Zolpidem

Zolpidem Hot

 
3.0 (15)
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Average user rating from: 15 user(s)

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  • Efficacy
  • Lack of side effects
Please tell us about your experience with this medicine

Relevant Brand Name and Medical Condition

Brand Name
Ambien
Medical Condition
Insomnia

Additional Information

How long have you taken this medicine for?
More than 2 years
Overall rating 
 
2.7
Overall satisfaction 
 
2.0
Efficacy  
 
1.0
Lack of side effects 
 
5.0
Reviewed by LindaHed July 28, 2017
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LindaHed is a member of the Pharmacy Reviewer forum
Total Posts: 95
Reputation Score: 73
User Title: Senior Member

Zolpidem is not for me.

I hav been prescribed it for long time. Atypical insomnia, PTSD, mixed anxiety depression disorder, no as I type this I already took 20 mg and still barely want to close my eyes. It's not very effective medication and after 2-3 hours I wake up and I am in square 1. I never tried brand it was always generic, maybe brand would work better? I know my insurance is stubborn and will. Or cover medication brand if it's available in generic form. It's so sad I wasn't to sleep!

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Relevant Brand Name and Medical Condition

Brand Name
Generic Ambien
Medical Condition
Insomnia

Additional Information

How long have you taken this medicine for?
0-1 months
Overall rating 
 
0.5
Overall satisfaction 
 
0.5
Efficacy  
 
0.5
Lack of side effects 
 
0.5
Reviewed by jake6198 February 09, 2017

zolpiderm 12.5 er

I have taken the brand Ambien 12.5 for years. It has worked so well for me. January 2017 I found out it is not covered. I had such a bad reaction to Zolpiderm years ago. I was very nervous to take the generic again. I called Sanofi, who manufactures Ambien. They told me to take Zolpiderm manufactured by Winthrop. Walgreens was kind enough to order it for me. I can tell you IT DOES NOT WORK! I dont know what to do. I am fighting with Blue Cross. My doctor is working with me to try to get this drug covered. Does anyone have any suggestions. This Zolpiderm made me feel jittery, and I had horrible dreams when I finally fell asleep. I finally had to take half a xanax. I dont know what to do. Please help!

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Relevant Brand Name and Medical Condition

Brand Name
Generic Ambien
Medical Condition
Insomnia

Additional Information

How long have you taken this medicine for?
More than 2 years
Overall rating 
 
3.7
Overall satisfaction 
 
4.0
Efficacy  
 
4.0
Lack of side effects 
 
3.0
November 06, 2016
Reviewed anonymously by a forum member

Good for sleep


I cut the zolpidem 10 mg into small pieces. With my sleep cycle, I wake up every two hours or so. I'll take a little piece and then-back to sleep. Works well (my version of Ambien CR). I do not take any after 8 hours of sleep. I have no side effects. There is tolerance, when I stop taking the medication, there are several sleepless nights. Sleep is important to restore the body, without it the risk of stroke, heart attack, and metabolic disorder increases dramatically, so it is valuable for sleep and health.

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Additional Information

How long have you taken this medicine for?
6 months - 2 years
Overall rating 
 
3.5
Overall satisfaction 
 
3.5
Efficacy  
 
3.5
Lack of side effects 
 
3.5
Reviewed by cupcake62 October 03, 2015
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cupcake62 is a member of the Pharmacy Reviewer forum
Total Posts: 2
Reputation Score: 4
User Title: Member

Ambien

I have used ambien for years. I think it is the best one for me, but maybe not for others. I wish someone could give me a site or two that is legit so I can purchase more.

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Additional Information

How long have you taken this medicine for?
0-1 months
Overall rating 
 
3.2
Overall satisfaction 
 
2.5
Efficacy  
 
5.0
Lack of side effects 
 
2.0
Reviewed by pennyc July 13, 2014
Last updated: July 15, 2014
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Total Posts: 77
Reputation Score: 65
User Title: Senior Member

Ambien Works TOO Long for Me!

I have struggled with insomnia for most of my adult life. When I tried Ambien, it worked wonders to put me to sleep and keep me asleep, but then 8 hours later, I still slept. It took about 12 hours to feel normal again. Just too long acting for me.

