Ambien (zolpidem) is currently the most commonly used sleeping medication on the market. Most physicians believe, unknowingly, that it can be prescribed with impunity. This is not the case. Ambien has many side effects that have resulted in a big increase in visits to emergency departments.
Emergency department (ED) visits for adverse reactions related to the sleep drug zolpidem increased by almost 220% in a recent 5-year period, according to the Substance Abuse and Mental Health Services Administration (SAMHSA).
Women and the elderly appear to be most prone to adverse reactions linked to zolpidem, a widely prescribed medication approved by the US Food and Drug Administration (FDA) for short-term treatment of insomnia.
The information was contained in a report from the SAMHSA's Drug Abuse Warning Network (DAWN), a public health surveillance system that monitors drug-related ED visits across the United States.
It is very easy to become addicted to Ambien, and the manufacturer recommends against taking it for more than 30 consecutive days. There are other more viable strategies for treating insomnia such as sleep hygiene which can include avoiding caffeine, exercising regularly, and sleeping in quiet darkened surroundings.
According to the report, in 2010 there were 64,175 ED visits involving zolpidem, about 30% of which were attributed to adverse reactions. The number of these visits increased nearly 220%, from 6111 in 2005 to 19,487 in 2010.
The increase appeared to have affected women more. Zolpidem-related ED visits involving adverse reactions increased overall by 274% among women and by 144% among men. In 2010, 13,180 zolpidem-related ED visits involved adverse reactions among women, which was more than double that for men (6306).
Earlier this year, the, FDA responded to increasing reports of adverse reactions by requiring manufacturers of drugs containing zolpidem to halve the recommended dose for women. Zolpidem comes in 5-mg and 10-mg doses, and an extended-release version comes in 6.25-mg and 12.5-mg doses. The FDA also suggested that manufacturers reduce the recommended dose for men.
Research shows that women metabolize the drug differently than men and that 8 hours after taking the drug, a sizable proportion of women still have levels in their system that could be impairing mentation and consciousness.
The elderly may also be more sensitive to the sleep drug. In 2010, patients aged 65 years and older represented the largest proportion (32%) of zolpidem-related ED visits involving adverse reactions, followed by patients aged 45 to 54 years (22%).
As with women, the FDA has recommended that the dose of most drugs containing zolpidem be reduced by half when prescribed for the elderly. However, studies show that the older population are often being prescribed the higher dose, which may increase adverse reactions.
According to the report, about 40% of the ED visits involved zolpidem alone and half involved other pharmaceuticals combined with zolpidem. Narcotic pain relievers were the most common type of pharmaceutical combined with zolpidem (21%), followed by other antianxiety and insomnia medications (16%).
Adverse Reactions
Adverse reactions related to zolpidem can include daytime drowsiness, dizziness, hallucinations, behavioral changes (eg, bizarre behavior and agitation), and complex behaviors, such as sleepwalking and "sleep driving" a form of somnambulism When zolpidem is combined with drugs that depress the central nervous system, such as antianxiety medications (eg, benzodiazepines), narcotic pain relievers, and alcohol, the sedative effects of zolpidem can be dangerously enhanced, said the report.
The complete survey is available here.
