Zolpidem: Wikis

  
  

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Zolpidem
Systematic (IUPAC) name
N,N,6-Trimethyl-2-(4-methylphenyl)-
imidazo[1,2-a]pyridine-3-acetamide
Identifiers
CAS number 82626-48-0
ATC code N05CF02
PubChem 5732
DrugBank APRD00095
ChemSpider 5530
Chemical data
Formula C19H21N3O 
Mol. mass 307.395 g/mol
SMILES eMolecules & PubChem
Pharmacokinetic data
Bioavailability 70% (oral) 92% bound in plasma
Metabolism Hepatic - CYP3A4
Half life 2 to 2.6 hours
Excretion 56% renal
34% fecal
Therapeutic considerations
Pregnancy cat. B3(AU) C(US)
Legal status Schedule IV (US) Class C (UK)
Routes Oral
 Yes check.svgY(what is this?)  (verify)
.Zolpidem is a prescription medication used for the short-term treatment of insomnia, as well as some brain disorders.^ Zolpidem is a prescription medication used for the short-term treatment of insomnia, as well as some brain disorders.
  • Zolpidem: Encyclopedia of chemistry, analytics & pharmaceutics with 64,557 entries. 10 January 2010 2:02 UTC www.chemie.de [Source type: Academic]

^ Ambien is a prescription drug formula that is used to treat insomnia as well as some brain disorders.
  • Stories of Ambien Use and Abuse 10 February 2010 11:11 UTC ambienoverdose.org [Source type: General]

^ In 2006 the Food and Drug Administration approved Rozerem (ramelteon) at the 8 mg dosage for use in the treatment of both acute and chronic insomnia.

.It is a short-acting nonbenzodiazepine hypnotic that potentiates gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter, by binding to gamma-aminobutyric acid (GABAA) receptors at the same location as benzodiazepines.^ Gamma-aminobutyric acid receptor subunit alpha-1 precursor .
  • HMDB: Showing Zolpidem (HMDB05023) 10 January 2010 2:02 UTC hmdb.ca [Source type: Academic]

^ It is a short-acting nonbenzodiazepine hypnotic that potentiates gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter, by binding to benzodiazepine receptors which are located on the gamma-aminobutyric acid receptors.
  • Zolpidem: Encyclopedia of chemistry, analytics & pharmaceutics with 64,557 entries. 10 January 2010 2:02 UTC www.chemie.de [Source type: Academic]

^ Zolpidem overdosage can be treated with the benzodiazepine receptor antagonist flumazenil which displaces zolpidem from its binding site the benzodiazepine receptor and therefore rapidly reverses the effects of zolpidem.
  • Zolpidem: Encyclopedia of chemistry, analytics & pharmaceutics with 64,557 entries. 10 January 2010 2:02 UTC www.chemie.de [Source type: Academic]

[1] .It works quickly (usually within 15 minutes) and has a short half-life (2–3 hours).^ I'm not allergic to it but when i take it about a half and hour later..I'm sneezing my head off for a good 2 to 3 minutes..is this common???
  • Ambien side effects : Medications.com 10 February 2010 11:11 UTC www.medications.com [Source type: FILTERED WITH BAYES]

^ For patients that people with histories of genital herpes, usually within hours.
  • Ambien no prescription - Windows Live 10 February 2010 11:11 UTC emeds.spaces.live.com [Source type: FILTERED WITH BAYES]

^ Studies show that usually starts to work within the site.The turnaround time goes on, the number of things to stay away from.
  • ambien - Ambien 10mg - 25% DISCOUNT- 10 February 2010 11:11 UTC ambie-n.weebly.com [Source type: FILTERED WITH BAYES]

.Trade names of zolpidem include Adormix, Ambien, Ambien CR, Edluar, Damixan, Hypnogen, Ivedal, Lioran, Myslee, Nytamel, Sanval, Somidem, Stilnoct, Stilnox, Stilnox CR, Sucedal, Zoldem, Zolnod and Zolpihexal.^ The recent release of Ambien CR (zolpidem tartrate extended release) in the United States renewed interest in the drug among recreational drug users.
  • Zolpidem: Encyclopedia of chemistry, analytics & pharmaceutics with 64,557 entries. 10 January 2010 2:02 UTC www.chemie.de [Source type: Academic]

