Abusive use of Zolpidem as a Result of COVID-19 and Perspectives of Continuity of the Problem in the Post-Pandemic Period


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Abstract

Zolpidem is a non-benzodiazepine hypnotic drug that works as a positive modulator of Gamma-Amino Butyric Acid-A (GABA-A) receptors, with high selectivity for α1 subunits. Given this selective binding, the drug has a strong hypnotic activity. Social isolation during the SARS-CoV-2 pandemic has contributed to increased rates of anxiety, depression, and insomnia. As a result, studies have pointed to a possible increase in the indiscriminate use of drugs with sedative effects, such as Zolpidem, during the pandemic. The aim of this work was to present prospective evidence that warns of the possibility of the abusive use of Zolpidem even after the pandemic. High rates of addiction to this drug have been reported around the world after the emergence of the coronavirus. Data from the National Survey on Drug Use and Health and from Medicaid support the continuing growth in prescription and indiscriminate use of Zolpidem during the pandemic and afterward. Therefore, there is enough evidence to support the indiscriminate use of this drug since the beginning of the pandemic. Rates of indiscriminate use of sedatives may continue to increase in the post-pandemic period, especially if strict control measures are not taken by health authorities.

About the authors

Wesley de Lima

Graduation in Medicine, Health Science Center, State University of Rio Grande do Norte (UERN)

Email: info@benthamscience.net

Michael da Silva

Graduation in Medicine, Health Science Center, State University of Rio Grande do Norte (UERN)

Email: info@benthamscience.net

Eurico de Souza Costa

Posgraduate Program of Biotechnology, Health School, Potiguar University (UnP)

Email: info@benthamscience.net

Francisco Pinheiro

Posgraduate Program of Biotechnology, Health School, Potiguar University (UnP)

Email: info@benthamscience.net

Eduardo de Azevedo

Posgraduate Program of Biotechnology, Health School, Potiguar University (UnP)

Email: info@benthamscience.net

Ricardo Cobucci

Posgraduate Program of Biotechnology, Health School, Potiguar University (UnP)

Email: info@benthamscience.net

José de Paiva Cavalcanti

Postgraduate Program in Physiological Sciences, Department of Biomedical Sciences, Faculty of Health Sciences,, State University of Rio Grande do Norte (UERN)

Email: info@benthamscience.net

Fausto Guzen

Posgraduate Program of Biotechnology, Health School, Potiguar University (UnP)

