• Sleep Medicine and Psychophysiology
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• v.4 no.2
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• pp.181-190
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• 1997

Zolpidem is a relatively new, short-acting, rapid onset, and nonbenzodiazepine hypnotics. Zolpidem selectively binds to the central benzodiazepine 1 (BZI) receptor subtype. The present study was designed to compare the hypnotic effects of zolpidem (10 mg), triazolam (0.25 mg), and placebo in 22 schizophrenic inpatients. Zolpidem, triazolam, and placebo were administered orally in a randomized, double-blind design. Compared with placebo, zolpidem and triazolam significantly decreased sleep latency (p<0.05), increased total sleep time (p<0.05), and increased improvement of satisfaction of sleep (p<0.05). Zolpidem decreased the number of awakenings significantly in comparison with placebo (p<0.05), but triazolam did not. In addition, both drugs were well tolerated and did not produce severe side effects. These results suggest that zolpidem is effective for transient insomnia of schizophrenic inpatients and zolpidem is superior to triazolam in hypnotic effect.

• Sleep Medicine and Psychophysiology
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• v.12 no.2
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• pp.144-147
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• 2005

Objective: The authors would like to find the relationship between zolpidem and nocturnal eating episodes in diverse psychiatric patients. Method: We evaluated case series of 6 patients who showed nocturnal eating episodes after takine zolpidem. Results: We have experienced 6 cases who showed nocturnal eating behavior after taking zolpidem. They included 3 patients with schizoprenia, a patient with major depressive disorder, a patient with PTSD and a patient with bipolra I disorder. With reducing or discontiuation of zolpidem, their nocturanl eating resolved. Conclusion: This finding strongly suggests the relationship between zolpidem and the nocturnal eating episode. Physicians should be aware that zolpidem might induce nocturnal eating behaviors.

• The Journal of the Korea Contents Association
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• v.20 no.2
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• pp.462-471
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• 2020

The Zolpidem, commonly used as a sleeping pill, binds to GABA receptors to increase neuro-inhibiting transporters. There are many cases where people take Zolpidem for more than four weeks in a row. The Drug Utilization Review, currently in effect in South Korea, can identify the use patterns of Zolpidem. It is necessary to prevent Zolpidem's misuse. The study was conducted from May 10, 2019 to May 15, 2019. Primary and secondary screening was performed out of 125,197 total retrieved documents. The final 254 literature cases directly related to Zolpidem's misuse were selected. Through systematic literature research through meta-analysis, we tried to find a way to prevent Zolpidem's misuse through the Drug Utilization Review. The distortion was minimized by applying it in the screening process. Zolpidem's misuse was severe and continued to increase its use. There has also been an increase in crime using Zolpidem. It has been analyzed that Zolpidem can be managed through Narcotics Integrated Management System and Drug Utilization Review. In order to reduce the use of Zolpidem, the supply through the Narcotics Integrated Management System and the demand through long-term user education should be suppressed.

• Journal of The Korean Society of Clinical Toxicology
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• v.6 no.2
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• pp.91-98
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• 2008

Purpose: The hypnotic effect of zolpidem is comparable to benzodiazepines, but has less abuse and addiction potential than benzodiazepines, so is one of the most commonly prescribed hypnotics. The frequency of acute zolpidem overdose has increased, but clinical analysis and severity predictors are not known in Korea. Methods: A retrospective evaluation of histories, clinical courses, and laboratory findings of each patient treated from June, 2000, to May, 2006, in a university hospital for acute zolpidem intoxication. Results: We evaluated 30 patients, including 16 co-intoxication cases. Twenty-five patients presented mental alterations but became alert within 2 days. All patients recovered completely. The median zolpidem concentration was 0.9 mg/L (range: $0.2{\sim}7.4\;mg/L$). There was a weak correlation between the amount ingested and zolpidem concentration (r=0.25). None of them presented severe laboratory abnormalities, and these abnormalities did not relate to zolpidem concentration. Conclusion: The clinical progress of acute zolpidem intoxication is mild. We could not predict zolpidem concentration or clinical severity from the amount ingested and could not predict the clinical course from laboratory findings in the emergency department.

• Journal of The Korean Society of Clinical Toxicology
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• v.11 no.2
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• pp.127-129
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• 2013

The imidazopyridine, zolpidem, a non-benzodiazepine hypnotic drug, is widely-prescribed for insomnia. It is regarded as a good alternative to benzodiazepine because of the reduced possibility for abuse and development of dependence. However, more recently, due to the reduced possibility for abuse and development of dependence, it is regarded as a good alternative to benzodiazepine. adverse effects of zolpidem have been recognized. The objective of this report is to provide information on the potential for occurrence of benzodiazepine-like withdrawal seizure in patients who chronically take zolpidem continually. We present and discuss a case of seizure after sudden interruption of the protracted use of an abusively high dose of zolpidem. Zolpidem may not be the ideal drug for longterm pharmacotherapeutic management of insomnia. Clinicians should administer zolpidem at a low-dose for a short period of time for prevention of drug abuse and dependence and the potential for occurrence of benzodiazepine- like withdrawal seizure.