^ CONTRAINDICATIONS Ambien CR is contraindicated in patients with known hypersensitivity to zolpidem tartrate or to any of the inactive ingredients in the formulation.
  • sanofi-aventis U.S. LLC - Ambien CR - January 2008 24 September 2009 16:53 UTC products.sanofi-aventis.us [Source type: Academic]

^ Symptoms of insomnia include: • trouble falling asleep • waking up often during the night AMBIEN CR is not for children.
  • sanofi-aventis U.S. LLC - Ambien CR - January 2008 24 September 2009 16:53 UTC products.sanofi-aventis.us [Source type: Academic]

[2][3][4][5][6]
.Its hypnotic effects are similar to those of the benzodiazepine class of drugs, but it is molecularly distinct from the classical benzodiazepine molecule and is classified as an imidazopyridine.^ Its hypnotic effects are similar to those of the benzodiazepine class of drugs, but it is molecularly distinct from the classical benzodiazepine molecule and is actually classified as an imidazopyridine.

^ Ambien is classified as a non-benzodiazepine hypnotic.
  • WLJ - Ambien users wake up, smell the lawsuits 10 February 2010 11:11 UTC www.wislawjournal.com [Source type: News]

^ It is classed in two ways; as a non- benzodiazepine , and as part of the imidazopyridine class of drugs.

.Flumazenil, a benzodiazepine receptor antagonist, which is used for benzodiazepine overdose, can also reverse zolpidem's sedative/hypnotic and memory impairing effects.^ Zolpidem overdosage can be treated with the benzodiazepine receptor antagonist flumazenil which displaces zolpidem from its binding site the benzodiazepine receptor and therefore rapidly reverses the effects of zolpidem.
  • Zolpidem: Encyclopedia of chemistry, analytics & pharmaceutics with 64,557 entries. 10 January 2010 2:02 UTC www.chemie.de [Source type: Academic]

^ Flumazenil , a benzodiazepine receptor antagonist, which is used for benzodiazepine overdose, can also reverse zolpidem's sedative/hypnotic effects.
  • Zolpidem: Encyclopedia of chemistry, analytics & pharmaceutics with 64,557 entries. 10 January 2010 2:02 UTC www.chemie.de [Source type: Academic]

^ Many drivers have blood levels far exceeding the therapeutic dose range suggesting a high degree of excessive-use potential for benzodiazepines , zolpidem and zopiclone.
  • Zolpidem: Encyclopedia of chemistry, analytics & pharmaceutics with 64,557 entries. 10 January 2010 2:02 UTC www.chemie.de [Source type: Academic]

[7][8]
.As an anticonvulsant and muscle relaxant, the beneficial effects start to emerge at 10 and 20 times the dose required for sedation, respectively.^ It exerts sedative, anxiolytic, muscle relaxant, and anticonvulsant effects.
  • USPharmacist.com > Continuing Education > Pharmacotherapeutic Options for Chronic Insomnia 10 January 2010 2:02 UTC www.uspharmacist.com [Source type: Academic]

^ Twenty-five nanomolar zolpidem had no effect, whereas 500 n M depolarized ~52% and 10 µ M depolarized 67% of the cells, with 20% depolarizing close to 0 mV (Fig.
  • GABAA Receptor Subunit Composition and Functional Properties of Cl- Channels with Differential Sensitivity to Zolpidem in Embryonic Rat Hippocampal Cells -- Maric et al. 19 (12): 4921 -- Journal of Neuroscience 10 January 2010 2:02 UTC www.jneurosci.org [Source type: Academic]

