The Clinical and Forensic Toxicology of Z-drugs

摘要: The Z-drugs zolpidem, zopiclone, and zaleplon were hailed as the innovative hypnotics of new millennium, an improvement to traditional benzodiazepines in management insomnia. Increasing reports adverse events including bizarre behavior falls elderly have prompted calls for caution regulation. significant hypnotic effects by reducing sleep latency improving quality, though duration may not be significantly increased. exert their through increased γ-aminobutyric acid (GABA) transmission at same GABA-type A receptor benzodiazepines. Their pharmacokinetics approach those ideal with rapid onset within 30 min short half-life (1–7 h). Zopiclone longest action has greatest residual effect, similar short-acting Neuropsychiatric been reported zolpidem hallucinations, amnesia, parasomnia. Poisoning involves predominantly sedation coma supportive being adequate majority. Flumazenil reverse from all three Z-drugs. Deaths are rare more likely occur polydrug overdose. can detected blood, urine, oral fluid, postmortem specimens, liquid chromatography–mass spectrometry techniques. Zolpidem exhibit redistribution. Zaleplon its ultra-short few clinical or forensic cases possibly due assay unavailability, low frequency use, window detection. Though improved pharmacokinetic profiles, effects, neuropsychiatric sequelae, incidence poisoning death prove older hypnotics.