Sleep disturbance in cannabis withdrawal

Q: Which of the following is preferred for disabling sleep disturbances in Cannabis withdrawal? - select one

A) Zolpidem

B) Eszopiclone

C) Trazodone 

D) Doxylamine

E) L-tryptophan

Answer: A

Severe disabling sleep disturbance can occur in cannabis withdrawal, with a domino effect, with potentially fatal consequences.

Only a handful of medications, including zolpidem, dronabinol, and gabapentin, have been studied and shown to benefit.

The most studied and supportive evidence is available for Zolpidem. 

Nitrazepam, being a benzodiazepine, is usually discouraged due to its potential addiction issues. Nitrazepam is not available in the United States. 

#toxicity

#pharmacology

References:

1. Vandrey R, Smith MT, McCann UD, et al. Sleep disturbance and the effects of extended-release zolpidem during cannabis withdrawal. Drug Alcohol Depend 2011; 117:38.

2. Herrmann ES, Cooper ZD, Bedi G, et al. Effects of zolpidem alone and in combination with nabilone on cannabis withdrawal and a laboratory model of relapse in cannabis users. Psychopharmacology (Berl) 2016; 233:2469.