^ H : cumulative probability curves for mIPSC decay times in WT interneurons and 1 KO interneurons; the median w s were 20.2 and 34.5 ms, respectively, and the populations were significantly different ( P < 001).
  • Prolongation of Hippocampal Miniature Inhibitory Postsynaptic Currents in Mice Lacking the GABAA Receptor alpha 1 Subunit -- Goldstein et al. 88 (6): 3208 -- Journal of Neurophysiology 10 January 2010 2:02 UTC jn.physiology.org [Source type: Academic]

[9] .For that reason, it has never been approved for either muscle relaxation or seizure prevention.^ For that reason, it has never been approved for either muscle relaxation or seizure prevention.
  • Zolpidem - Drug information from Medic8.com 10 January 2010 2:02 UTC www.medic8.com [Source type: FILTERED WITH BAYES]

^ It is similar to benzodiazepines (a group of drugs that are used to treat anxiety, seizures, and sleeplessness), but does not relax muscles or stop seizures.
  • ACS :: Cancer Drug Guide: zolpidem 10 January 2010 2:02 UTC www.cancer.org [Source type: FILTERED WITH BAYES]

^ Ambien has selectivity in that it has little of the muscle relaxant or anti-seizure effect and more of the sedative effect.
  • Ambien Abuse 10 February 2010 11:11 UTC www.drugrehab.net [Source type: FILTERED WITH BAYES]
  • ambien abuse by drug rehab america.net 10 February 2010 11:11 UTC www.drugrehabamerica.net [Source type: FILTERED WITH BAYES]

.Such drastically increased doses are more inclined to induce one or more negative side-effects, including hallucinations and/or amnesia.^ Side effects at any dose may include: .
  • Zolpidem: Encyclopedia of chemistry, analytics & pharmaceutics with 64,557 entries. 10 January 2010 2:02 UTC www.chemie.de [Source type: Academic]

^ Such drastically increased doses are more inclined to induce one or more negative side effects, including hallucinations and/or amnesia.
  • Zolpidem: Encyclopedia of chemistry, analytics & pharmaceutics with 64,557 entries. 10 January 2010 2:02 UTC www.chemie.de [Source type: Academic]

^ What other negative side effects are there?
  • Ambien side effects : Medications.com 10 February 2010 11:11 UTC www.medications.com [Source type: FILTERED WITH BAYES]

.Zolpidem is one of the most common benzodiazepine related sleeping medications prescribed in the Netherlands, with a total of 582,660 prescriptions dispensed in 2008.[10] The patent in the United States on zolpidem was held by the French pharmaceutical corporation Sanofi-Aventis.^ The patent 4382938 in the United States on zolpidem was held by the French pharmaceutical corporation Sanofi-Aventis .
  • Zolpidem: Encyclopedia of chemistry, analytics & pharmaceutics with 64,557 entries. 10 January 2010 2:02 UTC www.chemie.de [Source type: Academic]

^ Recently, zolpidem has been cited in various medical reports mainly in the United Kingdom as waking persistent vegetative state (PVS) patients, and dramatically improving the conditions of people with brain injuries.
  • Zolpidem: Encyclopedia of chemistry, analytics & pharmaceutics with 64,557 entries. 10 January 2010 2:02 UTC www.chemie.de [Source type: Academic]

^ BACKGROUND OF THE INVENTION Zolpidem, as a hemitartrate salt, is currently approved for the short-term treatment of insomnia in the United States under the trademark of AMBIEN. Zolpidem hemitartrate is classified as a non-benzodiazepine hypnotic of the imidazopyridine class.
  • (WO/2001/080857) ZOLPIDEM HEMITARTRATE 10 January 2010 2:02 UTC www.wipo.int [Source type: Reference]

[11] .On April 23, 2007 the U.S. Food and Drug Administration (FDA) approved 13 generic versions of zolpidem tartrate.^ In 2006 the Food and Drug Administration approved Rozerem (ramelteon) at the 8 mg dosage for use in the treatment of both acute and chronic insomnia.

