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Zolpidem, a derivative of imidazopyridine, is a drug used as a hypnotic and anxiolytic. Zolpidem is a non-benzodiazepine type hypnotic that potentiates the λ-aminobutyric acid (GABA) by binding to benzodiazepine type1 receptors. As opposed to the other benzodiazepine (BD) derivatives, zolpidem is regarded to have a low potential of tolerance and addiction in long-term treatment. While very few adverse side effects are experienced when taken at the suggested dosage (5-20 mg), it may lead to anterograd amnesia, hallucinations, delusion, ataxia, and disorder in motor coordination when used along with central nervous system depressants at higher dosages. Although no experience of generalized seizure during treatment with relatively low dosage has been reported, at higher dosages after sudden zolpidem withdrawal, generalized seizures have been observed. In this case report, the development of generalized seizure in a male patient regularly taking zolpidem at a higher than suggested clinical dosage (80 mg/day) for a long time was presented with related literature.
Zolpidem kullanımı sırasında gelişen jeneralize nöbet: Olgu sunumu
‹midazopiridin türevi olan zolpidem hipnotik ve anksiyete giderici olarak kullan›lan bir ilaçt›r. Non-benzodiazepin hipnotik bir ajan olan zolpidem benzodiazepin (BD) tip 1 reseptörlerine ba¤lanarak λ-aminobutirik asit (GABA) arac›l› inhibisyonu art›r›r. Di¤er benzodiazepin BD türevlerinden farkl› olarak uzun süre tedavide tolerans ve ba¤›ml›l›k potansiyelinin düflük oldu¤u kabul edilir. Önerilen dozlarda (5-20 mg) yan etki oldukça az yaflanmas›na ra¤men daha yüksek dozlarda Merkezi Sinir Sistemi (MSS) depresanlar›yla birlikte kullan›ld›¤›nda anterograd amnezi, halusinasyonlar, delüzyon, ataksi, motor koordinasyon bozuklu¤una yol açabilir. Zolpidem’i yüksek dozda (160-450 mg/gün) al›rken ani kesilme ile jeneralize nöbet geliflimi bildirilmesine karfl›l›k kesilme olmaks›z›n nispeten daha düflük dozlarda kullan›- m› s›ras›nda jeneralize nöbet geçirme bildirilmemifltir. Bu olguda, uzun süredir klinik dozun üstünde (80 mg/gün) düzenli zolpidem alan erkek hastada, jeneralize epileptik nöbet geliflmesi literatür eflli¤inde tart›fl›lm›flt›r.