Author for correspondence.
Email: info@benthamscience.net

References

  1. Dang, A.; Garg, A.; Rataboli, P.V. Role of zolpidem in the management of insomnia. CNS Neurosci. Ther., 2011, 17(5), 387-397. doi: 10.1111/j.1755-5949.2010.00158.x PMID: 20553305
  2. Rowlett, J.K.; Woolverton, W.L. Assessment of benzodiazepine receptor heterogeneity in vivo: Apparent pA 2 and pK B analyses from behavioral studies. Psychopharmacology (Berl.), 1996, 128(1), 1-16. doi: 10.1007/s002130050103 PMID: 8944400
  3. Salvà, P.; Costa, J. Clinical pharmacokinetics and pharmacodynamics of zolpidem. Therapeutic implications. Clin. Pharmacokinet., 1995, 29(3), 142-153. doi: 10.2165/00003088-199529030-00002 PMID: 8521677
  4. Woodward, M. Hypnosedatives in the elderly. Mol. Diagn. Ther., 1999, 11, 263-279. doi: 10.2165/00023210-199911040-00003
  5. Drake, C.L.; Durrence, H.; Cheng, P.; Roth, T.; Pillai, V.; Peterson, E.L.; Singh, M.; Tran, K.M. Arousability and fall risk during forced awakenings from nocturnal sleep among healthy males following administration of Zolpidem 10 mg and Doxepin 6 mg: A randomized, placebo-controlled, four-way crossover trial. Sleep, 2017, 40(7) doi: 10.1093/sleep/zsx086 PMID: 28575467
  6. Poceta, J.S. Zolpidem ingestion, automatisms, and sleep driving: A clinical and legal case series. J. Clin. Sleep Med., 2011, 7(6), 632-638. doi: 10.5664/jcsm.1468 PMID: 22171202
  7. Toner, L.C.; Tsambiras, B.M.; Catalano, G.; Catalano, M.C.; Cooper, D.S. Central nervous system side effects associated with zolpidem treatment. Clin. Neuropharmacol., 2000, 23(1), 54-58. doi: 10.1097/00002826-200001000-00011 PMID: 10682233
  8. Orsolini, L.; Chiappini, S.; Grandinetti, P.; Bruschi, A.; Testa, R.; Provenzano, A.; Berardis, D.D.; Volpe, U. ‘Z-trip’? A comprehensive overview and a case-series of zolpidem misuse. Clin. Psychopharmacol. Neurosci., 2021, 19(2), 367-387. doi: 10.9758/cpn.2021.19.2.367 PMID: 33888666
  9. Edinoff, A.N.; Wu, N.; Ghaffar, Y.T.; Prejean, R.; Gremillion, R.; Cogburn, M.; Chami, A.A.; Kaye, A.M.; Kaye, A.D. Zolpidem: Efficacy and side effects for insomnia. Health Psychol. Res., 2021, 9(1), 24927. doi: 10.52965/001c.24927 PMID: 34746488
  10. Morais, Eduarda Valéria de Freitas. Descriptive analysis of the consumption of psychotropic drugs in Brazil: scenarios before and during the COVID-19 pandemic. 2022.
  11. Kripke, D.F. Greater incidence of depression with hypnotic use than with placebo. BMC Psychiatry, 2007, 7(1), 42. doi: 10.1186/1471-244X-7-42 PMID: 17711589
  12. Lyu, X.; Hu, Y.; Zhao, Y.; Wang, H.; Du, J.; Wang, J.; Jiang, H. Euphoric effect induced by zolpidem: A case study of magnetoencephalography. Gen. Psychiatr., 2022, 35(1), e100729. doi: 10.1136/gpsych-2021-100729 PMID: 35243205
  13. Moore, T.J.; Mattison, D.R. Assessment of patterns of potentially unsafe use of zolpidem. JAMA Intern. Med., 2018, 178(9), 1275-1277. doi: 10.1001/jamainternmed.2018.3031 PMID: 30014137
  14. Sabe, M.; Kashef, H.; Gironi, C.; Sentissi, O. Zolpidem stimulant effect: Induced mania case report and systematic review of cases. Prog. Neuropsychopharmacol. Biol. Psychiatry, 2019, 94, 109643. doi: 10.1016/j.pnpbp.2019.109643 PMID: 31071363
  15. Victorri-Vigneau, C.; Dailly, E.; Veyrac, G.; Jolliet, P. Evidence of zolpidem abuse and dependence: Results of the French Centre for Evaluation and Information on Pharmacodependence (CEIP) network survey. Br. J. Clin. Pharmacol., 2007, 64(2), 198-209. doi: 10.1111/j.1365-2125.2007.02861.x PMID: 17324242
  16. Wang, L.J.; Ree, S.C.; Chu, C.L.; Juang, Y.Y. Zolpidem dependence and withdrawal seizure--report of two cases. Psychiatr. Danub., 2011, 23(1), 76-78. PMID: 21448102
  17. Liappas, I.A.; Malitas, P.N.; Dimopoulos, N.P.; Gitsa, O.E.; Liappas, A.I.; Nikolaou, C.H.K.; Christodoulou, G.N. A zolpidem and cocaine abuse case report. Int. J. Psychiatry Clin. Pract., 2002, 6(4), 217-219. doi: 10.1080/136515002761581036 PMID: 24937116
  18. Milani, S.A.; Raji, M.A.; Chen, L.; Kuo, Y.F. Trends in the use of benzodiazepines, z-hypnotics, and serotonergic drugs among us women and men before and during the COVID-19 pandemic. JAMA Netw. Open, 2021, 4(10), e2131012. doi: 10.1001/jamanetworkopen.2021.31012 PMID: 34694388
  19. Substance Abuse and Mental Health Services Administration. (2021). Key substance use and mental health indicators in the United States: Results from the 2020 National Survey on Drug Use and Health (HHS Publication No. PEP21-07-01-003, NSDUH Series H-56). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from: https://www.samhsa.gov/data/