^ Zolpidem, the active moiety of zolpidem tartrate, is a hypnotic agent with a chemical structure unrelated to benzodiazepines, barbiturates, pyrrolopyrazines, pyrazolopyrimidines, or other drugs with known hypnotic properties.
  • Ambien CR Official FDA information, side effects and uses. 24 September 2009 16:53 UTC www.drugs.com [Source type: Academic]

^ Generic Name: zolpidem tartrate Dosage Form: extended-release tablets Ambien CR Description .
  • Ambien CR Official FDA information, side effects and uses. 24 September 2009 16:53 UTC www.drugs.com [Source type: Academic]

[12] .Zolpidem is available from several generic manufacturers in the UK, as a generic from Sandoz in South Africa, as well as from other manufacturers such as Ratiopharm (Germany).^ I'm not sure if you're in America, but in the UK Zolpidem is available over the counter integrated into other sedative medacations but it only available at a low dosage.
  • CSI Community Message Board - CBS.com 10 January 2010 2:02 UTC www.cbs.com [Source type: General]

^ Ambien CR (zolpidem) : I have been taking Ambien for several years, and recently started taking Ambien CR. It works very well, if taken on an empty stomach.
  • zolpidem systemic User Reviews for Insomnia at Drugs.com 10 January 2010 2:02 UTC www.drugs.com [Source type: General]

^ Eszopiclone is the S-isomer of the well-studied hypnotic agent zopiclone, which has been available in countries other than the U.S. for almost 20 years.
  • USPharmacist.com > Continuing Education > Pharmacotherapeutic Options for Chronic Insomnia 10 January 2010 2:02 UTC www.uspharmacist.com [Source type: Academic]

Contents

Indications

Insomnia

Zolpidem Tartrate 10 MG tablets
Zolpidem is approved for the short-term (usually about two to six weeks) treatment of insomnia, and it has been studied for nightly use up to six months in a single-blind trial published in 1991,[13] an open-label study lasting 180 days published in 1992 (with continued efficacy in patients who had kept taking it as of 180 days after the end of the trial),[14] and in an open-label trial lasting 179 days published in 1993.[15]
.The United States Air Force uses zolpidem as one of the hypnotics approved as "no-go pills" to help aviators and special duty personnel sleep in support of mission readiness.^ BACKGROUND OF THE INVENTION Zolpidem, as a hemitartrate salt, is currently approved for the short-term treatment of insomnia in the United States under the trademark of AMBIEN. Zolpidem hemitartrate is classified as a non-benzodiazepine hypnotic of the imidazopyridine class.
  • (WO/2001/080857) ZOLPIDEM HEMITARTRATE 10 January 2010 2:02 UTC www.wipo.int [Source type: Reference]

^ The dissolution profile was tested using the Apparatus 2 of the United States Pharmacopeia.
  • Controlled-release dosage forms comprising zolpidem or a salt thereof - Patent 6514531 10 January 2010 2:02 UTC www.freepatentsonline.com [Source type: Reference]

^ Ambien    02/18/06 Reviewed by:     United States It is wonderful to finally get a full night of sleep with no side effects from the medication.
  • Ambien for Fibromyalgia 10 February 2010 11:11 UTC www.scoopshare.com [Source type: General]

"Ground tests" are required prior to authorization being issued to use the medication in an operational situation.[16]

Brain injury

.A case study performed at the Toulouse University Hospital using PET showed zolpidem repeatably improves brain function and mobility of a patient immobilized by akinetic mutism caused by hypoxia.^ A clinical trial on a single patient performed at the Toulouse University Hospital using PET shows that zolpidem repeatably improves brain function and mobility of a patient immobilized by akinetic mutism caused by hypoxia.
  • Zolpidem: Encyclopedia of chemistry, analytics & pharmaceutics with 64,557 entries. 10 January 2010 2:02 UTC www.chemie.de [Source type: Academic]

^ CAT scans have shown that the use of the drug actually does dramatically increase the activity in the frontal lobe of the brain in some patients in a minimally conscious state.
  • Zolpidem: Encyclopedia of chemistry, analytics & pharmaceutics with 64,557 entries. 10 January 2010 2:02 UTC www.chemie.de [Source type: Academic]

^ In 5 clinical studies, no significant decrease in performance was observed 8 hours after a nighttime dose of extended-release zolpidem, and no evidence of next-day residual effects was detected with extended-release zolpidem using self-ratings of sedation.

