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Asian J Psychiatr. 2017 Feb;25:79-90. doi: 10.1016/j.ajp.2016.10.006. Epub 2016 Oct 12.

Zolpidem's use for insomnia.

Author information

1
Department of Pharmacology and Therapeutics, University of the Republic School of Medicine, Montevideo, Uruguay. Electronic address: jmonti@mednet.org.uy.
2
652 Dufferin Street, Toronto, ON M6K 2B4, Canada.
3
Sleep Disorders Center, 601 Harwood Avenue South, Alax, ON L1S 2J5, Canada.
4
Somnogen Canada Inc, College Street, Toronto, ON, Canada.

Abstract

Zolpidem is a short-acting non-benzodiazepine hypnotic drug that belongs to the imidazopyridine class. In addition to immediate-release (IR) and extended-release (ER) formulations, the new delivery forms including two sublingual tablets [standard dose (SD) and low dose (LD)], and an oral spray form have been recently developed which bypass the gastrointestinal tract. So far, Zolpidem has been studied in several clinical populations: cases poor sleepers, transient insomnia, elderly and non-elderly patients with chronic primary insomnia, and in comorbid insomnia. Peak plasma concentration (Tmax) of zolpidem-IR occurs in 45 to 60min, with the terminal elimination half-life (t½) equating to 2.4h. The extended-release formulation results in a higher concentration over a period of more than 6h. Peak plasma concentration is somewhat shorter for the sublingual forms and the oral spray, while their t½ is comparable to that of zolpidem-IR. Zolpidem-IR reduces sleep latency (SL) at recommended doses of 5mg and 10mg in elderly and non-elderly patients, respectively. Zolpidem-ER at doses of 6.25mg and 12.5mg, improves sleep maintenance in elderly and non-elderly patients, respectively, 4h after its administration. Sublingual zolpidem-LD (5mg) and zolpidem oral spray are indicated for middle-of-the-night (MOTN) wakefulness and difficulty returning to sleep, while sublingual zolpidem-SD (10mg) is marketed for difficulty falling asleep. With their array of therapeutic uses and their popularity among physicians and patients; this review describes the clinical pharmacology, indications and uses, identifying withdrawal symptoms, abuse and dependence potentials, and adverse drug reactions are discussed.

KEYWORDS:

Hypnotic drugs; Insomnia disorder; Non-rapid eye movement sleep; Rapid eye movement sleep; Sleep; Zolpidem

PMID:
28262178
DOI:
10.1016/j.ajp.2016.10.006
[Indexed for MEDLINE]

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