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Objective: This case report highlights the abuse and dependence potential of Zolpidem and the risk of life-threatening withdrawal symptoms upon abrupt discontinuation. Method: We report a case of Zolpidem dependence which presented with withdrawal symptoms upon abrupt discontinuation. Results: A 32 year old male, who had abused non-benzodiazepine Zolpidem for 6 years presented to the accident and emergency unit with generalized seizures upon stopping Zolpidem ‘cold turkey’. He required admission to the neurology high dependency unit for stabilization of the seizures and was later managed by the addiction team where a tapering dose of benzodiazepine was prescribed. Conclusion: This case demonstrates that non-benzodiazepine agents can cause tolerance and dependence, and thus produce withdrawal symptoms upon discontinuation.
RESUMO
Objective To explore the effect of Electroacupuncture on anxiety mood and periaqueductal grey (PAG) β-endorphine expression in rats with morphine abstinence syndrome.Methods The model of heroin-addicted rat was firmly established by the subcutaneous injection of gradually-increased dosages of heroin. Rats were randomly divided into control group, herion-addict group, withdrawal group, electroacupuncture group.Anxiety mood of experimental rats were assessed by Elevated Plus Maze test. Expression of β-EP in PAG was detected by immunohistochemstry. The effect of electroacupuncture at bilateral zusanli and sanyinjiao on anxiety mood and expression of β-EP in PAG was observed in rats with herion abstinence symptom.Results The anxiety index in rats with herion abstinence symptom:the value of OT％,OE％and head-dips times was (12.5±4.3) ％, (17.1±6.7)％and (5.7±2.0) times respectively,lower than that in control group [ (26.8±8.7) ％,(32.4±6.0) ％ and (12.2±4.0) times respectively],there existed significant difference(The value of P was 0.003,0.018 and 0.003 respectively).Meanwhile,The expression of β-EP-positive neurons(206.1±23.1)was significantly higher than the control(186.2±15.3). There existed significant difference( P =0.041).Electroacupuncture could increase OT％,OE％,head-dips times[(26.5±8.7)％、(31.8±7.7)％ and (9.9±3.1) times respectively] in rats with herion abstinence symptom,which comparied with control group were not statistically distinctive(The value of P was 0.920,0.816 and 0.122 respectively).The expression of β-EP(185.3±11.4)in PAG increased, which comparied with control group(186.2±15.3)were not statistically distinctive( P =0.891).Conclusion Electroacupuncture could inhibit the abstinence syndrome effectively.And there is obvious promotion of β-EP expression in PAG. This is probably one of underlying mechanisms for electroacupuncture improving withdrawal symptoms.