• Fangfei Xie, Bo Liu, Liqiu Yang, Junqiang Huang, Bin Li, and Yuanyuan Li.
• Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, China.
• Medicine (Baltimore). 2024 Nov 1; 103 (44): e40280e40280.

RationaleZolpidem, a non-benzodiazepine sedative-hypnotic, is considered safer for the treatment of insomnia compared to benzodiazepines. However, in recent years, there have been growing reports of Zolpidem dependence, addiction, and withdrawal symptoms. We reported a case of Zolpidem addiction and successful detoxification, reviewed similar cases in the literature, and proposed a potential mechanism underlying Zolpidem addiction.Patient ConcernsThe patient was a 46-year-old Tibetan woman who had been using Zolpidem intermittently to treat insomnia for at least 8 years. She was overweight, with a BMI of 28.04 kg/m², and had hypertension, diabetes, a 20-year smoking history, and several years of alcohol abuse, often seeking instant gratification. She voluntarily increased both the dosage and frequency of Zolpidem, experiencing euphoria, anxiolysis, and increased appetite at higher doses, which led her to gradually escalate her dosage to 280 mg per day in divided doses. However, upon stopping Zolpidem, she experienced withdrawal symptoms, including insomnia, tension, and palpitations.DiagnosesShe was diagnosed with a combination of hypnotic use disorder, anxiety disorder, hypertension, and diabetes.InterventionsShe underwent diazepam replacement therapy, along with antianxiety medications and mindfulness-based cognitive therapy, to address Zolpidem addiction.OutcomesAfter 13 days of inpatient treatment, the patient successfully quit Zolpidem. During a 3-month follow-up, she returned to work and remained free from Zolpidem use.LessonsWe speculate that Zolpidem addiction is likely linked to the drug's euphoric effects and certain patient characteristics, such as sensation-seeking behavior. A comprehensive approach, involving both pharmacological and psychological interventions, is essential for an effective detoxification strategy for Zolpidem addiction.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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