Pharmacoepidemiological characterisation of zolpidem and zopiclone usage
Abstract
Purpose Zolpidem and zopiclone are two widely used non-benzodiazepine hypnotics whose usage seems to be associated to pharmacodependence. However, to our knowledge, there has as yet been no published epidemiological study which has compared their abuse or dependence potential. We used a pharmacoepidemiological approach to identify and characterise zolpidem and zopiclone users in real life situations.Methods Regular users of zolpidem or zopiclone were identified in the database of a French regional health insurance organisation. A latent class analysis (LCA) was used to identify different subgroups of users of these two hypnotics.Results The study cohort comprised 25,168 patients who regularly used zolpidem and 21,860 who regularly used zopiclone. The results of the latent class analysis, which enables subgroups with similar patterns of response to be identified, revealed four clinical subtypes of users of zolpidem: non-problematic users, users with associations with hypnotics/anxiolytics or with associated mental disorders, and problematic users. Only three subgroups were identified for zopiclone, and LCA did not discriminate a special class of problematic users for this drug.Conclusion Our analysis indicates that there is a subclass of zolpidem user suggestive of abuse; this was not the case for zopiclone. This methodology is very interesting because it allows analysis of databases and determination of a specific signature of drugs potentially leading to abuse or dependence.
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Chronic use of z drugs may lead to dose escalation and heavy use, and renewal of prescriptions without proper medical evaluation is associated with a higher risk of dependence.
“Previous studies have found evidence that chronic use of z drugs may lead to dose escalation and heavy use, and that the renewal of prescriptions without a proper medical evaluation is associated with a higher risk of dependence [44, 45].”
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- Authors
- Victorri-Vigneau, C., Feuillet, F., Wainstein, L., Grall-Bronnec, M., Pivette, J., Chaslerie, A., Sébille, V., & Jolliet, P.
- Affiliations
- Centre Hospitalier Universitaire de Nantes (FR)
- Venue
- European Journal of Clinical Pharmacology
- Published
- 2013-07-23
- Volume
- 69
- Issue
- 11
- Pages
- 1965-1972
- ISSN
- 0031-6970 (ISSN-L)
- 1432-1041
- OpenAlex
- W1976566286
- Cited by
- 49
- References
- 45
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 2 · 2022: 3 · 2021: 6 · 2020: 3 · 2019: 2 · 2018: 6 · 2017: 6 · 2016: 4 · 2015: 7 · 2014: 6
- FWCI
- 7.66
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- European Journal of Clinical Pharmacology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Keywords
- zolpidem, zopiclone, non-benzodiazepine hypnotics, hypnotic abuse, hypnotic dependence, problematic drug use, latent class analysis, user subgroups, anxiolytic use, mental illness, health insurance claims data
- MeSH terms
- Zolpidem, Aged, Drug Utilization, Female, France, Humans, Hypnotics and Sedatives, Male, Middle Aged, Piperazines, Pyridines, Substance-Related Disorders, Azabicyclo Compounds
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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