Citation

Terao T. PCN Rep. 2024; 3(1): e168.

Copyright

(Copyright © 2024, John Wiley and Sons)

DOI

10.1002/pcn5.168

PMID

38868473

PMCID

PMC11114368

Abstract

BACKGROUND: Benzodiazepines, such as flunitrazepam, may be at risk of disinhibition, leading to aggressiveness, impulsivity, self-harm, and possibly suicide attempts, whereas ramelteon may be far from disinhibition. CASE PRESENTATION: In a 43-year-old female with primary insomnia, flunitrazepam alone did not induce any type of disinhibition, but the addition of ramelteon to flunitrazepam brought about disinhibition, leading to aggressiveness and finally to her suicide attempt. Her disinhibition rapidly subsided as soon as ramelteon alone was discontinued.

CONCLUSION: These findings suggest that a suicide attempt may occur during ramelteon and flunitrazepam combination in a susceptible patient.

Language: en

Keywords

suicide attempt; flunitrazepam; primary insomnia; ramelteon