From the Guidelines
Ambien (zolpidem) is a prescription medication used for short-term treatment of insomnia, with a typical starting dose of 5mg for women and older adults or 5-10mg for men, taken once daily immediately before bedtime, and treatment should generally be limited to 7-10 days as prolonged use can lead to dependence and tolerance. The medication works by enhancing the effect of GABA, an inhibitory neurotransmitter in the brain that promotes sleep 1. Some key points to consider when using Ambien include:
- Taking the medication only when 7-8 hours are available for sleep
- Avoiding alcohol while using Ambien
- Discontinuing the medication gradually rather than stopping abruptly
- Using caution in patients with respiratory conditions, history of substance abuse, or liver disease
- Practicing good sleep hygiene alongside medication use, including maintaining a regular sleep schedule and avoiding screens before bedtime 1. It's also important to note that Ambien can cause side effects such as drowsiness, dizziness, headache, and rarely complex sleep behaviors like sleepwalking or sleep-driving 1. Overall, Ambien can be an effective treatment for short-term insomnia, but it's essential to use it responsibly and under the guidance of a healthcare professional.
From the FDA Drug Label
What is zolpidem tartrate? Zolpidem tartrate is a sedative-hypnotic (sleep) medicine Zolpidem tartrate is used in adults for the short-term treatment of a sleep problem called insomnia (trouble falling asleep).
Key Information about Ambien (Zolpidem):
- Indication: Zolpidem tartrate is used for the short-term treatment of insomnia in adults.
- Mechanism of Action: Zolpidem is a GABA A receptor positive modulator that exerts its therapeutic effects by binding to the benzodiazepine site of α1 subunit containing GABA A receptors.
- Dosage: The recommended dose for zolpidem tartrate should be 5 mg in the elderly [see WARNINGS AND PRECAUTIONS (5), DOSAGE AND ADMINISTRATION (2)].
- Contraindications: Do not take zolpidem tartrate if you are allergic to zolpidem or any other ingredients in zolpidem tartrate.
- Side Effects: Zolpidem tartrate may cause serious side effects, including complex sleep behaviors that have caused serious injury and death. 2
From the Research
Overview of Ambien (Zolpidem)
- Ambien, also known as Zolpidem, is a non-benzodiazepine hypnotic used for the short-term treatment of insomnia 3, 4, 5, 6.
- It is indicated for the treatment of insomnia characterized by difficulties with sleep initiation, sleep maintenance, or both 3, 6.
Efficacy and Safety
- Zolpidem has been shown to be effective in improving sleep in patients with insomnia, with a favorable tolerability profile when used according to the manufacturer's prescribing information 5, 6.
- The drug has a low propensity to cause clinical residual effects, withdrawal, dependence, or tolerance, and is associated with minimal rebound insomnia 5, 6.
- However, zolpidem has been linked to various adverse effects, including an increased risk of falls, hip fractures, and complex behaviors such as sleepwalking, hallucinations, and increased suicidality 3.
Pharmacology and Dosage
- Zolpidem is an imidazopyridine agent with a short plasma half-life and limited duration of action, making it suitable for the treatment of insomnia 4, 6.
- The recommended dosage is 10 mg/day in adults and 5 or 10 mg/day in the elderly or patients with hepatic impairment 6.
- Female patients may require smaller doses due to higher plasma concentrations of the drug 3.
Special Considerations
- Zolpidem should be used with caution in patients with a history of psychiatric illness, as it may exacerbate psychotic symptoms or induce new-onset psychosis 7.
- The drug is classified as a category C drug by the FDA, indicating potential adverse effects on fetal development, and its use during pregnancy should be carefully considered 3.
- Zolpidem has been associated with an increased risk of seizures, particularly during withdrawal, and should be used with caution in patients with a history of seizure disorders 3.