Zolpidem

Zolpidem is a non-benzodiazepine sedative-hypnotic. It is used in the short-term treatment of insomnia, specifically in patients who have trouble falling asleep or maintaining sleep.

Common Brand Names: Ambien, Ambien CR, Edluar, Intermezzo, Stilnox, Zolpimist

In the United States, zolpidem is a Schedule IV drug. This means that while it has accepted medical use, it also poses as risk for abuse and limited physical or psychological dependence.

Zolpidem is a GABA-A agonist, which increases the effects of GABA (a neurotransmitter) by binding to GABA-A receptors in the central nervous system (CNS). This action is what produces the drug’s depressant effects. Incidentally, zolpidem binds with the same GABA A receptors that bind with benzodiazepines like alprazolam and diazepam—both of which are also Schedule IV drugs.

What Is the Medical Use of Zolpidem?

Zolpidem is used to treat insomnia, helping patients stay asleep or else improve sleep onset and sleep onset latency. It is often prescribed only for a short period, usually only up to a maximum of 35 days.

Note that in 2013, the Food and Drug Administration required the manufacturers of various brands of zolpidem to lower the recommended dosage: 5 mg for immediate-release products and 6.25 mg for extended-release products. This is to lower the risk of next-morning impairment of mental alertness.

Those who have the following conditions are also advised against taking zolpidem:

• Liver or kidney problems
• Myasthenia gravis, a neuromuscular disorder that causes muscle weakness
• Breathing problems
• Sleep apnea
• Mental health issues

Zolpidem is also not recommended for women who are pregnant, already pregnant, or breastfeeding. If you meet any of these criteria, ask your doctor if you can be prescribed alternative medications.

How Is Zolpidem Abused?

There have been cases where patients self-medicate and take higher doses of zolpidem in order to take advantage of its sedative and hypnotic effects or to counteract the effects of other drugs.

Do note that as a non-benzodiazepine sleep aid, zolpidem has a lower risk of dependence. However, it is still prone to misuse.

Drugs That Interact With Zolpidem

There are various drugs and substances that interact with zolpidem, producing varying degrees of adverse effects. For example, using alcohol with zolpidem can worsen a patient’s psychomotor impairment.

Other notable zolpidem drug interactions include the following:

• CNS depressants: Taking zolpidem with other CNS depressants can enhance zolpidem’s own depressant effects.
• Chlorpromazine: It has been observed that using chlorpromazine with zolpidem results in impaired alertness and psychomotor performance.
• Imipramine: Taking imipramine with zolpidem has been found to decrease a person’s alertness.
• Ketoconazole: Ketoconazole can increase the effects of zolpidem.
• Rifampin: Rifampin can decrease the effects of zolpidem.

Zolpidem Side Effects

After taking zolpidem, it is possible to experience the following side effects:

• Drowsiness
• Tiredness
• Headache
• Dizziness or lightheadedness
• Getting a “drugged feeling”
• Unsteady walking and difficulty keeping balance
• Nausea
• Constipation
• Diarrhea
• Feeling bloated or gassy
• Heartburn
• Pain or tenderness in the stomach
• Uncontrollable shaking of a body part
• Pain, burning, numbness, or tingling sensation in the hands, arms, feet, or legs
• Unusual dreams
• Redness, burning, or tingling of the tongue (when sublingual tablets ae taken)
• Dryness of the mouth or throat
• Ringing in the ears
• Pain or itching in the ears
• Eye redness
• Muscle aches or cramps
• Joint, back, or neck pain

Some people may also experience or develop the following reactions that may be indicative of a serious adverse event:

• Rashes or hives
• Itching
• Swelling of the eyes, face, lips, tongue, or throat
• Difficulty breathing or swallowing
• Hoarseness of the voice or feeling as if the throat is closing up
• Shortness of breath
• Yellow eyes or skin
• Light-colored stools
• Pounding heartbeat
• Chest pain
• Blurred vision

If you or a loved one is taking zolpidem and experiences these adverse reactions, get in touch with your doctor immediately to receive appropriate medical care.

Long-Term Effects of Zolpidem

Some of the more serious long-term effects of zolpidem include:

• Menstrual disorders
• Glaucoma
• Hypotension or hypertension
• Weight loss
• Anorexia
• Hemorrhoids
• Gastroenteritis
• Anemia
• Gout
• Abnormal liver function
• Urinary tract infection
• Renal failure

Symptoms of Zolpidem Overdose

Zolpidem overdose cause the following symptoms:

• Drowsiness
• Light coma (loss of consciousness for a period of time)
• Slowed breathing or heartbeat
• Cardiorespiratory collapse

In rare occasions, patients may also experience seizures.

To treat symptoms of zolpidem overdose, doctors sometimes use the drug flumazenil. However, flumazenil may contribute to neurological symptoms like convulsions.

