Zolpidem Induced Depersonalization and Derealization

Zolpidem is an imidazopyridine agent indicated for the short-term treatment of insomnia (1, 2). Due to its milder and lower problematic side effects, chemically distinction from benzodiazepines and apparent selectively binding to a subset of benzodiazepine receptors, it has gained popularity as an alternative to benzodiazepine for the treatment of insomnia (3). This property may account for their apparently milder withdrawal effects. Zolpidem exerts hypnotic effect comparable to short- and medium-acting benzodiazepines, and shown similar or possibly fewer adverse reactions at the therapeutic doses (2), except for gastrointestinal disturbances which appear to be more common as well as visual hallucinations especially in women. On the other hand, zolpidem unexpectedly causes as much memory impairment as triazolam does, if not more, at least in young healthy adults (4).Depersonalization (DP), a complex and obscure subject of clinical psychiatry, has become a recurrent topic of psychopathology in the last 10 years (5). It is characterized by persistent or recurrent episodes of the patient detachment from him/herself. It means that individuals may feel like an automaton or they may have a sensation of estrangement from their own mental processes, emotions or body shape (5-8). Often accompanied by derealization (DR), a threatening sense of unreality from the environment, DP can assume various nuanced forms in clinical practice (5, 9-15).The purpose of this case report is to review the diagnosis of depersonalization/derealization disorder (DDD) Zolpidem use. Numerous case reports of DDD and articles about zolpidem s potential neuropsychiatric symptoms have been published. However, and to our knowledge, this is the first case report describing the onset of DDD following zolpidem exposure.