Sleeping Pill Safety Test

Reporter: David Richardson

Two million of us will be at the doctor's this year, to complain about not being able to get to sleep. Chronic insomnia is now recognised as a silent epidemic. It costs half a billion dollars per year in medical bills, 10 times the amount of lost productivity in the workplace. That's why so many are turning to sleeping pills, something we now know is dangerous - even fatal. But there's a test that may save you.

For 65 years, Martin Feenstra was in total control, until the night he popped two sleeping pills, woke up and killed himself. The tall, non-drinking father and grandfather had been having trouble sleeping. For three months, he was taking sleeping tablets and according to daughter Wendy, his behaviour just changed. "He was always in an agitated state, he would shake when he had a glass of water," Wendy said. "That was never him - he couldn't focus on conversation, we'd be in one conversation and he'd be thinking of something else."

It was not the father Wendy had grown up with, not the man she knew, and she blames his sleeping pills for the shocking changes: Stilnox. "I'm 100 per cent convinced that it was medically induced," Wendy said. "I'm 100 per cent convinced he took his life not knowingly, because he was on this medication." Martin woke after taking Stilnox, locked up his small house, jumped in his car and drove the hour to scenic Fitzroy Falls, one of his favourite places. He then climbed and fence and jumped.

Myrie Richardson spent years as a paramedic. She knew the dangers of drug abuse, but for chronic insomnia she needed chemical help: Stilnox. "The times that I tried to kill myself, I had a major reaction to some event, took a few too many tablets, probably with alcohol, and tried to kill myself 11 times," Myrie said Her extreme and bizarre reactions to the sleeping drug forced her doctor to take drastic measures."My doctor wrote on my file in big red texta across the front, NO STILNOX," Myrie said.

She was moved onto Immovane, a drug nicknamed "Stilnox lite", but she still had problems. It reacted with her anti-depressants. "I woke up in the middle of the night with my head in the fridge, eating my dog's chicken," Myrie said. Forensic psychiatirst Dr Yolande Lucire has seen the horrible effects of some sleeping tablets reacting with other medications.

Even antacids combined with sleeping pills can cause bizarre side effects. But she's not anti-pills. "Pills are useful, medication is useful - it's helpful," Dr Lucire said. "It's just that doctors don't understand that the metabolism of these drugs in each individual person is different." "We now know why some people can't metablolise certtain drugs at all and why they become crazy after one or two tablets."

It seems there is a perfectly simple genetic explanation why some people react to sleeping tablets, yet others don't. It is called cytochrome 2D6 and people need it to take any form of medicine or drug. A about one-in-10 people don't have it, which means an instant bad reaction. "Why don't we DNA test people before administering these drugs?" Dr Lucire said. "Well, the technology is available. It costs $190 to do three cytochromes and US$600 to do the whole lot. It would save millions."

"And save lives, and it would explain why some people have killed themselves and others while on these drugs. Why some people react badly, and it would teach doctors something about drug reactions and interractions." The DNA test is simple: a mouth swab collecting saliva is all that's needed, not a blood test. A three-cytochrome test can be performed in Australia and the results can be made available in 2-3 days. The full DNA work-up can also be done in Australia for about $1200, or in Seattle in the US.

The test will point out potential allergies to sleeping pills taken by many Australians. There are 2.8 million prescriptions written for Temazepam each year, making it the biggest selling sleeping tablet in Australia. Another 2.1 million scripts were for Diazepam and 1.4 million for Serapax, while Zolpidem - or Stilnox, as it's sold here - was prescribed to 770,000 Australians. All the drugs can have side effects, though some are only minor.

Judith Mackson is from the National Prescribing Service, which provides advice to consumers and doctors on Australia's medicines. "The most important thing about sleeping tablets is that they don't continue to work for inducing sleep," Judith said. "They're intended for short term use only." There have been hundreds of cases of strange behaviour like this reported to the Therapeutic Goods Administration, which licenses drugs in this country.

A warning has now been put on boxes of Stilnox, but many believe that is still not enough. "How many lives are they going to lose before they say 'we're not just going to put an extra warning on the box, we need to get rid of this stuff'?" Wendy asked."It's not saving anyone's life, it's not antibiotics or penicillin, or something like that, it is just a sleeping pill."

Further details

Information and fact sheets from the National Prescribing Service:
Patient Materials: Benzos PEM
NPS Fact Sheet: Zolpidem

Adverse Medicine Events Line, for reporting a reaction to a medicine: 1300 134 237
The hours of operation are 9am to 5pm (EST). NOTE: this number is not for use in emergencies â?? if people are in trouble, they should call 000. People usually call the Adverse Medicine Events Line after an event, to let them know.

Medicines Line, for information about medicines in general: 1300 888 763
The hours of operation are 9am to 5pm (EST).