zolpidem
Meaning of zolpidem: Sleep arrives sooner, but tolerance, dependence and next day drowsiness are the reasons courses are kept short.
Definition of zolpidem
Zolpidem is a prescription sedative used for short term treatment of insomnia, meaning persistent trouble falling asleep or staying asleep. It belongs to a group known as the Z drugs, which attach to the same site on a brain receptor that benzodiazepines use while having a different chemical structure. The effect is to quiet nerve cell activity so that sleep comes on.
How does it work?
The brain's main calming messenger is gamma-aminobutyric acid. When it binds its receptor, a channel opens, negative charge flows into the nerve cell and the cell becomes harder to fire. Zolpidem does not act as that messenger; it attaches at a separate spot on the same receptor and makes the receptor respond more strongly when the natural messenger arrives. The receptor comes in several versions, and zolpidem prefers the version most closely tied to sedation. That preference is why it produces sleepiness with comparatively little of the muscle relaxation, seizure protection and anxiety relief that benzodiazepines also deliver.
What forms does it come in?
| Form | Intended for |
|---|---|
| Immediate release tablet | Difficulty falling asleep at the start of the night |
| Extended release tablet | Difficulty staying asleep, with a layer that releases later |
| Low dose tablet dissolved under the tongue | Waking in the middle of the night with time still to sleep |
The drug is cleared quickly, which is what makes it suit insomnia rather than daytime sedation. Even so, the extended release form and higher doses can leave enough drug on board the following morning to slow reaction time before the person notices anything wrong.
Why is it meant for short courses?
Three reasons stack up. Tolerance develops, so the same dose gradually does less. Physical dependence can follow regular use, and stopping abruptly may bring a stretch of sleep that is worse than before treatment started, a rebound that tempts continued use. And the drug is associated with complex behaviors during sleep, including walking, eating, making telephone calls and even driving, with no memory of it afterward, which is the most serious of its recognized effects. Sensitivity is greater in older adults, in whom sedatives are linked with falls and confusion. Alcohol and other sedating drugs deepen every one of these effects.
Also known as
Used in a sentence
Zolpidem was prescribed for a limited course to address the patient's insomnia.
Good to know
Zolpidem is intended for short term use, since sedative hypnotics carry an increasing potential for tolerance and dependence with continued use, and it is associated with complex behaviors performed during sleep and not remembered afterward.