  20. Schifano, F.; Chiappini, S.; Corkery, J.M.; Guirguis, A. An insight into Z-Drug abuse and dependence: An examination of reports to the european medicines agency database of suspected adverse drug reactions. Int. J. Neuropsychopharmacol., 2019, 22(4), 270-277. doi: 10.1093/ijnp/pyz007 PMID: 30722037
  21. Barros, M.B.A.; Lima, M.G.; Malta, D.C.; Szwarcwald, C.L.; Azevedo, R.C.S.; Romero, D.; Souza Júnior, P.R.B.; Azevedo, L.O.; Machado, I.E.; Damacena, G.N.; Gomes, C.S.; Werneck, A.O.; Silva, D.R.P.D.; Pina, M.F.; Gracie, R. Report on sadness/ depression, nervousness/anxiety and sleep problems in the Brazilian adult population during the COVID-19 pandemic. Epidemiol. Serv. Saude, 2020, 29(4), e2020427. doi: 10.1590/s1679-49742020000400018 PMID: 32844918
  22. Escalante, S.P.A.; Galato, D.; de Souza Silva, C.M.; Rodrigues da Silva, I.C.; da Silva, E.V. Dispensing of psychotropic drugs in the Brazilian capital city before and during the COVID-19 pandemic (2018–2020). Front. Pharmacol., 2022, 13, 1028233. doi: 10.3389/fphar.2022.1028233 PMID: 36618914
  23. Babicki, M. Use of Alcohol, Cannabinoids, Psychostimulants, and Sedatives before and during the COVID-19 Pandemic among Students in 40 European Countries. Int. J. Environ. Res. Public Health, 2022, 19(22), 14879. doi: 10.3390/ijerph192214879 PMID: 36429598
  24. Carrasco-Garrido, P.; Fernández-de-Las-Peñas, C.; Hernández-Barrera, V.; Palacios-Ceña, D.; Jiménez-Trujillo, I.; Gallardo-Pino, C. Benzodiazepines and Z-hypnotics consumption in long-COVID-19 patients: Gender differences and associated factors. Front. Med. (Lausanne), 2022, 9, 975930. doi: 10.3389/fmed.2022.975930 PMID: 36160133
  25. Heydari, M.; Isfeedvajani, M.S. Zolpidem dependence, abuse and withdrawal: A case report. J. Res. Med. Sci., 2013, 18(11), 1006-1007. PMID: 24520235
  26. Chiappini, S.; Guirguis, A.; John, A.; Corkery, J.M.; Schifano, F. COVID-19: The hidden impact on mental health and drug addiction. Front. Psychiatry, 2020, 11, 767. doi: 10.3389/fpsyt.2020.00767 PMID: 32848937
  27. Davies, J.; Rae, T.C.; Montagu, L. Long-term benzodiazepine and Z-drugs use in England: A survey of general practice. Br. J. Gen. Pract., 2017, 67(662), e609-e613. doi: 10.3399/bjgp17X691865 PMID: 28716996
  28. Barreto Jr. Epitacio de Paiva. O uso de psicotrópicos durante a pandemia da Covid-19: uma consequência do isolamento social. 2022. 45 fl. (Trabalho de Conclusão de Curso – Monografia); Curso de Bacharelado em Farmácia, Centro de Educação e Saúde, Universidade Federal de Campina Grande, Cuité – Paraíba – Brasil, 2022.
  29. Begum, M.; Gonzalez-Chica, D.; Bernardo, C.; Woods, A.; Stocks, N. Trends in the prescription of drugs used for insomnia: An open-cohort study in Australian general practice, 2011–2018. Br. J. Gen. Pract., 2021, 71(712), e877-e886. doi: 10.3399/BJGP.2021.0054 PMID: 33950853
  30. Medicaid.gov. The official US government website for Medicare, 2022. Available from: https://www.medicaid.gov/
  31. Chiaro, G.; Castelnovo, A.; Bianco, G.; Maffei, P.; Manconi, M. Severe chronic abuse of zolpidem in refractory insomnia. J. Clin. Sleep Med., 2018, 14(7), 1257-1259. doi: 10.5664/jcsm.7240 PMID: 29991431
  32. Richter, D.; Riedel-Heller, S.; Zürcher, S.J. Mental health problems in the general population during and after the first lockdown phase due to the SARS-CoV-2 pandemic: Rapid review of multi-wave studies. Epidemiol. Psychiatr. Sci., 2021, 30, e27. doi: 10.1017/S2045796021000160 PMID: 33685551
  33. Melo, J.R.R.; Duarte, E.C.; Moraes, M.V.; Fleck, K.; Arrais, P.S.D. Self-medication and indiscriminate use of medicines during the COVID-19 pandemic. Cad. Saude Publica, 2021, 37(4), e00053221. doi: 10.1590/0102-311x00053221 PMID: 33852694
  34. Westermeyer, J.; Carr, T.M. Zolpidem-associated consequences. J. Nerv. Ment. Dis., 2020, 208(1), 28-32. doi: 10.1097/NMD.0000000000001074 PMID: 31834190
  35. Adhikari, S.; Kumar, R.; Driver, E.M.; Bowes, D.A.; Ng, K.T.; Sosa-Hernandez, J.E.; Oyervides-Muñoz, M.A.; Melchor-Martínez, E.M.; Martínez-Ruiz, M.; Coronado-Apodaca, K.G.; Smith, T.; Bhatnagar, A.; Piper, B.J.; McCall, K.L.; Parra-Saldivar, R.; Barron, L.P.; Halden, R.U. Occurrence of Z-drugs, benzodiazepines, and ketamine in wastewater in the United States and Mexico during the COVID-19 pandemic. Sci. Total Environ., 2023, 857(Pt 2), 159351. doi: 10.1016/j.scitotenv.2022.159351 PMID: 36243065
  36. Food and Drug Administration. FDA requires lower dosing of zolpidem. Med. Lett. Drugs Ther., 2013, 55(1408), 5. PMID: 23348358

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