Zolpidem

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In pharmacology, zolpidem is an agonist of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA). Zolpidem's pharmacological action is in the category of hypnotics and sedatives. Zolpidem is one of the Z drugs (zopiclone, eszopiclone, zolpidem, and zaleplon).

While it is a controlled substance in the Drug Enforcement Administration Schedule IV, its risk of dependency is nonzero but low, especially when compared to benzodiazepines or barbiturates.

Efficacy

In treating persistent insomnia in adults, 6 weeks of zolpidem 10 mg nightly along with weekly sessions of cognitive behavioral therapy followed by 6 months of monthly sessions and no medications yielded the most remission of insomnia in a randomized controlled trial.[1]

In geriatrics, the benefits of zolpidem for insomnia to not clearly exceed the drug toxicity.[2][3]

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References

  1. Morin CM, Vallières A, Guay B, Ivers H, Savard J, Mérette C et al. (2009). "Cognitive behavioral therapy, singly and combined with medication, for persistent insomnia: a randomized controlled trial.". JAMA 301 (19): 2005-15. DOI:10.1001/jama.2009.682. PMID 19454639. Research Blogging.
  2. Glass J, Lanctôt KL, Herrmann N, Sproule BA, Busto UE (2005). "Sedative hypnotics in older people with insomnia: meta-analysis of risks and benefits.". BMJ 331 (7526): 1169. DOI:10.1136/bmj.38623.768588.47. PMID 16284208. PMC PMC1285093. Research Blogging. Review in: ACP J Club. 2006 Jul-Aug;145(1):14 Review in: Evid Based Med. 2006 Aug;11(4):110 Review in: Evid Based Nurs. 2006 Jul;9(3):87
  3. Nowell PD, Mazumdar S, Buysse DJ, Dew MA, Reynolds CF, Kupfer DJ (1997 Dec 24-31). "Benzodiazepines and zolpidem for chronic insomnia: a meta-analysis of treatment efficacy.". JAMA 278 (24): 2170-7. PMID 9417012.