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Relevant Brand Name and Medical Condition

Brand Name
Ambien
Medical Condition
Insomnia

Additional Information

How long have you taken this medicine for?
More than 2 years
Overall rating 
 
4.0
Overall satisfaction 
 
4.5
Efficacy  
 
5.0
Lack of side effects 
 
2.5
Reviewed by Ray March 18, 2014

Zolpidem

I began waking every hour thru the night. Explained this to my doctor & he suggested my taking Zolpidem 10mg. I had heard horror stories about this medicine including horrible dreams, sleepwalking, even driving a car to MacDonalds not realizing she had left the house. My doctor assured me if I took it the way it was written & stayed away from all alcohol, I would be fine. I was. I take 1 tab at 11pm & am asleep by 11:20pm. It has been the same for 21/2 years. I've had insomnia since my teens. I tried drinking to fall asleep, no good. I took halcion which worked for 2 weeks then insomnia came back. I did feel a ill groggy the first two days after beginning this med. but has been great ever since.

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Relevant Brand Name and Medical Condition

Brand Name
Ambien
Medical Condition
Insomnia

Additional Information

How long have you taken this medicine for?
More than 2 years
Overall rating 
 
2.8
Overall satisfaction 
 
3.0
Efficacy  
 
3.5
Lack of side effects 
 
2.0
Reviewed by GoOnAndWalkItOut February 09, 2014
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Total Posts: 103
Reputation Score: 111
User Title: Senior Member

Zolpidem is strange for me...

Most of my experiences with Ambien have pleasant, and they worked as they should have on most of those occasions. I used to read the reports of sleep walking and laugh internally, me believing that it is simply not possible to do. Well, I found out one night. I trashed my bedroom up pretty badly, and when I woke up I was on my hands and knees on the floor of my bedroom! This only happened one time, out of literally hundreds, so it's just an anomaly. However, there is always the issue of taking the meds, and they simply not working for it's intended purpose. It's pretty easy to stay awake on Ambien if you aren't really tired when you took it anyway. Overall, I like Ambien for the simple reason that I've had more positive experiences than negatives...

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Relevant Brand Name and Medical Condition

Brand Name
Generic Ambien
Medical Condition
Insomnia

Additional Information

How long have you taken this medicine for?
More than 2 years
Overall rating 
 
1.3
Overall satisfaction 
 
1.0
Efficacy  
 
2.5
Lack of side effects 
 
0.5
Reviewed by rogue96 February 07, 2014

PLEASE BE AWARE THE WARNINGS ARE REAL, or not a be

I have used ambien (brand & generic) on & off for about ten years. At first I believed it was a miracle drug, it turned out to be a nightmare. My first experiences were perfect. I have suffered from bouts of insomnia for over 20 years. I took 5 milligrams my first time and worked like a charm. And this worked more or less for the next 7 years. At this point I had my 1st horrible side effect. I dont have much or any recollection except some vivid dreams. What was told to me and others was awful. I slept walked into my roommates room, babbled about needing the code, for what who knows. I even yelled at him to stop talking me "I'm sleeping'. My roommates came to the agreement I was on pcp or lsd or just lost my mind. The police and ems were called. I woke up in the hospital. I had been drug tested and came up negative for everything. I explained I took ambien & was told similar events have happened many others. The adverse effects have become more & more common to point that my girlfriend insisted (now I agree ) that I stop. Last summer a similar event happened where I remember taking my nightly dose then waking up in the ER. Again no drugs found in my system. My behavior was so disturbing my roommates asked me to leave. I have no recollection of anything I did but wanted to drive to work, @3am & only in boxers. This drug scares me. I have read many more experiences like mine. I was told by multiple doctors this is safer than Xanax or Klonopins. This Is simply not true. There are warnings that come with or on the script stating It (ambien, brand or not) may cause sleep walking, eating, driving or even having sex w/ no memory. I thought this was a joke. Its not. It is a rare side effect but bad enough I will never take it again.

