Zolpidem is an
imidazopyridine agent that is indicated for the short term (< or = 4 weeks) treatment of
insomnia (recommended dosage 10 mg/day in adults and 5 or 10 mg/day in the elderly or patients with hepatic impairment). Data have shown that the
hypnotic efficacy of
zolpidem is generally comparable to that of the
benzodiazepines flunitrazepam,
flurazepam,
nitrazepam,
temazepam and
triazolam as well as nonbenzodiazepine
hypnotic agents such as
zopiclone and
trazodone in the treatment of elderly and adult patients with
insomnia. The comparative efficacy of a recently available nonbenzodiazepine
hypnotic zaleplon and
zolpidem has yet to be established. There was no evidence of tolerance developing to the
hypnotic effects of
zolpidem in a number of studies of up to 6 months' duration. However, tolerance has been described in a few patients taking the
drug at high dosages for periods of up to several years.
Zolpidem is well tolerated in patients with
insomnia and the most common adverse events are generally
nausea,
dizziness and drowsiness. Although
zolpidem produced some psychomotor and memory impairment over the first few hours after administration, it had few next-day effects (including effects on daytime well-being and morning coordination). In this respect, it was comparable or superior to
flunitrazepam and
flurazepam and comparable to other
benzodiazepines in patients with
insomnia.
Zolpidem appears to have a low potential for abuse.
CONCLUSIONS: