4 ms·

Is it reasonable to assume that the same thing applies to the Z-drugs too, specifically Zolpidem? I have a family member that I'm worried about, that has taken

by sedeki 4y ago

Is it reasonable to assume that the same thing applies to the Z-drugs too, specifically Zolpidem? I have a family member that I'm worried about, that has taken Zolpidem for several years straight (apart from minor breaks in between prescription refills because of overconsumption during the previous refill...).

gzer0 4y ago
As zolpidem is associated with drug tolerance and substance dependence, its prescription guidelines are only for severe insomnia and short periods of use at the lowest effective dose [1]. Zolpidem increases risk of depression, falls and bone fracture, poor driving, suppressed respiration, and has been associated with an increased risk of death [2]. I would recommend you to seek a second opinion from another medical professional about whether this family member should perhaps slowly taper off of the Zolpidem. [1] https://www.nice.org.uk/guidance/ta77/chapter/1-Guidance https://www.nice.org.uk/guidance/ta77/chapter/1-Guidance [2] https://escholarship.org/content/qt08d9f3d5/qt08d9f3d5.pdf?t=nz1gjv https://escholarship.org/content/qt08d9f3d5/qt08d9f3d5.pdf?t...
mtlmtlmtlmtl 4y ago
From skimming the article, it seems they've linked this effect to benzos interacting with a specific protein in microglia. This is not the interaction benzos share with Z-drugs, which is modulation of the GABA-A receptor. So it seems unclear whether this can be extrapolated to Zolpidem. However, Z-drugs(and benzos as a sleep aid) generally should not be used daily for longer than a few weeks until a better solution is found. Unfortunately, doctors often do this anyway, following the path of least resistance, I suppose. I wouldn't worry about any kind of brain damage, but I would recommend reviewing their options, maybe seeing another doctor. Lots of people can manage just fine with something like extended release melatonin, or indeed nothing.
matheusmoreira 4y ago
Z drugs are better than benzodiazepines but not by much. Their pharmacodynamics are similar: they act on the same GABA receptors. Zolpidem is best used for a couple to regularize sleep patterns and help establish proper sleep hygiene. Trazodone at lower doses is better for long term use, especially in older patients.

by sedeki 4y ago

gzer0 4y ago

As zolpidem is associated with drug tolerance and substance dependence, its prescription guidelines are only for severe insomnia and short periods of use at the lowest effective dose [1]. Zolpidem increases risk of depression, falls and bone fracture, poor driving, suppressed respiration, and has been associated with an increased risk of death [2]. I would recommend you to seek a second opinion from another medical professional about whether this family member should perhaps slowly taper off of the Zolpidem. [1] https://www.nice.org.uk/guidance/ta77/chapter/1-Guidance https://www.nice.org.uk/guidance/ta77/chapter/1-Guidance [2] https://escholarship.org/content/qt08d9f3d5/qt08d9f3d5.pdf?t=nz1gjv https://escholarship.org/content/qt08d9f3d5/qt08d9f3d5.pdf?t...

mtlmtlmtlmtl 4y ago

From skimming the article, it seems they've linked this effect to benzos interacting with a specific protein in microglia. This is not the interaction benzos share with Z-drugs, which is modulation of the GABA-A receptor. So it seems unclear whether this can be extrapolated to Zolpidem. However, Z-drugs(and benzos as a sleep aid) generally should not be used daily for longer than a few weeks until a better solution is found. Unfortunately, doctors often do this anyway, following the path of least resistance, I suppose. I wouldn't worry about any kind of brain damage, but I would recommend reviewing their options, maybe seeing another doctor. Lots of people can manage just fine with something like extended release melatonin, or indeed nothing.

matheusmoreira 4y ago

Z drugs are better than benzodiazepines but not by much. Their pharmacodynamics are similar: they act on the same GABA receptors. Zolpidem is best used for a couple to regularize sleep patterns and help establish proper sleep hygiene. Trazodone at lower doses is better for long term use, especially in older patients.