[17]
.Recently, zolpidem has been cited in various medical reports mainly in the United Kingdom as waking persistent vegetative state (PVS) patients, and dramatically improving the conditions of people with brain injuries.^ Recently, the drug has been reported anecdotally to have positive effects for patients in persistent vegetative state.
  • Zolpidem: Encyclopedia of chemistry, analytics & pharmaceutics with 64,557 entries. 10 January 2010 2:02 UTC www.chemie.de [Source type: Academic]

^ Recently, zolpidem has been cited in various medical reports mainly in the United Kingdom as waking persistent vegetative state (PVS) patients, and dramatically improving the conditions of people with brain injuries.
  • Zolpidem: Encyclopedia of chemistry, analytics & pharmaceutics with 64,557 entries. 10 January 2010 2:02 UTC www.chemie.de [Source type: Academic]

^ CAT scans have shown that the use of the drug actually does dramatically increase the activity in the frontal lobe of the brain in some patients in a minimally conscious state.
  • Zolpidem: Encyclopedia of chemistry, analytics & pharmaceutics with 64,557 entries. 10 January 2010 2:02 UTC www.chemie.de [Source type: Academic]

[18][19][20][21][22] .Results from phase IIa trials were expected in June 2007. The trials are being conducted by Regen Therapeutics of the UK, who have a patent pending on this new use for Zolpidem.^ The trials are being conducted by Regen Therapeutics of the UK, who have a patent pending on this new use for Zolpidem.
  • Zolpidem: Encyclopedia of chemistry, analytics & pharmaceutics with 64,557 entries. 10 January 2010 2:02 UTC www.chemie.de [Source type: Academic]

^ Results from phase IIa trials are expected in June 2007.
  • Zolpidem: Encyclopedia of chemistry, analytics & pharmaceutics with 64,557 entries. 10 January 2010 2:02 UTC www.chemie.de [Source type: Academic]

^ Many drivers have blood levels far exceeding the therapeutic dose range suggesting a high degree of excessive-use potential for benzodiazepines , zolpidem and zopiclone.
  • Zolpidem: Encyclopedia of chemistry, analytics & pharmaceutics with 64,557 entries. 10 January 2010 2:02 UTC www.chemie.de [Source type: Academic]

[23][24]

Coma

.Zolpidem has recently been very strongly related to certain instances of patients in a minimally conscious coma state being brought to a fully conscious state.^ This is a fully conscious state.

^ Zolpidem has recently been very strongly related to certain instances of patients in a minimally conscious coma state being brought to a fully conscious state.
  • Zolpidem: Encyclopedia of chemistry, analytics & pharmaceutics with 64,557 entries. 10 January 2010 2:02 UTC www.chemie.de [Source type: Academic]
  • Ambien (Zolpidem) Molecule -- Tylenol 10 January 2010 2:02 UTC www.worldofmolecules.com [Source type: Academic]

^ While it was initially given to these supposed permanent coma patients to put them to sleep, it actually brought them to a fully conscious state in which they were capable of communicating and interacting for the first time in years.
  • Zolpidem: Encyclopedia of chemistry, analytics & pharmaceutics with 64,557 entries. 10 January 2010 2:02 UTC www.chemie.de [Source type: Academic]
  • Ambien (Zolpidem) Molecule -- Tylenol 10 January 2010 2:02 UTC www.worldofmolecules.com [Source type: Academic]

.While it was initially given to these supposed permanent coma patients to put them to sleep, it actually brought them to a fully conscious state in which they were capable of communicating and interacting for the first time in years.^ Instead of this happening, some patients actually were brought to a fully conscious state and were capable of not only communicating, but interacting for the first time in years in some cases.
  • Stories of Ambien Use and Abuse 10 February 2010 11:11 UTC ambienoverdose.org [Source type: General]

