PHARMACOLOGICAL STRATEGIES AND INTEGRATED APPROACHES IN THE TREATMENT OF ZOLPIDEM DEPENDENCE: A NARRATIVE REVIEW
DOI:
https://doi.org/10.56238/levv17n56-005Keywords:
Zolpidem Dependence, Insomnia Treatment, Cognitive-Behavioral Therapy, Withdrawal Symptoms, Discontinuation ProtocolsAbstract
INTRODUCTION Zolpidem, a widely prescribed hypnotic for the treatment of insomnia, has demonstrated efficacy in the short-term management of sleep disorders. However, prolonged use of this medication can lead to the development of physical and psychological dependence. This scenario has generated increasing interest in the search for therapeutic approaches that can effectively manage zolpidem dependence and prevent the adverse effects associated with its withdrawal. OBJECTIVES To evaluate pharmacological and non-pharmacological approaches in the treatment of zolpidem dependence, focusing on the effectiveness of gradual weaning protocols and therapeutic alternatives. METHODS This is a narrative review. The PubMed, SciELO, and Medline databases were used, and the following descriptors were applied: “Zolpidem dependence” AND “Pharmacological therapy” AND “Insomnia treatment” OR “Hypnotic withdrawal” OR “Gradual medication tapering” in the last 5 years. RESULTS AND DISCUSSION Several pharmacological approaches have been investigated in the treatment of zolpidem dependence, such as the use of benzodiazepine receptor antagonists and melatonin receptor agonists. Gradual weaning protocols have proven effective in minimizing withdrawal symptoms, especially when combined with psychotherapeutic support, such as cognitive-behavioral therapy (CBT). Studies suggest that CBT is effective in preventing relapses and restoring healthy sleep patterns. Emerging approaches, such as neuromodulation, are being explored to treat neurobiological changes induced by prolonged zolpidem use. CONCLUSION The management of zolpidem dependence requires a multidisciplinary approach that includes pharmacological and behavioral interventions. The combination of gradual weaning with psychotherapeutic support, in addition to pharmacological alternatives such as melatonin agonists, has proven effective in patient recovery. New therapeutic approaches, such as neuromodulation, may offer promising solutions for the treatment of complex addictions and deserve further investigation.
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