by Nicole Evans M.D.

Created on: April 12, 2010   Last Updated: November 04, 2010

Zolpidem tartrate is the generic name for the brand name prescription medications Ambien and Stilnox.  Zolpidem is a non-benzodiazepene that is prescribed for the short term treatment of difficulty falling asleep.  There are many contraindications and side effects of Zolpidem that limit its use.

Zolpidem should not  be prescribed in quantities that exceed the amount needed for a 1 month supply.  Zolpidem should be only used for the short term, not long-term, management of insomnia for several reasons:

-People can develop tolerance to this medication. Tolerance is defined as the need for increased doses of a medication in order to achieve a desired effect.

-Zolpidem decreases a particular aspect of sleep known as sleep latency. 

-The long-term requirement for insomnia medications implies a psychological and/or medical cause for insomnia that should be addressed.

In addition to tolerance, individuals can actually abuse Zolpidem tartrate or become addicted to this medication. Though Zolpidem has the potential for abuse, this potential is believed to be lower than the abuse potential of benzodiazepenes that are sometimes used for insomnia such as Lorazepam and Ativan.

The most common side effects of Zolpidem tartrate include dizziness, headache and intense sleepiness.  These may occur in over 10% of people who take Zolpidem.  Additionally, Zolpidem can caus ataxia, which is difficulty moving one’s body parts in a coordinated fashion, in 1 to 10% of people using this sleep aid.

Zolpidem can also cause some rather alarming psychological and sexual side effects.  Individuals taking Zolpidem may experience depersonalization, a dream-like feeling as though they aren’t themselves.  Other individuals experience hypoesthesia, or decreased sensitivity to touch and other sensations. Several side effects of Zolpidem inhibit sexual ability and/or sexual enjoyment.  In contrast, there are other potential Zolpidem side effects that cause people to be sexually dishinhibited and mentally or emotionally labile.

All formulations of Zolpidem, including Ambien and Stilnox, are rapidly absorbed but the absorption can be slowed if taken with, or after, full meals.  These medications are best taken on an empty stomach in order to acheive the most rapid onset of sleep, and because these medications begin acting almost immediately they should always be taken right before bed.

The dose of Zolpidem does not have to be adjusted for altered renal (kidney) function.  However, Zolpidem should be used with caution in individuals with liver failure.  Always discuss the risks and benefits of your medications with your physician.

Source:  Lexi-drugs, Lexi-Comp Online.

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