Zolpidem, also known by its brand name, Ambien, is classified as a non-benzodiazepine sedative-hypnotic. According to the manufacturer, Sanofi-Aventis U.S., it is used for short-term treatment of insomnia. The American Academy of Sleep Medicine defines insomnia as unsatisfactory sleep that negatively impacts daytime functioning. While zolpidem can have benefits, the possibility of adverse reactions exists.
Uses and Administration
Zolpidem is approved for use in the short-term treatment of insomnia characterized by difficulty falling asleep. Zolpidem should only be taken right before going to bed, and only when staying in bed for seven to eight hours is possible. It should not be taken with a meal or directly after one. Zolpidem must never be taken with alcohol. Zolpidem should be prescribed at a reduced dose for the elderly and disabled due to increased sensitivity to this medication. A reduced dose may also be necessary for patients with liver disorders due to decreased ability to clear zolpidem from the system.
Precautions
Zolpidem should not be used with alcohol or other central nervous system depressants such as prescription pain relievers, tranquilizers, and medicines for coughs, colds and allergies. When used alone, with alcohol or with other medication, zolpidem can cause "complex behaviors" while asleep, including driving a car, having sex and preparing food. Patients usually do not remember these potentially dangerous events. The prescribing physician should be made aware of all other medications being taken by the patient. Sanofi-Aventis U.S. advises that insomnia persisting for more than seven to 10 days requires an evaluation for an underlying physical or mental cause.
Common Side Effects
The most common side effects to zolpidem include diarrhea, dizziness and drowsiness, according to Sanofi-Aventis U.S. Other side effects can include headache, feeling "drugged," difficulty keeping balance, unusual dreams, dry mouth, heartburn, stomach pain and burning or tingling in the extremities. A physician should be notified if these side effects are distressing or severe.
Warnings
Sanofi-Aventis U.S. reports cases of rare, life-threatening allergic reactions to zolpidem. Symptoms include difficulty breathing and swelling of the throat. Abnormal thoughts and behaviors, such as aggression, hallucinations, decreased inhibitions and other bizarre behaviors, can occur. In depressed patients using zolpidem, worsening of depression, suicidal thoughts and actions and suicides have been reported. Zolpidem can cause physical dependence resulting in withdrawal symptoms after discontinuing the drug. These symptoms include insomnia, bad mood, diarrhea, trembling, sweating, muscle aches and convulsions. Zolpidem can cause amnesia after the dose is taken, and events that happen before it wears off may not be recalled.
Misconceptions
Too many people disregard important instructions for zolpidem use, according to an article in the March 8, 2006 issue of "The New York Times." Ann Marie Gordon, manager of Washington State's toxicology lab, explained that some people arrested for driving while under the influence of zolpidem took the medication before getting home so that it would be working by the time they got there. When commenting on the prevalence of traffic arrests involving a combination of zolpidem, alcohol or other medicines, Laura J. Liddicoat, a forensic toxicology supervisor, suggests that a stronger warning label is needed.
