Such effects may impair the ability of users to drive safely and increase risks of falls and hip fractures. ![]() Residual 'hangover' effects, such as sleepiness and impaired psychomotor and cognitive function, may persist into the day following nighttime administration. Upper and lower respiratory infections are also common (experienced by 1–10% of people). Zolpidem increases risk of depression, falls and bone fracture, poor driving, suppressed respiration, and has been associated with an increased risk of death. The most common adverse effects of short-term use include headache (reported by 7% of people in clinical trials), drowsiness (2%), dizziness (1%), and diarrhea (1%) the most common side effects of long-term use included Zolpidem is recommended for use during pregnancy only when benefits outweigh risks. In one case report, zolpidem was found in cord blood at delivery. There are no controlled data in human pregnancy. Animal studies have revealed evidence of incomplete ossification and increased intrauterine fetal death at doses greater than seven times the maximum recommended human dose or higher however, teratogenicity was not observed at any dose level. Zolpidem has not been assigned to a pregnancy category by the FDA. Zolpidem should not be prescribed to older people, who are more sensitive to the effects of hypnotics including zolpidem and are at an increased risk of falls and adverse cognitive effects, such as delirium and neurocognitive disorder. ![]() In 2013, the FDA recommended the dose for women be reduced and that prescribers should consider lower doses for men due to impaired function the day after taking the drug. Caution should be exercised by motor vehicle drivers. This adverse effect is not unique to zolpidem, but also occurs with other hypnotic drugs. Use of zolpidem may impair driving skills with a resultant increased risk of road traffic accidents. It should not be taken by people who are or have been addicted to other substances. Zolpidem should not be taken by people with obstructive sleep apnea, myasthenia gravis, severe liver disease, respiratory depression or by children, or people with psychotic illnesses. This is based in part on a 2012 review which found that zolpidem's effectiveness is nearly as much due to psychological effects as to the medication itself. cognitive behavioral therapy for insomnia). Guidelines from NICE, the European Sleep Research Society, and the American College of Physicians recommend medication for insomnia (including possibly zolpidem) only as a second line treatment after non-pharmacological treatment options have been tried (e.g. It may be used for both improving sleep onset, sleep onset latency, and staying asleep. Zolpidem is labeled for short-term (usually about two to six weeks) treatment of insomnia at the lowest possible dose. In 2020, it was the 47th most commonly prescribed medication in the United States, with more than 14 million prescriptions. More than ten million prescriptions are filled each year in the United States, making it one of the most commonly used treatments for sleeping problems. ![]() Zolpidem is a Schedule IV controlled substance under the Controlled Substances Act of 1970 (CSA). It became available as a generic medication in 2007. Zolpidem was approved for medical use in the United States in 1992. This, however, is increased in those with liver problems. It generally has a half-life of two to three hours. It works by increasing GABA effects in the central nervous system by binding to GABA A receptors at the same location as benzodiazepines. Zolpidem is a GABA A receptor agonist of the imidazopyridine class. Zolpidem is a nonbenzodiazepine or Z-drug which acts as a sedative and hypnotic. While flumazenil, a GABA A–receptor antagonist, can reverse zolpidem's effects, usually supportive care is all that is recommended in overdose. More severe side effects include memory problems and hallucinations. Ĭommon side effects include daytime sleepiness, headache, nausea, and diarrhea. It is taken by mouth and is available in conventional tablets, sublingual tablets, or oral spray. It decreases the time to sleep onset by about fifteen minutes and at larger doses helps people stay asleep longer. Guidelines recommend that it be used only after cognitive behavioral therapy for insomnia and behavioral changes, such as sleep hygiene, have been tried. ![]() Zolpidem, sold under the brand name Ambien among others, is a medication primarily used for the short-term treatment of sleeping problems.
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