唑吡坦致神经精神系统不良反应分析

Analysis of neuropsychiatric adverse reactions caused by zolpidem

目的通过分析唑吡坦致神经精神系统的药品不良反应(ADR)报告,探讨ADR的特点和规律,为临床合理使用新型催眠药物提供依据。方法选取并分析2004年1月1日至2021年12月31日我院上报的6例唑吡坦致神经精神系统ADR的病例,对患者的药物治疗情况、ADR情况、治疗措施及转归等进行分析,探讨唑吡坦导致神经精神系统ADR的特点。结果6例患者均为女性。患者服用唑吡坦后,患者多在较短时间内出现ADR。多数患者服药当晚即出现ADR、仅1例遗忘ADR发生在服药后第5天。ADR的临床表现方面,包括次日清晨不能回忆夜间的反常行为,意识不清楚等。患者出现ADR后,停药并换用其他镇静催眠药等处理后,症状均缓解或恢复正常。结论唑吡坦所致神经精神系统ADR中,谵妄及可疑谵妄占比较大。在正常日剂量使用时仍有发生ADR的可能。服用唑吡坦后,女性可能更容易出现神经精神系统ADR,在治疗初期,尤其是服药当晚,应密切观察ADR发生情况。临床应用过程中应严格把握药品适应证,保障用药安全。

Objective To analyze the reports of adverse drug reactions(ADR)in the neuropsychiatric system caused by zolpidem,and explore the characteristics and patterns of adverse reactions,and to promote rational use of new hypnotic drugs in clinical practice.Methods Six cases of neuropsychiatric ADR caused by zolpidem reported in our hospital from January 1,2004 to December 31,2021 were selected and analyzed.Medications,ADR,treatments and outcomes of the patients were analyzed.The characteristics of neuropsychiatric ADR caused by zolpidem were studied.Results All the six patients were female.Most of the patients had adverse reactions soon after taking zolpidem.ADR occurred on the very night this drug was taken in most patients,and only one case of amnesia occurred on the 5day after taking the drug.The clinical manifestations of adverse reactions included the inability to recall the abnormal behavior of the previous night and unclear consciousness.After the onset of adverse reactions,the patients discontinued this drug and shifted to other sedative and hypnotic drugs,and the symptoms were relieved or returned to normal.Conclusion ADR of the nervous system caused by zolpidem,delirium and suspected delirium make up a large proportion.There are still the chances of adverse reactions at normal daily doses.Women may be more prone to neuropsychiatric ADR after taking zolpidem,and adverse reactions should be closely monitored at the beginning of treatment,especially on the night of treatment.The indications of drugs should be kept in mind in clinical practice to ensure the safety of drug use.