• Journal of The Korean Society of Clinical Toxicology
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• v.17 no.2
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• pp.118-125
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• 2019

Purpose: Non-benzodiazepine hypnotic drugs (including zolpidem) are associated with an increased risk of suicide and suicidal ideation. Considering the wide usage of zolpidem, this drug should be considered a possible etiology for stupor or coma in any patient exposed to this drug. However, there are no reports on zolpidem blood levels in emergency department patients in Korea. We therefore reviewed the analyzed data of a toxicology laboratory at one university affiliated hospital. Methods: The sex, age, chief symptoms, suspiciousness of poisoning, and presumption of poison were analyzed from January 2018 to June 2019. The detection frequency and level of zolpidem in the patient blood were compared to the mental changes presented, which is the main consequence of zolpidem. Results: A total of 229 toxicological analyses, requested to a toxicological laboratory at one university affiliated hospital, were reviewed. Among 229 patients, the mean age was 54.3±20.7 years old with 113 women and 116 men. 8.7% of patients have psychiatric illness and 39.7% were poisoned intentionally. The chief symptoms detected were: mental change 55.0%, gastrointestinal 14.4%, cardiovascular 10.5%, focal neurological 7.4%, respiratory 3.5%, none 8.7%, and unknown 0.4%. A request for detailed reports revealed that causative poisons were specified only in 20.1% cases. Zolpidem was detected in 22.3% cases (51/229), with median blood level 1.26 mg/L (interquartile 0.1, 5.06 mg/L) and urine 0.90 mg/L (interquartile 0.11, 5.6 mg/L). Furthermore, zolpidem was more frequently detected in toxicology analysis of patients where mental change was the primary symptom, as compared to other symptoms (32.5% vs. 9.7%, p<0.01). Conclusion: This study reported the blood level of zolpidem in suspected poisoning patients admitted to the emergency department.

• Journal of Preventive Medicine and Public Health
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• v.45 no.4
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• pp.219-226
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• 2012

Objectives: To evaluate the risk of fractures related with zolpidem in elderly insomnia patients. Methods: Health claims data on the entire South Korean elderly population from January 2005 to June 2006 were extracted from the Health Insurance Review and Assessment Service database. We applied a case-crossover design. Cases were defined as insomnia patients who had a fracture diagnosis. We set the hazard period of 1 day length prior to the fracture date and four control periods of the same length at 5, 10, 15, and 20 weeks prior to the fracture date. Time independent confounding factors such as age, gender, lifestyle, cognitive function level, mobility, socioeconomic status, residential environment, and comorbidity could be controlled using the case-crossover design. Time dependent confounding factors, especially co-medication of patients during the study period, were adjusted by conditional logistic regression analysis. The odds ratios and their 95% confidence intervals (CIs) were estimated for the risk of fracture related to zolpidem. Results: One thousand five hundred and eight cases of fracture were detected in insomnia patients during the study period. In our data, the use of zolpidem increased the risk of fracture significantly (adjusted odds ratio [aOR], 1.72; 95% CI, 1.37 to 2.16). However, the association between benzodiazepine hypnotics and the risk of fracture was not statistically significant (aOR, 1.00; 95% CI, 0.83 to 1.21). Likewise, the results were not statistically significant in stratified analysis with each benzodiazepine generic subgroup. Conclusions: Zolpidem could increase the risk of fracture in elderly insomnia patients. Therefore zolpidem should be prescribed carefully and the elderly should be provided with sufficient patient education.

• Korean Journal of Psychosomatic Medicine
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• v.29 no.2
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• pp.144-152
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• 2021

Objectives : The purpose of this study is to identify differences between suicide attempters who used zolpidem and others who used different methods in emergency department. Methods : This study classified 2,734 suicide attempters, who went to emergency department from 2009 to 2018, into zolpidem user group, another drug user group and non-drug user group. For these three groups, chisquare test and logistic regression analysis were conducted regarding sociodemographic feature and clinical feature related with suicide. Results : In the result of logistic regression analysis of a variable, which showed meaningful difference between suicide attempter group who used zolpidem and the other group who did not use the drug, the occurrence of zolpidem-using suicide attempers was related with the case where anxiolytics/hypnotics was used or the case where lethality and intention was low. In the drug intoxication group which showed similar feature, there was also a relevance between anxiolytics/hypnotics and the occurrence of zolpidem-using suicide attempts. Conclusions : This study identified significant difference of sociodemographic and clinical feature in suicide attempter group who used zolpidem and the other group. This result can contribute to plan further medicinal treatment in using zolpidem.

• The Journal of Internal Korean Medicine
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• v.37 no.5
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• pp.750-754
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• 2016

The purpose of this study was to report a case of an insomnia patient treated with a traditional Korean medical treatment. The patient had suffered from insomnia for 4 months and had taken medicines such as Zolpidem. We diagnosed the patient as So-yang-in, according to the Sa-sang constitutional medicine. We prescribed medicine with herbs for So-yang-in and applied acupuncture for 9 days, and then we evaluated sleep time, quality, and awakening, based on the patient’s statement. The symptoms of insomnia were gradually improved during treatment. Therefore, traditional Korean medical treatment can help insomnia patients sleep well without Zolpidem.

• Korean Journal of Psychosomatic Medicine
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• v.30 no.2
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• pp.112-118
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• 2022

Objectives : Zolpidem is a common drug used in insomnia. However, there are several reports of side effects of the central nervous system or sleep related behavior in patients who took zolpidem. This study was conducted to investigate risk factors affecting sleep related behavior after taking zolpidem in inpatients. Methods : From January 1, 2019 to December 31, 2019, medical records of patients who took zolpidem hospitalized at Inha University Hospital were reviewed retrospectively. Results : 907 patients who took Zolpidem, 102 (11.2%) showed sleep related behavior, and if they were 65 years of age or older, men, taking antipsychotics, and taking antipsychotics and benzodiazepines at the same time, they were significantly more likely to show sleep related behavior. Conclusions : Risk factors for sleep-related behavior after use of zolpidem are estimated gender, elderly, antipsychotics, and combination of antipsychotics and benzodiazepines.