{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T07:23:11Z","timestamp":1774682591434,"version":"3.50.1"},"reference-count":58,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,8,17]],"date-time":"2022-08-17T00:00:00Z","timestamp":1660694400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Insomnia is a major public health problem that determines the quality of life. Among the many causes of insomnia, psychological factors have an important influence on the process, duration of insomnia, help-seeking behavior, and treatment choice. Regarding medical treatment, zolpidem is always chosen to treat acute and transient insomnia due to its few side effects. Although some randomized controlled trials have verified its safety, zolpidem abuse and withdrawal reactions have been reported in recent years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case report<\/jats:title><jats:p>A 25-year-old unmarried man with a college degree who worked as a graphic designer was referred and admitted to the inpatient ward for a chief complaint of \u201calternative episodes of lowering and elevation of mood for 10 years, overdosage use of zolpidem for two years.\u201d He underwent a time-dependent withdrawal reaction after admission. It was characterized by rebound insomnia, anxiety, craving, skin paresthesia, influenza-like symptoms, tonic-clonic-type seizures, and hallucinations. At the 1-year follow-up, he did not exhibit any remaining withdrawal symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The acute cessation of overdosage zolpidem use causes a series of withdrawal symptoms that manifest in chronological order. Additionally, long-term benzodiazepine exposure has potential influences on zolpidem dependence\/tolerance. However, patients with a history of abuse or dependence, or mental disorders seem to be at risk of drug abuse. Clinicians should be alert to the potential for zolpidem dependence and addiction. Once the acute cessation of overdosage zolpidem use occurs, the potential of the withdrawal reaction needs to be considered and addressed properly.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyt.2022.962836","type":"journal-article","created":{"date-parts":[[2022,8,17]],"date-time":"2022-08-17T05:27:16Z","timestamp":1660714036000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Case report: Chronological symptom profile after cessation of overdose zolpidem in a patient with comorbid bipolar disorder\u2014from anxiety, craving, paresthesia and influenza-like symptoms to seizures and hallucinations"],"prefix":"10.3389","volume":"13","author":[{"given":"Zi-xin","family":"Mao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xia","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui-yao","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wan-jun","family":"Guo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,8,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1016\/j.sleep.2021.03.028","article-title":"International study of the prevalence and factors associated with insomnia in the general population.","volume":"82","author":"Aernout","year":"2021","journal-title":"Sleep Med."},{"key":"B2","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1016\/j.jsmc.2022.03.003","article-title":"Epidemiology of insomnia: prevalence, course, risk factors, and public health burden.","volume":"17","author":"Morin","year":"2022","journal-title":"Sleep Med Clin."},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2015.26","article-title":"Insomnia disorder.","volume":"1","author":"Morin","year":"2015","journal-title":"Nat Rev Dis Primers."},{"key":"B4","doi-asserted-by":"publisher","first-page":"S76","DOI":"10.37765\/ajmc.2020.42769","article-title":"Insomnia overview: epidemiology, pathophysiology, diagnosis and monitoring, and nonpharmacologic therapy.","volume":"26","author":"Dopheide","year":"2020","journal-title":"Am J Manag Care."},{"key":"B5","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1016\/j.jsmc.2022.02.009","article-title":"Neurodegenerative disorders and sleep.","volume":"17","author":"Malhotra","year":"2022","journal-title":"Sleep Med Clin."},{"key":"B6","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/j.smrv.2009.09.003","article-title":"Comorbidity of insomnia and depression.","volume":"14","author":"Staner","year":"2010","journal-title":"Sleep Med Rev."},{"key":"B7","doi-asserted-by":"publisher","first-page":"628","DOI":"10.1016\/S2215-0366(20)30136-X","article-title":"Sleep disturbance and psychiatric disorders.","volume":"7","author":"Freeman","year":"2020","journal-title":"Lancet Psychiatry."},{"key":"B8","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1016\/j.smrv.2006.03.002","article-title":"The attention-intention-effort pathway in the development of psychophysiologic insomnia: a theoretical review.","volume":"10","author":"Espie","year":"2006","journal-title":"Sleep Med Rev."},{"key":"B9","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1037\/a0025730","article-title":"(Mis)perception of sleep in insomnia: a puzzle and a resolution.","volume":"138","author":"Harvey","year":"2012","journal-title":"Psychol Bull."},{"key":"B10","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1097\/PSY.0b013e3181fe365a","article-title":"Sleep misperception and chronic insomnia in the general population: role of objective sleep duration and psychological profiles.","volume":"73","author":"Fernandez-Mendoza","year":"2011","journal-title":"Psychosom Med."},{"key":"B11","doi-asserted-by":"publisher","first-page":"323","DOI":"10.9758\/cpn.2019.17.2.323","article-title":"Comorbid zolpidem dependence and over-the-counter compound analgesic abuse.","volume":"17","author":"Kim","year":"2019","journal-title":"Clin Psychopharmacol Neurosci."},{"key":"B12","doi-asserted-by":"publisher","first-page":"142","DOI":"10.2165\/00003088-199529030-00002","article-title":"Clinical pharmacokinetics and pharmacodynamics of zolpidem. 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