@article{ref1,
title="Zolpidem use and risk of suicide: a systemic review and meta-analysis",
journal="Psychiatry research",
year="2022",
author="Khan, Hiba and Garg, Aakriti and Yasmeen,  and Agarwal, Nidhi B. and Yadav, Deepak Kumar and Khan, Mohd. Ashif and Hussain, Salman",
volume="",
number="",
pages="e114777-e114777",
abstract="Introduction : Zolpidem is one of the most commonly prescribed nonbenzodiazepine hypnotic drugs for insomnia. Published epidemiological studies linked zolpidem with the risk of suicide. However, to date, no meta-analysis investigated this association. Hence, we systematically reviewed and meta-analysed the current evidence from real-world studies reporting the risk of suicide with the use of zolpidem.   Methods : Medline (Ovid), Embase (Ovid), and PsycINFO databases were searched from inception till June 2021 for real-world evidence studies reporting the risk of suicide with the use of zolpidem. The quality assessment of included studies was assessed using the New-Castle Ottawa Scale (NOS). Random-effect meta-analysis was performed using a generic inverse variance method.   Results : This meta-analysis was based on four studies with 344,753 participants, of which 42,279 were zolpidem users. The methodological quality of all the included studies was of high quality. A significantly increased risk of suicide or suicide attempt was found in zolpidem users compared to non-users, with a pooled relative risk of 1.88 (95% CI: 1.54 - 2.30). Furthermore, an increased risk of suicidal death was observed in zolpidem users compared to non-users, with a pooled relative risk of 1.82 (95% CI: 1.43 - 2.30). Dose-response analysis also revealed a significantly increased risk of suicide in patients receiving ≥ 180cDDD (cumulative defined daily doses) of zolpidem (124 times), followed by 90-179cDDD (113 times) and <90cDDD (93 times) of zolpidem compared to non-users.   Conclusion : In conclusion, zolpidem use was associated with an increased risk of suicide or suicide attempt and suicidal death. Therefore, careful prescribing practices must be followed by computing the risk-benefit profile.<p /> <p>Language: en</p>",
language="en",
issn="0165-1781",
doi="10.1016/j.psychres.2022.114777",
url="http://dx.doi.org/10.1016/j.psychres.2022.114777"
}