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Severe addiction of sleeping pill

Severe addiction of sleeping pill sleeping pill


Heavy addiction to harmless sleeping pills

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A young woman with a history of alcohol dependence and anorexia took a sleeping pill in high dosages for 13 years.

According to the materials sonata pill: a case of anorexia nervosa: a case report. Morinan A., Keaney F.

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Journal of Medical Case Reports 2010, 4:40

A thirty-year-old British woman with alcohol addiction (ICD-10, F10.2) was admitted to hospital for detoxification. For four weeks before hospitalization, the woman drank 6 liters of cider (7.5% ethanol) four times a week. Upon receipt complained of memory lapses and periodic clouding of consciousness. Physical examination revealed no pathological changes. According to laboratory data, the concentration of aspartate aminotransferase (AST) in serum is increased to 86 U / l (N<31 ЕД/л) и гамма-глутамилтранспептидазы (ГГТП) до187 ЕД/л (N<32 ЕД/л). Когнитивных нарушений не выявлено. При поступлении больная с целью седации принимала хлорпромазин в дозе 50 мг × 2 р/день, антидепрессант флуоксетин — 40 мг/день, и снотворное зопиклон — 7,5 мг × 4 р/день.

History of anorexia, for which she was hospitalized at the age of 17, as well as cases of self-harm and intentional overdose of drugs. From the age of eighteen, she had been treated for six times as an alcohol addict with various periods of remission. Family history: father died of alcohol-related problems, some relatives suffer from alcohol dependence, his sister died of anorexia complications.

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Sleeping pills zopiclone at a dose of 7.5 mg at night was first prescribed for her in the treatment of anorexia. However, having discovered the sedative effect of the drug, the patient began taking it during the day, for which she asked the doctor to increase the dose due to the development of addiction and a decrease in the soporific effect. According to the patient, she took zopiclone immediately after waking up and then throughout the day, the average dose was 60 mg / day, sometimes reaching 90 mg / day. The amount of alcohol consumed did not affect the use of the drug. In addition to prescribed doses, the woman additionally purchased the medicine, and also received it free from friends.

The patient responded to zopiclone as “her best friend.” Like alcohol, he “made her confident,” “helped relax” and “increased self-esteem.”

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A woman highly valued stocks of the drug and always had with him some of it. For 13 years of his admission, there was one short period of refusal from zopiclone six years ago during another attempt to treat alcohol dependence. However, as a result, anorexia relapse developed and the patient was again prescribed zopiclone for hypnotic purposes.

The patient underwent detoxification therapy, including an anxiolytic chlordiazepoxide with a dose reduction from 130 mg to complete withdrawal within 6 days, intramuscular injections of a preparation containing the complex of vitamins C, B1, B2, B3 and B6, for 5 days, then Group B vitamins in tablets. Zopiclone was gradually discontinued while taking chlordiazepoxide, instead of which the patient was prescribed a tranquilizer diazepam 20 mg / day with a gradual reduction in the dose to 1 mg / day. In the course of therapy, a woman found diazepam ineffective compared with zopiclone, expressed an urgent desire to return to taking “her” drug.

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However, for 17 months of follow-up after a course of detoxification, the patient refrained from taking zopiclone and alcohol, but at the same time noted a significant craving for this sleeping pill, stronger than alcohol.

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Discussion Insomnia is a sleep disorder that is subjectively characterized by a lack of duration and / or poor sleep quality over a long period of time. Zopiclone, a short-acting sleeping pill, was synthesized in the late 1970s. and introduced to the clinic about ten years later. Zopiclone, as well as other derivatives of cyclopirrolone, zolpidem and zaleplon, selectively interacts with the omega1 benzodiazepine receptors of the GABA-receptor complex [1, 2]. The hypnotic effects and adverse reactions are practically the same as those of benzodiazepines [3], but the mortality index (number of deaths / 106 prescriptions) for zopiclone is significantly lower than for temazepam: 2.1 against 9.9 [4].

Individual cases of zopiclone use by adolescents to enhance the effects of alcohol have been described [5]. According to a review of publications, for 1996–2002. 22 cases of abuse of zopiclone and 36 – zolpidem were described, with a maximum excess of recommended doses of 51 and 121 times, respectively [6]. The authors concluded that an overdose of the described drugs is much safer, and the risk of developing dependence is lower than when using benzodiazepines, however, they urged that caution be kept when prescribing them.

The development of dependence is more likely in people taking psychoactive substances or suffering from mental illness [6]. Cases of intravenous administration and inhalation of crushed tablets of zolpidem and zaleplon by opioid addicts have been published [7, 8]. Canadian researchers identified 20 cases of zopiclone dependence in the country from 1991 to 2006, the dose of the drug being taken was 7.5–390 mg / day [9].

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