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Additional Information

How long have you taken this medicine for?
0-1 months
Overall rating 
 
2.3
Overall satisfaction 
 
2.0
Efficacy  
 
4.0
Lack of side effects 
 
1.0
Reviewed by msaok February 06, 2014
Last updated: February 07, 2014
Top 10 Reviewer  -   View all my reviews (14)

Worked but side effects were prohibitive

The rapid and powerful onset of this medicine was impressive.
Therefore, I don't recommend taking it 'til immediately before getting into bed.
Unfortunately, I experienced auditory hallucinations and increased anxiety, so I was unable to take it on a long term basis.
I didn't try the longer acting version, but like most other LA meds, I suspect the punch would be less and the duration longer.

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Relevant Brand Name and Medical Condition

Brand Name
Generic Ambien
Medical Condition
Insomnia

Additional Information

How long have you taken this medicine for?
More than 2 years
Overall rating 
 
4.7
Overall satisfaction 
 
5.0
Efficacy  
 
5.0
Lack of side effects 
 
4.0
Reviewed by DrMongo January 25, 2014
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Total Posts: 83
Reputation Score: 138
User Title: Senior Member

Ambien (better than a Benzo in my opinion for inso

It works and I get a great anxiolytic affect to.

I f I wasn't using this I'd be drinking to get to sleep.

Therefore, it comes on fast and wears off fast. Really helps me because I stress a lot at night.

I prefer it to any benzo, because it wears off so fast.

However, it is addictive, for me not physical (that I can detect) but definitely psychologically.

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Relevant Brand Name and Medical Condition

Brand Name
Ambien
Medical Condition
Insomnia

Additional Information

How long have you taken this medicine for?
More than 2 years
Overall rating 
 
4.5
Overall satisfaction 
 
4.5
Efficacy  
 
4.5
Lack of side effects 
 
4.5
Reviewed by Kimbo January 24, 2014
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Total Posts: 407
Reputation Score: 666
User Title: Honorable Member

Zolpimist

I have used Ambien since it first hit the market. Dr presribed Zolpimist (the spray) form of Zolpidem/Ambien because of it's rapid action onset and it can be taken shortly after a meal. Pill form Zolpidem requires you need to wait 2 hours at least after lady meal.
Also ideal for sleeping during flights to assist with jet lag, as you can control dosage to 5 mg by reducing spray pumps.

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Additional Information

How long have you taken this medicine for?
More than 2 years
Overall rating 
 
3.5
Overall satisfaction 
 
3.5
Efficacy  
 
3.0
Lack of side effects 
 
4.0
Reviewed by COSGringo January 24, 2014
Last updated: January 24, 2014
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Total Posts: 5813
Reputation Score: 3732
User Title: Banned

Hit or miss; stick to the extended release

I've used Ambien for many years off and on somewhat successfully. I think one key thing is I rarely take it more than once per week. I prefer the CR as it helps me stay asleep better.

I won't say that it works every time I've used it but probably over 60-70%. Since it's covered on my plan it's a no brainer. If you are used to using benzos I suspect this will be a fail for you.

I've left those out of my life for the most part now and I think they are best for only occasional use as a sleep aid.

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Relevant Brand Name and Medical Condition

Brand Name
Generic Ambien
Medical Condition
Insomnia

Additional Information

How long have you taken this medicine for?
6 months - 2 years
Overall rating 
 
3.5
Overall satisfaction 
 
4.0
Efficacy  
 
4.0
Lack of side effects 
 
2.5
Reviewed by Alicenwonderland January 23, 2014
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Total Posts: 1041
Reputation Score: 1799
User Title: Eminent Member

ambien helps me sleep like a baby

I've taken this off and on for a couple years. I was prescribed it by an internist who diagnosed me with fibromyalgia and insomnia (the two usually go hand in hand). I get the 10mg because for me I needed more than the 6.5. I fall asleep right away and can continue sleeping until the morning. The problem I alwAys had was staying asleep not just falling asleep. I feel I bit groggy when i first wake up but after 20min I'm ok to go on with my day

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Relevant Brand Name and Medical Condition

Brand Name
Ambien
Medical Condition
Insomnia

Additional Information

How long have you taken this medicine for?
More than 2 years
Overall rating 
 
4.2
Overall satisfaction 
 
5.0
Efficacy  
 
3.5
Lack of side effects 
 
4.0
Reviewed by 2005cbr January 23, 2014
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Total Posts: 1265
Reputation Score: 1076
User Title: Eminent Member

Works great for me.