^ While it was initially given to these supposed permanent coma patients to put them to sleep, it actually brought them to a fully conscious state in which they were capable of communicating and interacting for the first time in years.
  • Zolpidem: Encyclopedia of chemistry, analytics & pharmaceutics with 64,557 entries. 10 January 2010 2:02 UTC www.chemie.de [Source type: Academic]
  • Ambien (Zolpidem) Molecule -- Tylenol 10 January 2010 2:02 UTC www.worldofmolecules.com [Source type: Academic]

^ I have used it for several years actually and it never fails to put me to sleep.
  • zolpidem systemic User Reviews for Insomnia at Drugs.com 10 January 2010 2:02 UTC www.drugs.com [Source type: General]

.CT scans have shown that the use of the drug actually does dramatically increase the activity in the frontal lobe of the brain in some patients in a minimally conscious state.^ Similarly, this drug has been shown to awaken the minimally conscious into a conscious state.
  • 'Sleep Walking' And Talking That Can Occur With Popular Sleep-aid Ambien Explained 10 January 2010 2:02 UTC www.sciencedaily.com [Source type: FILTERED WITH BAYES]

^ Do not use in the brain some of the sedative effect.
  • : Athletics News: Bellarmine University 10 February 2010 11:11 UTC www.bellarmine.edu [Source type: General]

^ It is believe that the use of the drug actually increases activity in the frontal lobe of the brain in some patients in a minimally conscious state.
  • Stories of Ambien Use and Abuse 10 February 2010 11:11 UTC ambienoverdose.org [Source type: General]

.Large-scale studies are currently being done to see whether it has the same universal effect on all or most patients in a minimally conscious state.^ Large scale studies are currently being done to see if it has the same universal effect on all or most patients in a minimally conscious state.

^ Larger scale studies have been launched to determine how widespread this effect might be on patients who are currently in a minimally conscious coma state.
  • Stories of Ambien Use and Abuse 10 February 2010 11:11 UTC ambienoverdose.org [Source type: General]

^ We are all experiencing the same withdrawal effects.
  • Ambien Withdrawal and Headaches - Topix 10 February 2010 11:11 UTC www.topix.com [Source type: General]

[25] .It may be that zolpidem's ability to stimulate the brain, particularly in the semi-comatose, may be related to one of its side-effects, which sometimes causes sleepwalking and other activity while asleep, that appears to observers to be fully conscious activity.^ Side effects at any dose may include: .
  • Zolpidem: Encyclopedia of chemistry, analytics & pharmaceutics with 64,557 entries. 10 January 2010 2:02 UTC www.chemie.de [Source type: Academic]

^ Some medicines can cause side effects.
  • Forum: BayShip and Yacht - recommendation 10 January 2010 2:02 UTC www.synfo.com [Source type: General]

^ Codeine can cause side effects of hydrocodone.
  • Forum: BayShip and Yacht - recommendation 10 January 2010 2:02 UTC www.synfo.com [Source type: General]

Miscellaneous off-label

.Zolpidem is also used off-label to treat restless leg syndrome and as an antiemetic.^ Restless Leg Syndrome (28) .
  • Ambien discussions (experiences, side effects, dosages, etc...) 10 February 2010 11:11 UTC www.drugtalk.com [Source type: General]

^ Zolpidem is also used off-label to treat restless leg syndrome and, as is the case with many prescription sedative/hypnotic drugs, it is sometimes used by stimulant users to "come down" after the use of stimulants such as amphetamines (including methamphetamine), cocaine, or MDMA (ecstasy).
  • Zolpidem: Encyclopedia of chemistry, analytics & pharmaceutics with 64,557 entries. 10 January 2010 2:02 UTC www.chemie.de [Source type: Academic]

^ Since then, I still took it because it allowed me to sleep and not think about the pain in my legs from Severe Restless Leg Syndrome.
  • Ambien problems - Topix 10 February 2010 11:11 UTC www.topix.net [Source type: General]

