Zolpidem

Zolpidem is a nonbenzodiazepine hypnotic medication used for the short-term treatment of insomnia, particularly difficulty with sleep onset. It is marketed under various brand names, including Ambien, and is commonly prescribed for periods of a few weeks, with long-term use generally discouraged due to risks of dependence and tolerance.

Zolpidem acts on gamma-aminobutyric acid type A (GABA-A) receptors, binding preferentially to subtypes associated with sedative effects, especially the alpha-1 subunit. This enhances GABA-mediated chloride influx and promotes sleep, while producing relatively less anxiolytic, anticonvulsant, or muscle-relaxant activity compared with benzodiazepines.

Pharmacokinetics and dosing information indicate rapid absorption, with onset of sleep typically within 15 to 30 minutes and a short half-life of about 2 to 3 hours. The short duration is intended to limit next-day impairment, though residual drowsiness can occur. Dosing is individualized; typical adult doses for immediate-release formulations range from 5 to 10 mg. Lower doses are often used for older adults and for those with hepatic impairment. Women may be advised to start at lower doses due to slower clearance.

Safety considerations include common side effects such as drowsiness, dizziness, headache, and nausea. Serious but uncommon adverse effects include complex sleep-related behaviors, anterograde amnesia, and severe confusion. There is potential for dependence and withdrawal after prolonged use or abrupt discontinue. Zolpidem can interact with other central nervous system depressants and with drugs that affect CYP3A4 metabolism. It is a prescription medication and is controlled in many jurisdictions due to abuse potential.