IMPACTS RELATED TO THE INCREASE IN THE ABUSIVE AND PROLONGED USE OF ZOLPIDEM

Abstract

INTRODUCTION: insomnia is a common sleep disorder that occurs in approximately 6-10%  of the population. The treatment of insomnia may involve non-pharmacological approaches  such as Cognitive-Behavioral Therapy and sleep hygiene, as well as the use of hypnotic  medications like zolpidem. Between 2017 and 2022, zolpidem became the most prescribed medication globally. It is a non-benzodiazepine hypnotic that acts on the GABA-A receptor,  providing sedative effects and improving sleep quality and quantity. However, prolonged and  abusive use of zolpidem can lead to adverse effects and dependence. The aim of this study is to  investigate the impacts and adverse effects resulting from the inappropriate use of zolpidem in  order to guide clinical practice. METHODOLOGY: this study is a narrative review that seeks  to understand the consequences of prolonged and abusive use of zolpidem. Using databases  such as PubMed, Scielo, and Medline, articles addressing the effects of the medication  published between 2018 and 2023 were selected. After analyzing titles, abstracts, and inclusion  criteria, 10 relevant articles were found. RESULTS AND DISCUSSION: the studies indicate  that high doses and prolonged treatment increase the risk of dependence and abuse, as well as  the potential for becoming ineffective due to tolerance. Withdrawal syndrome and rebound  insomnia are common concerns in these circumstances, resulting in symptoms such as tremors,  sweating, and seizures. Another adverse effect is sleepwalking, which can increase the risk of  falls and fractures. CONCLUSION: it is concluded that the efficacy of zolpidem in the  treatment of insomnia is proven, but risks and benefits should be considered. The administration  of the medication should be done with caution, avoiding high doses and prolonged treatment in  order to prevent dependence and abuse.