Z類鎮靜安眠藥品處方型態與不良反應

Prescription Patterns and Adverse Events of Z-hypnotics

治療失眠的第一線藥品為benzodiazepine（BZD）類藥品及Z 類鎮靜安眠藥品（Z-drugs）如：zolpidem。臨床上，普遍認為Z-drugs 與BZD 類藥品相比，具治療效果相似但安全性較高的優點，因此Z-drugs 類藥品的使用量近年來有明顯增加的趨勢。然而，隨著Z-drugs 上市後使用人數增加以及潛在的長期使用情形，相關的不良反應也漸漸浮出檯面。本文整合近年來各國對Z-drugs 所做的處方型態分析以及其相關不良反應的研究，針對Z-drugs 的使用進行深入的分析後發現，目前各國於Z-drugs 的使用量已大幅攀升，其中又以zolpidem 及zopiclone 為最常使用的兩個成分。而於不良反應部分，少數研究指出zolpidem 可能會增加交通事故、骨折與不尋常睡眠相關行為的風險，研究學者也指出這可能與zolpidem 的不適當使用有關。本文藉由彙整Z-drugs 相關的實證資料，期能提醒醫療人員注意使用此類藥品的正當性與安全性，讓這些藥品發揮其最大的治療效果。

Use of benzodiazepines (BZD) and Z-hypnotics (e.g. zolpidem) are very common in patients with insomnia. Nevertheless, adverse events associated with BZD hypnotics may limit their use. Z-hypnotics have therefore been marketed as having a better safety profile than the older BZD hypnotics. However, significant concerns regarding use of z-hypnotics and potential adverse events remain. This review focuses on empirical data on prescription patterns and safety profile of Z-hypnotics to promote appropriate use of these drugs. We found a significant consumption of Z-hypnotics (zolpidem and zolpiclone) worldwide. Existing studies suggested that zolpidem, especially inappropriate use of zolpidem, may be associated with increased risk of traffic accident, fracture, and complex sleep behaviors.