PsychRounds: The Psychiatry Podcast The Sleep Series: Z Drugs (Zolpidem, Zaleplon, EsZopiclone)
4 snips
Oct 23, 2024 Discover the fascinating world of Z Drugs—Zolpidem, Zaleplon, and Eszopiclone—commonly used to tackle insomnia. Delve into their unique pharmacology and mechanisms of action, distinguishing them from traditional benzodiazepines. Learn about their half-lives, dosing guidelines, and the varying safety profiles for different demographics. The discussion also highlights significant risks, including misuse and side effects like sleepwalking. Join the conversation on balancing the benefits and complexities of these medications for effective sleep treatment.
AI Snips
Chapters
Transcript
Episode notes
Selective GABA Receptor Targeting
- Z-drugs are positive allosteric modulators of GABA receptors that enhance inhibitory effects by allowing more chloride ion flow.
- They selectively target the alpha-1 GABA receptor subunit, mainly affecting sleep without some benzodiazepines' other effects.
Z-Drugs Vary by Half-Life
- Zolpidem has a short half-life, effective mainly for sleep onset but less so for maintenance.
- Eszopiclone has the longest half-life (~6 hours), making it potentially better for sleep maintenance.
Dosing Adjustments for Females
- Female patients should not exceed 5 mg IR or 6.25 mg controlled-release doses of zolpidem due to slower metabolism.
- Adjust dosing carefully, especially in elderly populations, to reduce risk.