The Korean Journal of Medicine

  • 제84권6호
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  • Pages.804-809
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  • 2013
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  • 1738-9364(pISSN)
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  • 2289-0769(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
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졸피뎀 유발 섬망의 발생률 및 위험요인

Incidence of and Risk Ractors for Zolpidem-Induced Delirium

  • Kim, Young Min (Department of Internal Medicine, Dankook University Hospital, Dankook University Medical College) ;
  • Lee, Sora (Department of Internal Medicine, Dankook University Hospital, Dankook University Medical College) ;
  • Jung, Ji Yun (Department of Internal Medicine, Dankook University Hospital, Dankook University Medical College) ;
  • Shin, Kyoung Hwang (Department of Internal Medicine, Dankook University Hospital, Dankook University Medical College) ;
  • Kim, Doh Hyung (Department of Internal Medicine, Dankook University Hospital, Dankook University Medical College) ;
  • Kim, Jee Hyun (Department of Neurology, Dankook University Hospital, Dankook University Medical College) ;
  • Jee, Young-Koo (Department of Internal Medicine, Dankook University Hospital, Dankook University Medical College)
  • 투고 : 2012.11.02
  • 심사 : 2012.12.26
  • 발행 : 2013.06.01
⟨ 이전 논문 다음 논문 ⟩

초록

목적: 졸피뎀은 불면증의 치료로 안전하고 효과적인 약물이다. 하지만 졸피뎀을 복용한 후 섬망과 같은 부작용이 발생했다는 보고가 있다. 졸피뎀 유발 섬망의 발생률과 위험요인에 대해 연구하였다. 방법: 2011년 1월부터 2011년 5월까지 입원하여 졸피뎀을 복용한 481명의 환자를 대상으로 졸피뎀 유발 섬망의 발생률과 위험요인에 대하여 후향적으로 분석하였다. 결과: 졸피뎀을 복용한 481명 가운데 19명(4.0%)에서 섬망이 발생하였다. 65세 이상의 고령(OR = 4.35, 95% CI = 1.52-12.44, p = 0.006)과 벤조디아제핀과의 동시 복용(OR = 4.30, 95% CI = 1.52-12.12, p = 0.006)이 졸피뎀 유발 섬망과 유의하게 연관되었다. 특히 65세 이상의 고령 환자가 벤조디아제핀과 졸피뎀을 동시에 복용한 경우에는 상당히 높은 섬망 발생률(OR 6.04, 95% CI 1.80-20.20, p = 0.003)을 보였다. 졸피뎀 용량을 포함한 다른 요인들은 섬망 발생에 영향을 미치지 않았다. 결론: 고령과 벤조디아제핀과의 동시 복용이 졸피뎀 유발 섬망의 독립적인 위험인자이다. 따라서 노인에게 졸피뎀을 처방하기 전에는 철저한 약물 복용력 확인이 필요하고 신중한 사용과 주의 깊은 감시가 필요하다.

Background/Aims: Zolpidem is a safe and effective drug for the treatment of insomnia. However, there are some reports of adverse effects, such as delirium, after administration of zolpidem. The aim of this study was to evaluate the incidence of and risk factors for zolpidem-induced delirium. Methods: This retrospective study enrolled 481 patients who were admitted to hospital and received zolpidem between January and May 2011. We analyzed the incidence and risk factors associated with zolpidem-induced delirium. Results: Zolpidem-induced delirium occurred in 19 of 481 (4.0%) patients. Zolpidem-induced delirium was significantly associated with old age (${\geq}$ 65 years; odds ratio [OR] = 4.35, 95% confidence interval [CI] = 1.52-12.44, p = 0.006) and co-administration of benzodiazepine (OR = 4.30, 95% CI = 1.52-12.12, p = 0.006). When males > 65 years-old took both benzodiazepine and zolpidem simultaneously, the incidence of delirium was notably elevated (OR = 6.04, 95% CI = 1.80-20.20, p = 0.003). Other factors, including dosage, did not influence the occurrence of delirium. Conclusions: Old age and co-administration of benzodiazepine were independent risk factors for zolpidem-induced delirium. Therefore, a detailed medical history should be taken before prescribing zolpidem to an older person, and zolpidem should be used cautiously, with careful monitoring, in these patients.

키워드

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피인용 문헌

  1. Zolpidem, Is it a Safe Drug for Insomnia Management? vol.84, pp.6, 2013, https://doi.org/10.3904/kjm.2013.84.6.802
  2. 아로마목걸이를 병용한 수면증진 프로그램이 재가 노인여성의 수면, 우울, 불안 및 혈압에 미치는 효과 vol.47, pp.5, 2013, https://doi.org/10.4040/jkan.2017.47.5.651