Zolpidem is a short-acting imidazolpidine sedative hypnotic drug, clinically often used to treat early insomnia or occasional insomnia patients, which has the advantages of fast onset of action, good safety, etc., can be taken orally for a long time, but after long-term oral administration will produce a certain drug dependence, and there will be certain side effects, so for different degrees of insomnia patients its use method is different, today and we will talk about how to take zolpidem scientifically.
With the increase of work and life pressure, there are more and more patients with clinical sleep disorders, according to incomplete statistics, the proportion of insomnia in Chinese adults can reach 12%-20%, and the proportion of the elderly is as high as 50%. Sleep as an important moment of human rest, for maintaining health is of great significance, and the pain caused by insomnia is not only leading to patient mental malaise, but also induces the occurrence of a variety of cardiovascular and cerebrovascular diseases, and even induces a variety of anxiety, depression and other emotional problems, so it is very necessary to actively treat insomnia.
Non-benzodiazepine sleeping pills are one of the commonly used types of sleeping pills in clinical practice, which have the characteristics of good efficacy, high safety and low drug dependence, and are common in dexzopiclone, zopiclone, zolpidem and so on. Among them, the action characteristics of zolpidem are the most special, which is very obvious for patients with early insomnia or occasional insomnia, and it is also suitable for patients with chronic insomnia to take, it is characterized by the ability to promote patients to fall asleep quickly, very suitable for insomnia patients with difficulty falling asleep, and good safety, no obvious drug dependence, but its mechanism of action is very special, and the clinical effect is relatively single, overdose will damage the body, so scientific taking is the key.
What is zolpidem? What is its mechanism of action?
Zolpidem is an imidazopyridine sedative hypnotic, but its main action receptor is also the benzodiazepine OMEGA-1 receptor in the brain, so it can quickly produce a strong sleep-inducing effect to promote the body to fall asleep quickly. Pharmacological studies have shown that Zolpidem can bind to benzodiazepine receptors on γ-aminobutyric acid receptors, activating ion channels that increase chloride ion conduction, thereby inhibiting central nervous system excitability and producing a sedative effect.
Relevant studies have shown that the onset of action of zolpidem is very fast, the peak of drug concentration can be reached within 0.5 to 1 hour after taking, and the utilization rate can reach more than 70%, so it has a strong pro-sleep effect, and can also effectively prolong the time of deep sleep, but the half-life of zolpidem is 2-3 hours, the action time is short, and there is generally no daytime reaction. The action of zolpidem entering the human body is metabolized by the liver, and its metabolites are processed by the kidneys and excreted through the urine.
Because the mechanism of action of zolpidem is relatively single and the time of action is short, it will not affect memory, cognitive function, motor ability, etc., but because it has no anxiolytic effect, it is not as effective as dexzopiclone in patients with anxiety and insomnia. Sleep studies have found that zolpidem acts mainly on the second sleep phase of the non-recmot phase, which can increase slow-wave sleep, but has a mild effect on remultosis.
Can Zolpidem be taken for a long time?
Zolpidem can be used both for occasional insomnia and for the treatment of chronic insomnia, so it can be taken for a long time, but dose and drug dependence need to be noted.
Clinically, zolpidem is divided into regular-release tablets and extended-release tablets. Regular-release tablets are suitable for short-term use, mainly for difficulty falling asleep; extended-release tablets can not only improve the difficulty of falling asleep, but also prolong the depth of sleep, and also have a good effect on patients who are not easy to fall asleep after waking up.
In the short-term use, the mechanism of action of zolpidem is relatively single, which only binds to the benzodiazepine receptor on the γ-aminobutyric acid receptor after entering the human body, so it can only produce a sedative effect, so short-term use will not produce obvious drug dependence; secondly, because the half-life of zolpidem is short, it is generally not accumulated in the human body, and short-term use even if the drug is discontinued will not have a withdrawal reaction, and there will be almost no daytime reaction, which has little effect on the daytime.
In long-term use, due to the prolongation of the half-life of zolpidem, so its action time is longer, not only can improve sleep, but also can maintain the depth of sleep, but its side effects are also more, has a significant impact on the mental state during the day, and is easy to cause drug dependence, so if it is a long-term use of zolpidem extended-release tablets patients, it is recommended to reduce the dose, and slowly reduce the amount of drug when stopping the drug, to prevent the withdrawal reaction of the drug.