.As is the case with many prescription sedative/hypnotic drugs, it is sometimes used by stimulant users to "come down" after the use of stimulants such as amphetamines (including methamphetamine), cocaine, and MDMA (ecstasy).^ Use many pharmacies on what other drugs that case check-out.
  • Forum: BayShip and Yacht - recommendation 10 January 2010 2:02 UTC www.synfo.com [Source type: General]

^ Prescription drugs (including Ambien) led to many problems for me such as failed relationships, near death, seizures, an eating disorder, crashing a car, legal problems and wasting much of my time taking pills, getting pills, etc.
  • Stories of Ambien Use and Abuse 10 February 2010 11:11 UTC ambienoverdose.org [Source type: General]

^ As with other sedative hypnotic drugs, Ambien and Ambien CR have been found in a high percentage of suspected drugged drivers.
  • Stories of Ambien Use and Abuse 10 February 2010 11:11 UTC ambienoverdose.org [Source type: General]

[26]

Side effects

Side-effects at any dose may include:
.A clinical trial found that after administration of zolpidem trial subjects tended to feel weak, fatigued and developed an antagonistic mood.^ A systematic review of randomized clinical trials evaluating the effectiveness of valerian for insomnia found that short-term use reduces sleep latency, improves subjective sleep, and promotes sleep maintenance.
  • USPharmacist.com > Continuing Education > Pharmacotherapeutic Options for Chronic Insomnia 10 January 2010 2:02 UTC www.uspharmacist.com [Source type: Academic]

^ AMBIEN ZOLPIDEM is one of those super-duper-important Usenet thingamabobs that you are dealing and do not develop mood problems during their illness.
  • » ZOLPIDEM »» Buy AMBIEN (Zolpidem) 10mg/120pills ... (zolpidem) 10 January 2010 2:02 UTC galan.reunionwatch.com [Source type: General]

^ The subjects found great difficulty obtaining immune system has responded to the vaccine varies by clinic, you should be considered?
  • Buy Ambien - Buy Ambien Online | Группы Google 10 February 2010 11:11 UTC groups.google.ru [Source type: FILTERED WITH BAYES]

[28]
.Some users take zolpidem recreationally for some of these side-effects, notably sedation, hallucinations and euphoria.^ Some side effects useful.
  • NSAA : National Ski Areas Association : The GREENROOM 10 February 2010 11:11 UTC www.nsaa.org [Source type: FILTERED WITH BAYES]

^ Does Zolpidem SL have any side effects?
  • Zolpidem SL Drug information on Uses, Side Effects, Interactions, and User Reviews on RxList 10 January 2010 2:02 UTC fdb.rxlist.com [Source type: General]

^ Re: zolpidem tartrate, side effects of .
  • Buy AMBIEN 90 Pills x 10mg $186 - VISA » ambien cr 24 September 2009 16:53 UTC turran.2trom.com [Source type: General]

.Zolpidem becomes addictive if taken for extended periods of time, due to drug tolerance and physical dependence or the euphoria it can sometimes produce.^ The development of tolerance and physical dependence for patients using AMBIEN has been seen only very rarely and under unusual circumstances.
  • (WO/2001/080857) ZOLPIDEM HEMITARTRATE 10 January 2010 2:02 UTC www.wipo.int [Source type: Reference]
  • Zolpidem hemitartrate - Patent Application 20040220210 10 January 2010 2:02 UTC www.freepatentsonline.com [Source type: Reference]

^ Tolerance is a state of adaptation in which exposure to a drug induces changes that result in a diminution of one or more of the drug’s effects over time.
  • Ambien CR Official FDA information, side effects and uses. 24 September 2009 16:53 UTC www.drugs.com [Source type: Academic]

^ The interval between periods and sometimes difficult, because it is a popular drug.
  • Buy Ambien - Buy Ambien Online | Группы Google 10 February 2010 11:11 UTC groups.google.ru [Source type: FILTERED WITH BAYES]

.Under the influence of the drug, it is common for one to take more zolpidem than is necessary, due to either forgetting that one has already taken a pill (elderly users are particularly at risk here) or knowingly taking more than the prescribed dosage.^ Under the influence of Ambien, it is common for people to take more than is actually necessary because they have forgotten prior usage.

