The problem now is that many folks count on zolpidem long term for their chronic insomnia. With that comes risks—and here they are.
1) Drowsiness
The FDA recently warned that patients should not drive or engage in other activities that require complete mental alertness the day after taking zolpidem ER (extended-release).
2) Impaired driving and car accidents
Know this. In research, after eight hours of taking just 10 mg zolpidem, 15% of women and 3% of men still had high enough levels of zolpidem in their bodies to impair driving ability. In fact, a South Korean study of folks taking zolpidem for sleep showed a significantly increased risk of fatal motor accidents the following day.
3) Hallucinations
Hallucinations have been reported in folks taking zolpidem. They last anywhere from one to seven hours, and are more likely to occur if you take zolpidem along with an SSRI (selective serotonin reuptake inhibitor) antidepressant like sertraline (Zoloft) or fluoxetine (Prozac). It’s very scary for folks who have been through this.
4) Falls, hip fractures and brain bleeds
An increased risk of falls resulting in brain injury and hip fracture has been observed in those taking zolpidem. This is especially true for folks 65 and older.
5) Upper respiratory tract infections
Patients taking zolpidem have shown an increased risk of upper respiratory infections (e.g. ear infections, throat infections, etc.) along with a reported increased risk of pneumonia.
6) Impaired memory and Alzheimer’s
Older adults have a particularly high risk of side effects from zolpidem, which include memory impairment, delirium (confused thinking), night wandering and agitation. A recent study from Taiwan showed that patients who took zolpidem for a relatively high number of days in a year (more than 180 days) had an increased risk of Alzheimer’s disease compared to those who took zolpidem less than 28 days out of the year.
7) Other complicated behaviors
Folks who committed violent crimes after taking zolpidem have sometimes blamed their actions on side effects of the drug as they testified in court. While violent crimes are extreme, abnormal sleep-related behaviors associated with zolpidem are common, which is concerning given its widespread use.
8) Emergency room visits
Between 2009 and 2011, zolpidem accounted for 12% of all emergency department visits for adverse drug events related to psychiatric medications. 21% of all such visits involved adults 65 years of age and older.
9) Cancer and death
Multiple studies have shown an association between the use of zolpidem and an increased risk of cancer and/or death. (This increased risk was found with other prescription sleep aids too.) The association appeared even in patients who took zolpidem at a rate of less than 18 doses per year over a two and a half year time period. Yipes.
10) Not approved for long-term use
It surprises many folks to hear that zolpidem is not approved for long-term treatment of insomnia. In contrast, zolpidem ER (Ambien CR), is not limited to short-term use and can be used long term. Just FYI.
What has your experience been?
Dr O.
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