Is an acute overdose of zolpidem fatal? Case report of a suicide attempt with zolpidem and paracetamol

Katarzyna Camlet; Kinga Kocur; Mateusz Ziomek; Anna Ziobro; Jakub Jurek; Anna Lis; Paulina Lis; Wojciech Kaźmierski

doi:10.56782/pps.237

Data publikacji : 2024-08-31

Tom 22 Nr 3 (2024)

Is an acute overdose of zolpidem fatal?

Katarzyna Camlet

Kinga Kocur

Mateusz Ziomek

Anna Ziobro

Jakub Jurek

Anna Lis

Paulina Lis

Wojciech Kaźmierski

DOI: https://doi.org/10.56782/pps.237

Case report of a suicide attempt with zolpidem and paracetamol

Abstrakt

Zolpidem, widely prescribed for short-term management of insomnia, is a non-benzodiazepine hypnotic agent. It carries a high potential for abuse and an elevated risk of suicide. Overdose generally results in mild central nervous system depression, though severe outcomes are possible when co-ingested with other CNS depressants. Standard treatments include gastric lavage, flumazenil administration, and intravenous fluids.

This case report describes a 66-year-old female admitted after an apparent suicidal ingestion of approximately 200 mg of zolpidem. Upon admission, she was unconscious, with bradypnea and hypotension, scoring 5 on the Glasgow Coma Scale. Gastric lavage and N-acetylcysteine were administered due to elevated liver enzymes suggesting concomitant paracetamol poisoning, which was confirmed by urine tests. Flumazenil temporarily improved her condition, and she was subsequently transferred to the Intensive Care Unit for mechanical ventilation. Her clinical status stabilized, leading to extubation on the second day and transfer to the Psychiatry Unit.

This case highlights the critical need for timely intervention and continuous monitoring in zolpidem overdose scenarios, particularly when polypharmacy is involved. In instances of respiratory failure following zolpidem overdose, it is imperative to investigate the potential co-ingestion of additional substances.

Inne teksty tego samego autora

Paulina Lis, Anna Lis, Wojciech Kaźmierski, Jakub Jurek, Mateusz Ziomek, Kinga Kocur, Anna Ziobro, Katarzyna Camlet, INCLISIRAN - A NEW SOLUTION FOR THE PREVENTION AND TREATMENT OF ATHEROSCLEROTIC CARDIOVASCULAR DISEASE , Prospects in Pharmaceutical Sciences: Tom 22 Nr 3 (2024)
Kinga Kocur, Katarzyna Camlet, Anna Ziobro, Mateusz Ziomek, Wojciech Kaźmierski, Paulina Lis, Jakub Jurek, Anna Lis, Renaissance of Ketamine , Prospects in Pharmaceutical Sciences: Tom 22 Nr 3 (2024)
Anna Lis, Paulina Lis, Wojciech Kaźmierski, Kinga Kocur, Katarzyna Camlet, Jakub Jurek, Mateusz Ziomek, Anna Ziobro, Sodium bicarbonate - known medication, new prospects? , Prospects in Pharmaceutical Sciences: Tom 22 Nr 3 (2024)
Wojciech Kaźmierski, Jakub Jurek, Paulina Lis, Anna Lis, Anna Ziobro, Mateusz Ziomek, Katarzyna Camlet, Kinga Kocur, Sodium-Glucose Cotransporter-2 Inhibitors In Heart Failure , Prospects in Pharmaceutical Sciences: Tom 22 Nr 3 (2024)