This is about the only medication that will consistently put me to sleep. I've tried other prescriptions and over the counter meds without much luck.
Tolerance builds pretty quickly. Not something you want to use daily.
I don't personally have any hang over effect but I know some people do.

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Relevant Brand Name and Medical Condition

Brand Name
Generic Ambien
Medical Condition
Insomnia

Additional Information

How long have you taken this medicine for?
0-1 months
Overall rating 
 
0.5
Overall satisfaction 
 
0.5
Efficacy  
 
0.5
Lack of side effects 
 
0.5
Reviewed by edyth January 22, 2014
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Zolpidem--No Good for Me

It did not help w/ my insomnia, and gave me a horrible headache to boot. I went back to using inexpensive clonazepam (.25 mg does it usually) or Benadryl.

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More about Zolpidem

What is/are Zolpidem?

Zolpidem (brand names Ambien, Ambien CR, Intermezzo, Stilnox, and Sublinox) is a prescription medication used for the treatment of insomnia and some brain disorders. It is a short-acting nonbenzodiazepine hypnotic of the imidazopyridine class  that potentiates GABA, an inhibitory neurotransmitter, by binding to GABAA receptors at the same location as benzodiazepines. It works quickly, usually within 15 minutes, and has a short half-life of two to three hours.

Zolpidem has not adequately demonstrated effectiveness in maintaining sleep, unless delivered in a controlled-release (CR) form. However, it is effective in initiating sleep. Its hypnotic effects are similar to those of the benzodiazepine class of drugs, but it is molecularly distinct from the classical benzodiazepine molecule and is classified as an imidazopyridine. Flumazenil, a benzodiazepine receptor antagonist, which is used for benzodiazepine overdose, can also reverse zolpidem's sedative/hypnotic and memory-impairing effects.

As a muscle relaxant and anticonvulsant, the drug's effects are not evident until dosages 10 and 20 times those required for sedation, respectively, are reached. For that reason, zolpidem has never been approved for either muscle relaxation or seizure prevention. Such drastically increased doses are also more inclined to induce one or more of the drug's adverse side effects, including hallucinations and amnesia.

The United States patent for zolpidem was held by the French pharmaceutical corporation Sanofi-Aventis. On April 23, 2007, the U.S. Food and Drug Administration (FDA) approved 13 generic versions of zolpidem tartrate. Zolpidem is available from several generic manufacturers in the UK, as a generic from Sandoz in South Africa and TEVA in Israel, as well as from other manufacturers such as Ratiopharm (Germany).

On 2012, a study published in the BMJ Open journal revealed that sleeping pills, including zolpidem, are associated with a higher risk of death and cancer diagnosis. Nevertheless, the study only showed a link, and did not prove the deaths were caused by the pills or by other symptoms related to insomnia.

On January 10, 2013, the Food and Drug Administration announced it is requiring the manufacturer of Ambien and Zolpimist to cut the recommended dosage for women in half, after laboratory studies showed that the medicines can leave patients drowsy in the morning and at risk for car accidents.The FDA recommended that manufacturers extend the new dosage cuts to men as well, who process the drug at a faster rate. However, the reasons why men and women catabolize the drugs at different rates is still unknown.  In May 2013, the FDA approved label changes specifying new dosage recommendations for Zolpidem products because of concerns regarding next-morning impairment.

Medical uses

Clinicians prescribe zolpidem for short-term (usually about two to six weeks) treatment of insomnia. Zolpidem has not proven effective in maintaining sleep, but addresses sleep-initiation problems. The effect over placebo is of marginal clinical benefit.

