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"Thus, high-dose BZD abuse/dependence involves almost 3–4% of patients taking anxiolytic drugs (Lader, 2011; Petitjean et al., 2007; Ohayon and Lader, 2002). The low toxicity of BZD coupled with a high potential of tolerance can raise doses to an extremely high level of abuse (Lader, 2011; Quaglio et al., 2005 Quaglio et al., , 2012a Faccini et al., 2012). In the past, high dose BZD users (HDUs) were categorised as patients with major psychiatric disorders or drug addiction (O'Brien, 2005 Lequeille et al., 2009; Marini et al., 2013). "
[Show abstract][Hide abstract]ABSTRACT: INTRODUCTION Insomnia is a commonly reported clinical symptom. The annual prevalence of insomnia symptoms has been reported to range from 35–50% of the population, 1 including cases of in-somnia disorders occurring at 10–22%, 2,3 although the exact frequency depends on the diag-nostic criteria applied. The prevalence of insomnia symptoms in Korea was reported to be 17– 23%, 4,5 including Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition diagnosis in 5% of the patients. 4 Insomnia is predictive of psychiatric disorders, including de-pression, anxiety disorders, and alcohol or drug abuse, and is also associated with physical function and quality of life. The prevalence of insomnia is greater in the elderly population. 4,5 Insomnia shows a female predisposition which is consistent and progressive with age, becom-ing more prevalent in the elderly. 6 Additionally, it has been reported that chronic benzodiaze-pine or hypnotic drug users are most often elderly. 7,8 The pharmacokinetics and clearance of hypnotic drugs may be altered in elderly individuals compared to younger individuals. It is well known that benzodiazepine, which has a long half-life, may be associated with an in-creased incidence of adverse events, such as confusion or falling down, among the elderly. 9-11 Several hypnotic drugs have been approved by the Korean Food and Drug Administration (KFDA). Physicians can also prescribe many hypnotic medications for insomnia without KFDA indication, including antipsychotics, benzodiazepine, and sedative antidepressants such as am-itriptyline and trazodone antihistamine. Many people who suffer from sleep problems do not Correspondence Background and ObjectiveaaThis study aimed to characterize patterns of hypnotic drug prescription based on age and gender using data from the Health Insurance Review and Assessment Service-National Patients Sample (HIRA-NPS) of South Korea.