Zolpidemにより幻覚を呈したと思われる1症例

Zolpidem-associated Hallucination：A case report

序言

　超短時間作用型非ベンゾジアゼピン系睡眠導入剤であるzolpidem(マイスリー^®)はω₁受容体に対する選択的作用のため，ふらつき，筋弛緩作用などの副作用が少ない¹¹⁾。Zolpidem服用後の幻覚症状発現が海外を中心に報告されているが^{1～3,5,6,8～10,12,14)}，国内での詳細報告は2例のみで^5,8)，国内外で幻聴を呈した症例の報告は1件⁹⁾しかない。今回，我々は，zolpidem服用後に幻視と幻聴を来した若年女性の1症例を経験したので報告する。また，過去の症例および本症例の臨床的背景をまとめ，zolpidemによる幻覚の発症要因を考察する。

　Zolpidem is an ω₁-receptor-selective hypnotic with an ultrashort period of activity. In comparison with other hypnotics, it is associated with fewer instances of side effects such as falling. Zolpidem-induced hallucinations have been reported in patients in some countries, but only a few such cases have been observed in Japan. We report the case of a 17-year-old girl who experienced zolpidem-associated visual and auditory hallucinations, and we have reviewed the past cases to assess the factors the factors influencing zolpidem-associated hallucinations. In our case, the patient exhibited characteristic auditory hallucinations. Zolpidem-associated hallucinations may be caused by selectivity to ω₁receptors along with an increase in the zolpidem concentration in the blood. In spite of the safe and widespread use of zolpidem, it is essential to monitor and avoid zolpidem-associated hallucinations, especially in female patients.