Adverse effects

Side effects may include:
  •     Headaches
  •     Nausea
  •     Vomiting
  •     Dizziness
  •     Anterograde amnesia
  •     Hallucinations, through all physical senses, of varying intensity
  •     Delusions
  •     Altered thought patterns
  •     Ataxia or poor motor coordination, difficulty maintaining balance
  •     Euphoria and/or dysphoria
  •     Increased appetite
  •     Increased or decreased libido
  •     Impaired judgment and reasoning
  •     Uninhibited extroversion in social or interpersonal settings
  •     Increased impulsivity
  •     When stopped, rebound insomnia may occur
Some users have reported unexplained sleepwalking while using zolpidem, as well as sleep driving, binge eating while asleep, and performing other daily tasks while sleeping. Research by Australia's National Prescribing Service found these events occur mostly after the first dose taken, or within a few days of starting therapy. Rare reports of sexual parasomnia episodes related to zolpidem intake have also been reported. Sleepwalkers can sometimes perform these tasks as normally as they might if they were awake. They can sometimes carry on complex conversations and respond appropriately to questions or statements, so much so that observers may believe them to be awake. This is in contrast to "typical" sleep talking, which can usually be identified easily and is characterised by incoherent speech that often has no relevance to the situation or that is so disorganised as to be completely unintelligible.

Those under the influence of this medication may seem fully aware of their environments, though they are still asleep. This can bring about concerns for the safety of the sleepwalkers and others. These side effects may be related to the mechanism that also causes zolpidem to produce its hypnotic properties. It is unclear whether the drug is responsible for the behavior, but a class-action lawsuit was filed against Sanofi-Aventis in March 2006 on behalf of those who reported symptoms. Conversely, it is possible some users believed they were asleep during these events because they do not remember the events, due to the short-term memory loss and anterograde amnesia side effects.

Residual 'hangover' effects, such as sleepiness and impaired psychomotor and cognitive function, may persist into the day following nighttime administration. Such effects may impair the ability of users to drive safely and increase risks of falls and hip fractures.

The Sydney Morning Herald in Australia in 2007 reported a man who fell 30 meters to his death from a high-rise unit balcony may have been sleepwalking under the influence of Stilnox. The coverage prompted over 40 readers to contact the newspaper with their own accounts of Stilnox-related automatism, and as of March 2007, the drug was under review by the Adverse Drug Reactions Advisory Committee.

In February 2008, the Australian Therapeutic Goods Administration attached a Black Box Warning to zolpidem, stating, that "Zolpidem may be associated with potentially dangerous complex sleep-related behaviours that may include sleep walking, sleep driving, and other bizarre behaviours. Zolpidem is not to be taken with alcohol. Caution is needed with other CNS depressant drugs. Limit use to four weeks maximum under close medical supervision." This report received widespread media coverage after the death of Australian student Mairead Costigan, who fell 20 m from the Sydney Harbour Bridge while under the influence of Stilnox.

Tolerance, dependence, and withdrawal

A review medical publication found long-term use of zolpidem is associated with drug tolerance, drug dependence, rebound insomnia and CNS-related adverse effects. It was recommended that zolpidem be used for short periods of time using the lowest effective dose. Zolpidem 10 mg is effective in treating insomnia when used intermittently no fewer than three and no more than five pills per week for a period of 12 weeks. The 15-mg zolpidem dosage provided no clinical advantage over the 10-mg zolpidem dosage.

Nonpharmacological treatment options (e.g. cognitive behavioral therapy for insomnia), however, were found to have sustained improvements in sleep quality. Animal studies of the tolerance-inducing properties have shown that in rodents, zolpidem has less tolerance-producing potential than benzodiazepines, but in primates the tolerance-producing potential of zolpidem was the same as that of benzodiazepines. Tolerance to the effects of zolpidem can develop in some people in just a few weeks. Abrupt withdrawal may cause delirium, seizures, or other severe effects, especially if used for prolonged periods and at high dosages.

