Zolpidem-induced Psychiatric Symptoms

Zolpidem引起之精神症狀

10.29478/TJP.200606.0009

郭約瑟(Joseph Kuo)；胡海國(Hai-Gwo Hwu)；林子舜(Tze-Sun Lin)

zolpidem ； 夢遊症 ； 譫妄 ； 精神病性症狀 ； zolpidem ； somnambulism ； delirium ； psychotic symptoms

台灣精神醫學

20卷2期（2006 / 06 / 01）

163 - 168

英文

目的：Zolpidem被認為是安全且有效的安眠藥，但有些個案報告指出zolpidem會造成夢遊症、譫妄或精神病性症狀。本文報告10位個案出現zolpidem引起之精神症狀副作用，並回顧相關文獻及建議小心監測服用zolpidem可能造成的危險副作用。病例報告：我們發現10位個案使用zolpidem之後，出現精神症狀副作用，其中3位出現失憶、3位出現夢遊、3位出現譫妄、1位出現精神病性症狀。而且有2位病患在夢遊時對家人造成身體傷害。所有個案在使用zolpidem之前，並無失憶、夢遊、譫妄或精神病性症狀病史，停止使用之後，全都不再復發。結論：Zolpidem可能造成失憶、夢遊、譫妄及精神病性症狀。因此，臨床使用zolpidem過程，必須對所有個案監測是否出現這些潛在的副作用。

Objective: Zolpidem is considered a safe and effective hypnotic agent for the short-term treatment of insomnia. Sporadic cases of zolpidem-induced psychiatric symptoms, however, such as somnambulism, delirium or psychotic symptoms have been reported. We report 10 additional cases with zolpidem-induced psychiatric symptoms in patients from a single psychiatric clinic. These cases illustrate the need for clinicians to carefully monitor patients for adverse events associated with zolpidem. Case reports: We identified 10 patients with zolpidem-induced psychiatric symptoms from a review of medical records between June 2002 and February 2003. Among these patients, three had amnesia, three had somnambulism, three had symptoms of delirium and one had psychotic symptoms. Two of these patients had exhibited dangerous behaviors towards their family members. All of these patients denied any history of above psychiatric problems before the use of zolpidem as well as any recurrence after discontinuation. Conclusion: Zolpidem may induce amnesia, somnambulism, delirium or psychotic symptoms in a small percentage of patients. Careful monitoring of these potential adverse events and alerting of patients to their possible occurrence is warranted.

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