Stilnox prescriptions prove hard to track
from more than one doctor. If that was the case, there would have been no easy way for doctors involved, or the pharmacists who dispensed the medicines, to know about the previous prescribing history.
This week’s statement from the TGA said the agency would meet urgently with the NPS ‘‘ to discuss development of additional educational materials for prescribers, further emphasising the need to only use sleeping medicines where clinically indicated for short periods of time, and to remind them of the risks of inappropriate use of these medicines’’.
Weekes said ‘‘ a lot of people’’ took sleeping pills such as zolpidem for extended periods of time, and the NPS ‘‘ will be making sure that doctors know that there have been concerns around Stilnox, and that they understand those concerns’’.
‘‘ Our message to doctors will be that this is something we are still learning about,’’ Weekes said.
‘‘ They don’t need to take all their patients off Stilnox, but it should be used according to the recommended directions.’’
However, Weekes says many of the concerns apply just as much to other sleeping medications, which include temazepam and diazepam (Valium).
Limitations in existing drug data is such that it’s impossible to tell how many doctors are prescribing zolpidem for prolonged periods of time, beyond the recommended four-week limit.
But Weekes said the NPS might ask doctors to look through their records to see if any patients fell into this category: ‘‘ That’s something we might ask them to do — review their own patient databases to see if there are any patients who have been taking Stilnox for a long time,’’ she said.
If such patients come to light, the usual practice is not to suddenly stop the medication at once. While not addictive, prolonged use of zolpidem can cause tolerance to the drug — which means patients suddenly taken off it can experience a distressing increase in insomnia.
Weekes says the widely publicised cases of patients sleep walking or experiencing other strange behaviours after taking zolpidem has to be interpreted with caution, and it can not be assumed that zolpidem is to blame in each case.
This week the head of the Therapeutic Goods Administration, Rohan Hammett, said reports of bizarre sleep effects had been far more common in Australia than in other countries, in many of which the drug has been available for far longer.
Possible explanations for this could be that there was more awareness of the issue in Australia, or that it was media-related, Hammet told a Senate committee.
Concerned: Lynn Weekes, CEO of the National Prescribing Service, wants doctors to be vigilant