When drug tolerance and physical dependence to zolpidem has developed, treatment usually entails a gradual dose reduction over a period of months to minimise withdrawal symptoms, which can resemble those seen during benzodiazepine withdrawal. Failing that, an alternative method may be necessary for some patients, such as a switch to a benzodiazepine equivalent dose of a longer-acting benzodiazepine drug, such as diazepam or chlordiazepoxide, followed by a gradual reduction in dosage of the long-acting benzodiazepine. Sometimes for difficult-to-treat patients, an inpatient flumazenil rapid detoxification program can be used to detoxify from a zolpidem drug dependence or addiction.

Alcohol has cross tolerance with GABAA receptor positive modulators such as the benzodiazepines and the nonbenzodiazepine drugs. For this reason, alcoholics or recovering alcoholics may be at increased risk of physical dependency on zolpidem. Also, alcoholics and drug abusers may be at increased risk of abusing and or becoming psychologically dependent on zolpidem. It should be avoided in those with a history of alcoholism, drug misuse, physical dependency, or psychological dependency on sedative-hypnotic drugs. Zolpidem has rarely been associated with drug-seeking behavior, the risk of which is amplified in patients with a history of drug or alcohol abuse.

Overdose

An overdose of zolpidem may cause excessive sedation, pin-point pupils, or depressed respiratory function, which may progress to coma, and possibly death. Combined with alcohol, opiates, or other CNS depressants, it may be even more likely to lead to fatal overdoses. Zolpidem overdosage can be treated with the benzodiazepine receptor antagonist flumazenil, which displaces zolpidem from its binding site on the benzodiazepine receptor to rapidly reverse the effects of the zolpidem.

Detection in body fluids

Zolpidem may be quantitated in blood or plasma to confirm a diagnosis of poisoning in hospitalized patients, provide evidence in an impaired driving arrest, or to assist in a medicolegal death investigation. Blood or plasma zolpidem concentrations are usually in a range of 30–300 μg/l in persons receiving the drug therapeutically, 100–700 μg/l in those arrested for impaired driving, and 1000–7000 μg/l in victims of acute overdosage. Analytical techniques, in general, involve gas or liquid chromatography. 

Mechanism of action

Zaleplon and Zolpidem both are agonists at the GABA A ɣ 1 subunit. Due to its selective binding, Zolpidem has very weak anxiolytic, myorelaxant, and anticonvulsant properties but very strong hypnotic properties. Zolpidem binds with high affinity and acts as a full agonist at the α1-containing GABAA receptors, about 10-fold lower affinity for those containing the α2- and α3- GABAA receptor subunits, and with no appreciable affinity for α5 subunit-containing receptors. ω1 type GABAA receptors are the α1-containing GABAA receptors and ω2 GABAA receptors are the α2-, α3-, α4-, α5-, and α6-containing GABAA receptors. ω1 GABAA receptors are found primarily in the brain, whereas ω2 receptors are found primarily in the spine. Thus, zolpidem has a preferential binding for the GABAA-benzodiazepine receptor complex in the brain but a low affinity for the GABAA-benzodiazepine receptor complex in the spine.

Like the vast majority of benzodiazepine-like molecules, zolpidem has no affinity for α4 and α6 subunit-containing receptors. Zolpidem positively modulates GABAA receptors, it is presumed by increasing the GABAA receptor complex's apparent affinity for GABA without affecting desensitization or peak current. Like zaleplon (Sonata), zolpidem may increase slow wave sleep but cause no effect on stage 2 sleep.

A meta-analysis of the randomised, controlled, clinical trials that compared benzodiazepines against Z-drugs such as zolpidem has shown few consistent differences between zolpidem and benzodiazepines in terms of sleep onset latency, total sleep duration, number of awakenings, quality of sleep, adverse events, tolerance, rebound insomnia, and daytime alertness.

Drug-drug interactions

Notable drug-drug interactions with the pharmacokinetics of zolpidem include chlorpromazine, fluconazole, imipramine, itraconazole, ketoconazole, rifampicin, and ritonavir. Interactions with carbamazepine and phenytoin can be expected based on their metabolic pathways, but have not yet been studied. There does not appear to be any interaction between zolpidem and cimetidine or ranitidine.

This article uses material from the Wikipedia article Zolpidem, which is released under the Creative Commons Attribution-Share-Alike License 3.0.

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