Abuse Potential Differs Between Hypnotic Classes: Real-World Data

Moline ML, Cheng JY, Durgin C, Pype S, Buchhalter A, Henningfield J

The two major hypnotic classes with distinct mechanisms of action, GABAergic drugs (benzodiazepines [BZs] and nonbenzodiazepines [i.e. zolpidem]) and dual orexin receptor antagonists (DORAs), are Schedule IV (CIV) drugs, but have notable differences in human abuse profiles. BZs are associated with drug tolerance/dependence, rebound insomnia, and abuse-related side effects (ie, euphoria). DORAs were placed in CIV largely on the basis of required human abuse potential (HAP) studies, in which recreational sedative abusers could identify and like zolpidem. Nonclinical abuse studies were uniformly negative for the DORAs. In HAP studies, there was no important differences between zolpidem and DORA conditions on drug-liking. However, the FDA has noted that CIV does not appear to match real-world abuse.

To be presented at the 2023 International College of Neuropsychopharmacology (CINP 2023), May 8, 2023 at 12:15 – 13:15 in Montreal, Canada.