Podobne artykuły

Łukasz Dobrek, English , Prospects in Pharmaceutical Sciences: Tom 20 Nr 4 (2022)
Agata Pisula, Agnieszka Sienicka, Agnieszka Dobrowolska-Redo, Joanna Kacperczyk-Bartnik, Ewa Romejko-Wolniewicz, INHIBITORY PARP W TERAPII RAKA JAJNIKA , Prospects in Pharmaceutical Sciences: Tom 22 Nr 2 (2024)
Mateusz Żaczko, Tomasz Lorenc, Wioletta Olejarz, Grażyna Nowicka, PERSPEKTYWY ZASTOSOWANIA TERAPEUTYCZNEGO EGZOSOMÓW W NAJCZĘŚCIEJ WYSTĘPUJĄCYCH NOWOTWORACH , Prospects in Pharmaceutical Sciences: Tom 17 Nr 6 (2019)
Agnieszka Kalicka, Natalia Tarłowska, COUNTERFEIT AND ILLEGAL MEDICINAL PRODUCTS AS AN EXAMPLE OF DRUGS THAT DO NOT MEET THE BASIC QUAITY REQUIREMENTS , Prospects in Pharmaceutical Sciences: Tom 21 Nr 4 (2023)
Maciej Bara, Agata Janczak, Toxicity of anesthetic gases: exposure in operating rooms and influence on the environment. , Prospects in Pharmaceutical Sciences: Tom 21 Nr 3 (2023)
Maciej Bara, Jakub Starownik, Jakub Szydło, Patryk Gryszkiewicz, Jakub Nieznański, Dapagliflozin - new solution in chronic kidney disease treatment , Prospects in Pharmaceutical Sciences: Tom 22 Nr 2 (2024)
Mustafa Sevindik, Celal Bal, Emre Cem Eraslan, İmran Uysal, Falah Saleh Mohammed, Medicinal mushrooms: a comprehensive study on their antiviral potential , Prospects in Pharmaceutical Sciences: Tom 21 Nr 2 (2023)
Katarzyna Kozon, Małgorzata Krzyżanowska, Jakub Olszewski, Andrzej Patyra, Spinal muscular atrophy – the effectiveness of treatment and new therapeutic possibilities for selected groups of patients in Poland , Prospects in Pharmaceutical Sciences: Tom 21 Nr 2 (2023)
Marta Szymańska, Andrzej Baranowski, Dariusz Płachta, PRZEGLĄD PREPARATÓW NAJCZĘŚCIEJ STOSOWANYCH W LECZENIU CHORÓB GRZYBICZYCH , Prospects in Pharmaceutical Sciences: Tom 5 Nr 1 (2007)
Grażyna Kubiak-Tomaszewska, Jan Pachecka, Jacek Łukaszkiewicz, Piotr Tomaszewski, RECEPTOROWE MECHANIZMY REGULACJI METABOLIZMU KWASÓW ŻÓŁCIOWYCH I KSENOBIOTYKÓW. ZNACZENIE EKSPRESJI CYP3A4 DLA BEZPIECZEŃSTWA I SKUTECZNOŚCI FARMAKOTERAPII , Prospects in Pharmaceutical Sciences: Tom 14 Nr 9 (2016)

<< < 1 2 3 4 5 6 > >>

Możesz również Rozpocznij zaawansowane wyszukiwanie podobieństw dla tego artykułu.

Szczegóły

Bibliografia

Statystyki

Autorzy

Pobierz pliki

PDF (English)

Zasady cytowania

Camlet, K., Kocur, K., Ziomek, M., Ziobro, A., Jurek, J., Lis, A., … Kaźmierski, W. (2024). Is an acute overdose of zolpidem fatal? Case report of a suicide attempt with zolpidem and paracetamol. Prospects in Pharmaceutical Sciences, 22(3), 152–155. https://doi.org/10.56782/pps.237

Wskaźniki altmetryczne

Cited by / Share

Licencja

Utwór dostępny jest na licencji Creative Commons Uznanie autorstwa 4.0 Międzynarodowe.

Bibliografia

Chong, Y.; Fryer, C.D.; Gu, Q. Prescription sleep aid use among adults: United States, 2005-2010. NCHS Data Brief. 2013, 127, 1-8.

Garnier, R.; Guerault, E.; Muzard, D.; Azoyan, P.; Chaumet-Riffaud, A.E.; Efthymiou, M.L. Acute zolpidem poisoning - analysis of 344 cases. J. Toxicol. Clin. Toxicol. 1994, 32(4), 391-404. doi: 10.3109/15563659409011040. DOI: https://doi.org/10.3109/15563659409011040

Sun, Y.; Lin, C.C.; Lu, C.J.; Hsu, C.Y.; Kao, C.H. Association Between Zolpidem and Suicide: A Nationwide Population-Based Case-Control Study. Mayo Clin. Proc. 2016, 91(3), 308-15. doi: 10.1016/j.mayocp.2015.10.022. DOI: https://doi.org/10.1016/j.mayocp.2015.10.022

McCall, W.V.; Benca, R.M.; Rosenquist, P.B.; et al. Hypnotic medications and suicide: risk, mechanisms, mitigation, and the FDA. Am. J. Psychiatr. 2017, 174, 18-25. DOI: https://doi.org/10.1176/appi.ajp.2016.16030336

Sedative-Hypnotic Toxicity. Available online: https://emedicine.medscape.com/article/818430-overview (accessed on 21.07.2024).

Simone, C.G.; Bobrin, B.D. Anxiolytics and Sedative-Hypnotics Toxicity; Publisher: Stat Pearls Publishing, Internet, 2024. Available online: https://www.ncbi.nlm.nih.gov/books/NBK562309/ (accessed on 21.07.2024).

Koziołek, W.; Komisarz, M.; Szypuła, G.; Szczepaniak, P.; Konopka, T.; Kanclerz, G.; Hapkiewicz, K. Porównanie samobójczych zatruć substancjami chemicznymi i lekami w latach 1930–1939 oraz 2010–2019 w materiale Zakładu Medycyny Sądowej w Krakowie. Kwartalnik Historii Nauki i Techniki, 2021, 4, 215-230. DOI: https://doi.org/10.4467/0023589XKHNT.21.035.14799

Lheureux, P.; Debailleul, G.; De Witte, O.; Askenasi, R. Zolpidem intoxication mimicking narcotic overdose: response to flumazenil. Hum. Exp. Toxicol. 1990, 9(2), 105-7. doi: 10.1177/096032719000900209. DOI: https://doi.org/10.1177/096032719000900209

Wyss, P.A.; Radovanovic, D.; Meier-Abt, P.J. Akute Uberdosierungen mit Zolpidem (Stilnox) [Acute overdose of Zolpidem (Stilnox)]. Schweiz Med. Wochenschr. 1996, 126(18), 750-6.

