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Are Z drugs addictive?

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  • 04-12-2020 6:19pm
    #1
    mr_fegelien
    Banned (with Prison Access) Posts: 1,483 ✭✭✭


    I've had experience with psychiatrists who are reluctant to prescribe 5-10 tablets of Z drugs (zolpidem and zolpiclone) a month. The worry is that you build up tolerance to them quickly and they have harsh withdrawals.

    The thing is, I thought zolpidem itself wasn't as addictive as benzodiazepines due to the selective binding to the GABA-A alpha 1 receptor. They don't bind to the other GABA receptors that cause muscle relaxation or anxiolyis so the withdrawal is most likely to be insomnia rather than muscle cramps and seizures caused by benzos.

    It seems that across the Atlantic, you'll here of many people who have been on Ambien since they came out in the 90s (as American doctors are very liberal with prescriptions) and even though they are technically dependent, they don't experience many negative side effects.

    The alternatives that a doctor might offer are antihistamines (Piriton/chlorpheniramine, Benadryl/diphenhydramine) which in my experience are very weak. The other one is the antipsychotic Seroquel which is too sedating and leaves you feeling groggy.


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    #2
    Wesser
    Registered Users Posts: 1,813 ✭✭✭Wesser


    The doctors probably detect from you some pressure to prescribe ( given your previous posts here you seem to be very focussed on this). If a patient puts the doctor under alot of pressure, it can be a sign if addiction or tolerance.


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    #3
    Orionis
    Registered Users Posts: 18 ✭Orionis


    They do bind to the other receptors though. Just less so. The Z drugs are more or less just as harmful as the other benzos in the medium to long term. Only real difference is that they seem to have a better PR company!

    Worsening cognitive impairment + increased risk of dementia etc etc
    I know insomnia is awful but these drugs really aren't a sustainable solution unfortunately.

    Have you looked into cognitive behavioural therapy for insomnia? A lot of people also find light therapy and exercise helpful.


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    #4
    bo0li5eumx12kp
    Banned (with Prison Access) Posts: 1,355 ✭✭✭bo0li5eumx12kp


    Mr Feg has been put on time out again?

    lol

    Interesting question.

    Anything which slows nerve firing is going to be questionable in muh opinion.

    In old age conditions where insomnia can become devastating, Z drugs seem to act as lifesavers and can dramatically increase quality of life.

    But when it comes down to it, they are essentially slowing effectiveness of the nervous system and that seems to result in clinical compromises like neural code disturbance (memory loss) with long term use.

    Benzo's if i recall, can be associated with euphoric outcome in some capacity due to secondary neural affect - which may not be the case with Z drugs.

    But the primary consideration is alternate means to address insomnia without actually inducing that neural slowing associated with GABA based drugs I guess.

    ......

    Some swear by cannabis, as pointed out above anti-histamines can have somnolence properties at higher doses, and I'm sure there's others.


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