents; D002492:Central Nervous System Depressants; D006993:Hypnotics and Sedatives; D009294:Narcotics; D011725:Pyridines; D001569:Benzodiazepines; D000431:Ethanol; D000077334:Zolpidem