Signs of Zolpidem Addiction

According to the Diagnostic and Statistical Manual of Mental Disorders – 5th Edition, there are 11 criteria for substance use disorders. These criteria may be applicable to those who have been abusing zolpidem and have developed a sedative-, hypnotic-, or anxiolytic- (SHA) use disorder:

• Taking higher doses of zolpidem or for longer than intended
• Wanting yet failing to stop or reduce the use of zolpidem
• Spending a lot of time acquiring, using, or recovering from use of zolpidem
• Feeling cravings or urges to use zolpidem
• Inability to manage commitments or obligations due to zolpidem use
• Continuing to use zolpidem even when it causes interpersonal or relationship problems
• Missing important social, occupational, or recreational activities because of zolpidem use
• Repeated use of zolpidem even when it endangers you or others
• Continuing to use the zolpidem even when it causes or worsens physical and psychological problems
• Tolerance, which is described by the need for higher and higher doses of zolpidem in order to achieve the desired effects
• Experiencing withdrawal symptoms after suddenly stopping the usage of zolpidem

Signs of Zolpidem Withdrawal

Some of the most common signs of zolpidem withdrawal are the following:

• Headaches
• Muscle pain
• Anxiety and tension
• Restlessness
• Confusion
• Irritability

Meanwhile, severe withdrawal symptoms can include:

• Derealization
• Depersonalization
• Hyperacusis, which is a loudness perception disorder where the patient may experience oversensitivity to a range of sounds
• Hypersensitivity to light
• Hypersensitivity to physical contact
• Hallucinations
• Epileptic seizures
• Numbness and tingling of the extremities

Do note that it’s possible to develop a dependence on zolpidem even if the risk is low and even if you’re using it as prescribed. However, dependence and addiction are two different conditions. You can become dependent on zolpidem if your body has become used to the substance, which means you are likely to experience withdrawal symptoms if you suddenly stop using the drug. Addiction on the other hand, is a pathological, repeating pattern of drug use despite the negative consequences.

If you suspect that you or your loved one has become dependent on zolpidem, it’s best to approach medical professionals for help. This way, you can be eased out of using the drug without developing dangerous withdrawal symptoms.

Zolpidem Detoxification

Undergoing a zolpidem detoxification program is the best and safest way to deal with withdrawal symptoms. A detox program aims to accomplish two goals: to remove the presence of the drug in your system, in this case zolpidem, and to manage any symptoms of withdrawal.

The following can be expected in zolpidem detox:

• You will be put on a customized tapering schedule to lower the dose of zolpidem you receive daily.
• You may be given a regimen of symptomatic medications and nutritional supplements to restore your health and help your body recover.
• Constant monitoring and supervision by medical professionals so that you can feel safe and comfortable throughout the process, thus increasing the program’s chances of success.

Rehabilitation and Treatment for Zolpidem Addiction

It’s not easy to overcome zolpidem addiction alone. In fact, any professional rehabilitation or treatment program will be more effective if you have the support of friends and loved ones. If you or someone you know wants to beat addiction from drugs like zolpidem, inpatient or outpatient treatment options are available.

• Outpatient zolpidem addiction treatment: For mild cases of addiction, with fewer and less dangerous symptoms, outpatient addiction treatment may be recommended. In this rehabilitation option, you’re allowed to continue with your previous living arrangements. You can stay home and go to work or school as usual. However, you’re required to attend all the prescribed treatment programs at the assigned facility. This simply means that outpatient addiction treatment is ideal and more effective if you’re able to get support from your family and friends at home and in your community.
• Inpatient zolpidem addiction treatment: For more serious cases of addiction, where there is a high risk of non-compliance, inpatient rehab is the better solution. This is a close-in and intensive treatment, where you will be required to stay in the rehabilitation facility. You will be given a combination of treatment modalities such as medications and psychological interventions, and you will be placed under the care and supervision of medical professionals.

Get the Help You Need Today

Accepting that you need help is the first step toward overcoming addiction and living a drug-free life. Once you’ve gotten over this initial hurdle, your next move is to get in touch with Better Addiction Care at (800) 429-7690. Our recovery support advisors are here to help you find the most suitable treatment center wherever you are in the country.

Batter Addiction Care will also help you find ways to fund your treatment. If you have insurance, our advisors can help verify your policy’s coverage. If you don’t currently have insurance coverage, don’t worry; we can give you recommendations about other financing options for your treatment.

A Short History of Zolpidem

​​Zolpidem was first used in Europe in 1988 for the short-term treatment of insomnia and was approved for use in the U.S. in 1992. Later, the manufacturers of zolpidem developed a modified-release formulation of the drug; it was approved for use in the U.S. in 2005.

In an effort to address the demand for a more effective sleep maintenance medication, the manufacturer Sanofi-Aventis developed a modified-release (MR) formulation of zolpidem tartrate that was approved for use in the US in 2005.