Zolpidem is used differently for different patients
Zolpidem is used differently in the treatment of occasional insomnia and chronic insomnia, so it is clinically necessary to formulate an appropriate drug regimen according to the individual situation of the specific patient.
1. Occasional insomnia
For the treatment of occasional insomnia (such as travel insomnia, off-site insomnia, etc.), the initial dose is 5 mg, the maximum dose is 10 mg, once a day, half an hour before bedtime, the treatment time is 2-5 days, the drug can be stopped immediately, without the need to stop the drug gradually.
2. Transient insomnia
For the treatment of transient insomnia (such as mental disorders, etc.), the initial dose is 5 mg, the maximum dose is 10 mg, once a day, half an hour before bedtime, the treatment is 2-3 weeks, the drug can be stopped immediately, without the need to stop the drug gradually.
3. Chronic insomnia
For the treatment of transient insomnia (such as mental disorders, etc.), the initial dose is 5 mg, the maximum dose is 10 mg, and then gradually reduced to the minimum effective dose, once a day, half an hour before bedtime, treatment for 4 weeks or more, can not be stopped immediately, the dose needs to be gradually reduced, and whether there is a withdrawal reaction.
Precautions for the use of zolpidem
Zolpidem can be effective in the treatment of insomnia, and short-term use will not have obvious drug dependence and withdrawal reactions, so it is often used as a common drug for the treatment of occasional or transient insomnia in the clinic, but there are still 5 aspects to be paid attention to when clinically used.
(1) Pay attention to the use of dosage forms
Clinically, there are two dosage forms of regular-release tablets and extended-release tablets, of which the dose of regular-release tablets (such as Snows, etc.) is 10mg per tablet, while the dose of extended-release tablets is 12.5mg per tablet, and the starting dose of extended-release tablets is generally halved to 6.25mg, so it is necessary to pay attention to the dosage form taken.
(2) Pay attention to the dosage used
Clinically, it is recommended that the daily dose of zolpidem should not exceed 10mg, because long-term high-dose oral zolpidem will cause a burden on liver and kidney function, cause abnormal liver and kidney function, and lead to obvious central inhibition, resulting in mental disorders, coma, drowsiness and other adverse reactions, and it is very easy to cause drug dependence.
(3) Pay attention to eating habits
During taking zolpidem, you must not drink alcohol, because alcohol will enhance the sedative effect of zolpidem, resulting in serious daytime reactions, making the patient's lack of energy during the day, malaise, inability to concentrate, and will also lead to dizziness, headaches and other adverse reactions; secondly, the night diet should not be too full, and it is not advisable to eat a large number of high-heat and high-fat foods, because it will affect the absorption of zolpidem and lead to a decrease in drug efficacy.
(4) Pay attention to adverse reactions
The main adverse reactions of zolpidem are the inhibition of the central nervous system and the stimulation of gastrointestinal peristalsis, and the common adverse reactions in the clinic are dizziness, nausea, headache, memory loss, diarrhea, etc.; secondly, for long-term oral patients, there will be muscle weakness, resulting in unstable standing and easy falls; a small number of elderly patients will have memory loss.
(5) Pay attention to the medication of special groups
When the elderly over 65 years of age take zolpidem, the maximum daily dose should not exceed 5mg; pregnant, lactating women should be banned from this drug, because zolpidem can enter the body of young children through the placental barrier and milk, affecting the development of the central system of young children; patients with obstructive sleep apnea syndrome are disabled, zolpidem has a certain inhibition of the respiratory center, so if there is obstructive sleep apnea syndrome, it can not be used, otherwise it will aggravate the hypoxic state in sleep, and even asphyxia occurs; children under 15 years of age are banned , zolpidem can affect the development of the central system in adolescents.
summary
Zolpidem is a good drug for the treatment of insomnia, which is most suitable for patients with occasional insomnia or short-term insomnia, and there is no obvious addiction and drug resistance in short-term use, but if it is taken for a long time, it is necessary to adhere to the minimum effective dose, and when stopping the drug, it is necessary to pay attention to reducing the dosage and slowly stopping the drug. Secondly, although zolpidem can be taken orally for a long time, it is still recommended that patients adjust their work and sleep habits while taking drugs, try to alleviate the disease through non-drug therapy, and reduce dependence on drugs. Finally, the dosage of zolpidem is different in different conditions, so it is necessary to take the drug according to the doctor's medical advice.
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