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Cited by 94Sleep and related disordersObstructive Sleep Apnea ResearchCircadian rhythm and melatonin

Hypnotics in Insomnia: The Experience of Zolpidem

MacFarlane, James, Morin, Charles M., Montplaisir, Jacques·2014·Clinical Therapeutics
DOI 10.1016/j.clinthera.2014.09.017
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Abstract

Purpose One of the most commonly prescribed medications to treat insomnia is zolpidem, a nonbenzodiazepine compound that is available as an immediate-release oral tablet formulation, an extended-release oral formulation, an oral spray formulation, and as sublingual formulations. The purpose of this review was to summarize the data currently available on the efficacy and safety of zolpidem in the treatment of insomnia among adults.Methods Published studies on the use of zolpidem in the treatment of insomnia were identified by using combinations of relevant search terms in PubMed and Google Scholar. Studies were included if they were placebo- or active comparator-controlled studies, with the exception of trials on the long-term use of zolpidem. Studies were limited to those conducted in adults. Studies were not included if the patient population was small, if the study was not designed or powered to assess the efficacy or safety of zolpidem, if insomniac patients had a medical condition in addition to insomnia (with the exception of comorbid depression or anxiety for studies on comorbid insomnia), or if zolpidem was given concomitantly with any other therapy (with the exception of selective serotonin reuptake inhibitors for studies on comorbid insomnia).Findings Twenty-five studies designed to evaluate the efficacy of zolpidem in insomnia and 51 studies reporting the safety of zolpidem in insomnia were included in this review.Implications The studies discussed in this review report the efficacy and safety of zolpidem in both young adults and the elderly. It can be used for either bedtime or middle-of-the-night administration, over the short or long term, with minimal risk of withdrawal or abuse. The use of zolpidem is associated with rebound insomnia, complex sleep-related behaviors, and next-day residual effects (after middle-of-the-night dosing) on driving ability, memory, and psychomotor performance.

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Crossref · 10.1016/j.clinthera.2014.09.017

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  • Current diagnostic methods in psychiatry (DSM-5 and ICD-11) are inadequate to assess psychotropic medication withdrawal because they do not account for iatrogenic comorbidity and refer to drug-free patients, although most first-visit psychiatric cases are already on psychotropic medication.

    “Current diagnostic methods in psychiatry, both DSM-5 [182] and ICD-11 [205], are inadequate to assess psychotropic medication withdrawal because they do not take into account the issue of iatrogenic comorbidity [28] and they refer to drug-free patients, although most of the psychiatric cases seen at first visit in psychiatry and in clinical psychology are already under a psychotropic medication [”

    From Acute and Persistent Withdrawal Syndromes Following Discontinuation of Psychotropic Medications (2020) · cites this paper as [28]

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Authors
MacFarlane, J., Morin, C. M., & Montplaisir, J.
Affiliations
  • University of Toronto (CA)
  • Institut Universitaire en Santé Mentale de Québec (CA)
  • Hôpital du Sacré-Cœur de Montréal (CA)
Corresponding author
MacFarlane, James
ORCID
Venue
Clinical Therapeutics
Publisher
Elsevier BV
Published
2014-11
Volume
36
Issue
11
Pages
1676-1701
ISSN
0149-2918 (ISSN-L)
DOI
10.1016/j.clinthera.2014.09.017
OpenAlex
W2054421884
Cited by
94
References
137
Citations by year
2025: 5 · 2024: 2 · 2023: 4 · 2022: 4 · 2021: 6 · 2020: 7 · 2019: 42 · 2018: 11 · 2017: 5 · 2016: 5 · 2015: 2
FWCI
0.59
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Clinical Therapeutics (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Valeant Pharmaceuticals International
  • Canada Research Chairs
  • Servier
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
Keywords
zolpidem, insomnia, hypnotics, drug efficacy, drug safety, rebound insomnia, driving impairment, elderly patients, young adults, long-term use
MeSH terms
Zolpidem, Adult, Humans, Hypnotics and Sedatives, Sleep Initiation and Maintenance Disorders, Memory, Psychomotor Performance, Pyridines, Selective Serotonin Reuptake Inhibitors

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