I Kahlert1, M Brüne. 1. Westfälisches Zentrum für Psychiatrie und Psychotherapie, Ruhr-Universität-Bochum.
Abstract
MEDICAL HISTORY: A 59-year-old female patient reported an increasing intake of up to 20 pills of zopiclone per day (150 mg) during the past 3 years. The dose increase was associated with euphoria and subjectively improved fitness. The patient suffered from anxiety and inner restlessness when trying to discontinue the medication, as well as from fatigue and forgetfulness when on medication. The medical history was free of psychiatric disorders and abuse of psychoactive substances. CLINICAL FINDINGS: Apart from mild attention and concentration deficits with a mildly depressed mood the psychiatric findings were normal. COURSE AND TREATMENT: Consistent with the preliminary diagnosis of a primary non-benzodiazepine dependence (zopiclone), after withdrawal of zopiclone the patient suffered from inner restlessness and psychomotor agitation, vague abdominal pain, and hypertension. The symptoms subsided after administration and subsequent gradual discontinuation of diazepam. CONCLUSION: Zopiclone dependence has repeatedly been reported in patients with pre-existing substance-related addictions, and in patients with other psychiatric disorders. Primary zopiclone dependence may be regarded as rare. Despite the low dependence potential of non-benzodiazepine hypnotics, the indication of prescription should be thoroughly considered.
MEDICAL HISTORY: A 59-year-old female patient reported an increasing intake of up to 20 pills of zopiclone per day (150 mg) during the past 3 years. The dose increase was associated with euphoria and subjectively improved fitness. The patient suffered from anxiety and inner restlessness when trying to discontinue the medication, as well as from fatigue and forgetfulness when on medication. The medical history was free of psychiatric disorders and abuse of psychoactive substances. CLINICAL FINDINGS: Apart from mild attention and concentration deficits with a mildly depressed mood the psychiatric findings were normal. COURSE AND TREATMENT: Consistent with the preliminary diagnosis of a primary non-benzodiazepine dependence (zopiclone), after withdrawal of zopiclone the patient suffered from inner restlessness and psychomotor agitation, vague abdominal pain, and hypertension. The symptoms subsided after administration and subsequent gradual discontinuation of diazepam. CONCLUSION:Zopiclone dependence has repeatedly been reported in patients with pre-existing substance-related addictions, and in patients with other psychiatric disorders. Primary zopiclone dependence may be regarded as rare. Despite the low dependence potential of non-benzodiazepine hypnotics, the indication of prescription should be thoroughly considered.