镇静催眠药的合理使用与滥用  

Appropriate Use and Abuse of Sedative-Hypnotic Drugs

作　　者：郑俊玮 孟适秋[1] 刘王玥 常祥文 时杰[1,2] ZHENG Jun-wei;MENG Shi-qiu;LIU Wang-yue;CHANG Xiang-wen;SHI Jie(National Institute on Drug Dependence,Peking University,Beijing 100191,China;School of Basic Medical Sciences,Peking University,Beijing 100191,China;Peking University Sixth Hospital,Beijing 100191,China)

机构地区：[1]北京大学中国药物依赖性研究所,北京100191 [2]北京大学基础医学院,北京100191 [3]北京大学第六医院,北京100191

出　　处：《四川大学学报（医学版）》2023年第2期231-239,共9页Journal of Sichuan University(Medical Sciences)

基　　金：国家自然科学基金重点项目(No.82130040);科技部科技创新2030-“脑科学与类脑研究”重大项目(No.2021ZD0202100)资助。

摘　　要：近年来,失眠的发生率日益升高,同时由于疫情的影响,越来越多的人出现了入睡困难、早醒、睡眠时间短等多种失眠问题。长期失眠会严重影响个体的工作和生活,增加罹患躯体以及精神疾病的风险,造成极大的经济和社会负担。镇静催眠药是大多数失眠患者较为常用的治疗手段,主要包括苯二氮?类受体激动剂、褪黑素受体激动剂、促食欲素受体拮抗剂和对睡眠具有调节作用的抗抑郁药等。然而,目前存在镇静催眠药非医疗使用和滥用的现象,主要是苯二氮?类受体激动剂。这种药物滥用会导致精神和躯体依赖、认知障碍、抑郁焦虑、跌倒风险和死亡风险升高等,因此国内外药品监督管理部门相继出台了有关政策以加强监管。本文对镇静催眠药的使用现状和安全性进行了综述,并提出了合理使用的思考,临床上应辩证地看待镇静催眠药的有效性和安全性,在充分、及时地解决患者失眠问题的同时,也客观、科学地评估其潜在滥用问题,以期为临床失眠药物的规范使用提供参考。The incidence of insomnia has been increasing in recent years. In addition, due to the impact of the COVID-19 pandemic, more and more people are experiencing a variety of insomniac problems, including having difficulty in sleep initation, waking up too early, and short sleep duration. Chronic insomnia may seriously affect patients’ life and work, increase their risks of developing physical and mental illnesses, and cause crushing social and economic burdens. Sedative-hypnotics, including benzodiazepine agonists, melatonin receptor agonists, orexin receptor antagonists,and antidepressants with hypnotic effects, are widely used to treat most patients suffering from insomnia. However, there is the phenomenon of the non-medical use and abuse of sedative-hypnotic drugs, especially benzodiazepine receptor agonists. The abuse of sedative-hypnotic drugs may lead to mental and physical dependence, cognitive impairment,depression and anxiety, as well as an increased risks of falls and death. Therefore, drug regulatory authorities in China and other countries have issued relevant policies to reinforce regulation. Herein, we reviewed the prevalent use and safety of sedative-hypnotic drugs and proposed suggestions concerning their appropriate use. Both the efficacy and safety of sedative-hypnotic drugs should be carefully considered so that patients suffering from insomnia receive thorough and prompt treatment and the problem of potential abuse of sedative-hypnotic drugs is assessed in an objective and scientific manner. We also hope to provide references for the standardized clinical use of insomnia drugs.

关 键 词：失眠 镇静催眠药 滥用 成瘾性 安全性 合理使用 

分 类 号：R971.3[医药卫生—药品]