Winek, C.L.; Wahba, W.W.; Janssen, J.K.; Rozin, L.; Rafizadeh, V. Acute overdose of zolpidem. Forensic Sci. Int. 1996, 78(3), 165-8. doi: 10.1016/0379-0738(95)01875-1. DOI: https://doi.org/10.1016/0379-0738(95)01875-1

Gock, S.B.; Wong, S.H.; Nuwayhid, N; Venuti, S.E.; Kelley, P.D.; Teggatz, J.R.; Jentzen, J.M. Acute zolpidem overdose--report of two cases. J. Anal. Toxicol. 1999, 23(6), 559-62. doi: 10.1093/jat/23.6.559. DOI: https://doi.org/10.1093/jat/23.6.559

Sein Anand, J.; Chodorowski, Z.; Hajduk, A. Acute intoxication with zaleplon – a case report. Przegl. Lek. 2007, 64(4-5), 310-311.

Kuzniar, T. J.; Balagani, R.; Radigan, K. A.; Factor, P.; Mutlu, G. M. Coma With Absent Brainstem Reflexes Resulting From Zolpidem Overdose. Am. J. Ther. 2010, 17(5), e172–e174. doi:10.1097/–mjt.0b013e318188bdc DOI: https://doi.org/10.1097/MJT.0b013e318188bdca

Hamad, A.; Sharma, N. Acute zolpidem overdose leading to coma and respiratory failure. Intensive Care Med. 2001, 27(7), 1239. doi: 10.1007/–s001340100972. DOI: https://doi.org/10.1007/s001340100972

Suarez, L.; Kolla, B.P.; Hall-Flavin, D.; Mansukhani, M.P. QTc Prolongation Secondary to Zolpidem Use. Prim. Care Companion CNS Disord. 2020, 22(2), 27195. DOI: https://doi.org/10.4088/PCC.19l02506

Campagnari, S.; Zamboni, L.; Fusina, F.; Casari, R.; Lugoboni, F. Case Report: High doses of Zolpidem and QT interval lengthening: Is there a relationship? A case series. Front. Psychiatry. 2022, 13, 1033061. DOI: https://doi.org/10.3389/fpsyt.2022.1033061

Pfeifer, P.; Greusing, S.; Kupferschmidt, H.; Bartsch, C.; Reisch, T. A comprehensive analysis of attempted and fatal suicide cases involving frequently used psychotropic medications. Gen. Hosp. Psychiatry. 2019. doi:10.1016/j.genhosppsych.2019.07.011 DOI: https://doi.org/10.1016/j.genhosppsych.2019.07.011

De Donatis, D.; Porcelli, S.; Serretti, A.; Gaspari, D.; Caltagirone, S.S.; Giupponi, G.; Ferraro, M.; Conca, A.; Florio, V.; Zernig, G.; Mercolini, L. Extremely High-Dosage Zolpidem Poisoning With Favorable Outcome. J. Clin. Psychopharmacol. 2021, 41(2), 222-223. doi: 10.1097/JCP.0000000000001353 DOI: https://doi.org/10.1097/JCP.0000000000001353

Sein, A.J.; Chodorowski, Z.; Hajduk, A. Ostre zatrucie zaleplonem: opis przypadku [Acute intoxication with zaleplon: a case report]. Przegl. Lek. 2007, 64(4-5), 310-311.

Forrester, M.B. Comparison of zolpidem and zaleplon exposures in Texas, 1998-2004. J. Toxicol. Environ. Health. 2006, 69, 1883. DOI: https://doi.org/10.1080/15287390600631763

Darke, S.; Deady, M.; Duflou, J. Toxicology and Characteristics of Deaths Involving Zolpidem in New South Wales, Australia 2001-2010. J. Forensic Sci. 2012, 57(5), 1259–1262. doi:10.1111/j.1556-4029.2012.02117.x DOI: https://doi.org/10.1111/j.1556-4029.2012.02117.x

Mortaz Hejri, S.; Faizi, M.; Babaeian, M. Zolpidem-induced suicide attempt: a case report. Daru. 2013, 21(1), 77. doi: 10.1186/2008-2231-21-77. DOI: https://doi.org/10.1186/2008-2231-21-77

Willner, N.; Schiff, E. A case of suicide attempt with Zolpidem - will Zolpidem show up on standard urine toxicology screening? EXCLI J. 2014, 13, 454-456.

Huang, C.L.; Chang, C.J.; Hung, C.F.; Lin, H.Y. Zolpidem-induced distortion in visual perception. Ann Pharmacother. 2003, 37(5), 683-686. doi: 10.1345/aph.1C318. DOI: https://doi.org/10.1345/aph.1C318

Katarzyna Camlet

camkasia@interia.pl

Afiliacja:

a:1:{s:5:"en_US";s:55:"District Hospital in Zakopane, 34-500, Zakopane, Poland";} Poland