Which medication is associated with potential dependence and is discouraged for pediatric sleep problems?

Which medication is associated with potential dependence and is discouraged for pediatric sleep problems?

• A. Diphenhydramine
• B. Melatonin
• C. Zolpidem
• D. Lorazepam

Answer: (D)

Dependence risk is a key consideration when treating sleep problems in children. Lorazepam is a benzodiazepine that promotes sleep by enhancing GABA activity, but this class has a well-established potential for physical dependence and withdrawal with regular or long-term use. In pediatric patients, dependence can develop relatively quickly, and stopping the medication can trigger withdrawal, along with daytime sedation, cognitive and mood changes, and, in some cases, respiratory depression. For these safety reasons, benzodiazepines are generally discouraged for pediatric sleep problems and are not used as routine treatment. Other options tend to have more favorable safety profiles for short-term use or lack strong evidence of dependence in children. Diphenhydramine can sedate but carries anticholinergic risks; melatonin is used as a supplement in some cases with limited data on long-term safety but is not typically associated with classic dependence; zolpidem is a non-benzodiazepine hypnotic with some dependence potential but has limited pediatric data and is not routinely recommended for children.

Dependence risk is a key consideration when treating sleep problems in children. Lorazepam is a benzodiazepine that promotes sleep by enhancing GABA activity, but this class has a well-established potential for physical dependence and withdrawal with regular or long-term use. In pediatric patients, dependence can develop relatively quickly, and stopping the medication can trigger withdrawal, along with daytime sedation, cognitive and mood changes, and, in some cases, respiratory depression. For these safety reasons, benzodiazepines are generally discouraged for pediatric sleep problems and are not used as routine treatment.

Other options tend to have more favorable safety profiles for short-term use or lack strong evidence of dependence in children. Diphenhydramine can sedate but carries anticholinergic risks; melatonin is used as a supplement in some cases with limited data on long-term safety but is not typically associated with classic dependence; zolpidem is a non-benzodiazepine hypnotic with some dependence potential but has limited pediatric data and is not routinely recommended for children.