以靜脈點滴注射短效型benzodiazepines治療zolpidem依賴病人的嚴重暈眩

Detoxifi cation with Intravenous Drip Short-acting Benzodiazepines in a Zolpidem-dependent Patient with Intolerable Withdrawal Dizziness

目的：Zolpidem依賴的案例報告越來越多，一般建議以口服benzodiazepine類藥物治療zolpidem戒斷症狀。然而使用口服benzodiazepine可能加重zolpidem戒斷症狀之頭暈不適，影響戒斷症狀的治療。病例報告：我們報告一位高劑量zolpidem依賴的病人，使用口服benzodiazepine類藥物治療戒斷症狀時，有嚴重頭暈情形。後來改用靜脈點滴注射benzodiazepines，成功的治療zolpidem戒斷症狀。結論：當使用口服benzodiazepine類藥物治療zolpidem戒斷症狀時，若產生戒斷症之頭暈加重，改以靜脈點滴注射benzodiazepines可避免此副作用，達到治療zolpidem戒斷症狀之效果。

Objective: To report a case of physical and psychological addiction to an excessive dose of zolpidem and subsequent completed detoxifi cation using intravenous drip benzodiazepines. Case report: A 30-year-old female patient had highdose zolpidem dependence with 120 mg-160 mg per day for two years. She suffered from severe withdrawal symptoms including dizziness when she discontinued zolpidem. She experienced more severe dizziness under oral benzodiazepine medication for detoxifi cation. She was later successfully treated with intravenous drip short-acting benzodiazepines for the zolpidem withdrawal symptoms without dizziness adverse effects. Conclusion: Given the similarities in receptor binding and pharmacologic activities of zolpidem and the benzodiazepines, benzodiazepines are commonly used for zolpidem detoxifi cation. Intravenous drip short-acting benzodiazepines may improve the zolpidem withdrawal symptoms without aggravating dizziness symptoms.