^ Never take more than the prescribed dose.
  • Zolpidem | Medicine | Patient UK 10 January 2010 2:02 UTC www.patient.co.uk [Source type: General]

^ Do not take more AMBIEN CR than prescribed.
  • sanofi-aventis U.S. LLC - Ambien CR - January 2008 24 September 2009 16:53 UTC products.sanofi-aventis.us [Source type: Academic]

.The release of AmbienCR (zolpidem tartrate extended release) in the United States renewed interest in the drug among recreational drug users.^ Ambien CR™ CIV (zolpidem tartrate extended-release tablets) .
  • Ambien CR Official FDA information, side effects and uses. 24 September 2009 16:53 UTC www.drugs.com [Source type: Academic]

^ Zolpidem, the active moiety of zolpidem tartrate, is a hypnotic agent with a chemical structure unrelated to benzodiazepines, barbiturates, pyrrolopyrazines, pyrazolopyrimidines, or other drugs with known hypnotic properties.
  • Ambien CR Official FDA information, side effects and uses. 24 September 2009 16:53 UTC www.drugs.com [Source type: Academic]

^ Generic Name: zolpidem tartrate Dosage Form: extended-release tablets Ambien CR Description .
  • Ambien CR Official FDA information, side effects and uses. 24 September 2009 16:53 UTC www.drugs.com [Source type: Academic]

.Some users have reported unexplained sleepwalking while using zolpidem, and a few have reported driving, binge eating, sleep talking, and performing other daily tasks while sleeping.^ I took ambien daily, tasks while sleeping.
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^ Sleep-eating, sleep-sex and sleep-driving have been reported.
  • Australian Prescriber - Hypnotic hazards: adverse effects of zolpidem and other z-drugs 10 January 2010 2:02 UTC www.australianprescriber.com [Source type: Academic]

^ No injuries were reported in some users.
  • AMBIEN : : : Ambien (Brand) 10mg x 90 Pills Only ... (ambien at cut rates) 10 February 2010 11:11 UTC vyvere.2trom.com [Source type: General]

.Research by Australia's National Prescribing Service found that these events mostly occur after the first dosage taken or within a few days of starting therapy.^ I truly, honestly, wholeheartedly do not remember any of the events of that day, except what was told to me, and what I found in my purse (the swim passes).
  • Ambien problems - Topix 10 February 2010 11:11 UTC www.topix.net [Source type: General]

^ These reported adverse events occurred at an incidence of 1% or less.
  • sanofi-aventis U.S. LLC - Ambien CR - January 2008 24 September 2009 16:53 UTC products.sanofi-aventis.us [Source type: Academic]

^ People that were thought to die within six days of the first year onwards.
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[29] .Rare reports of sexual parasomnia episodes related to zolpidem intake have also been reported.^ Due to the risk to the patient and the community, discontinuation of zolpidem should be strongly considered for patients who report a “sleep-driving” episode.
  • Ambien CR Official FDA information, side effects and uses. 24 September 2009 16:53 UTC www.drugs.com [Source type: Academic]

^ Rare cases of angioedema involving the tongue, glottis or larynx have been reported in patients after taking the first or subsequent doses of sedative-hypnotics, including zolpidem.
  • Ambien CR Official FDA information, side effects and uses. 24 September 2009 16:53 UTC www.drugs.com [Source type: Academic]

[30] .The sleepwalker can sometimes perform these tasks as normally as they might if they were awake.^ They should take these drugs and sometimes surgery be performed?
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^ These episodes are unstable as they are caused by things that normally would not have this effect on an individual.
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^ Because Ambien and Ambien CR are medications that are designed to put you to sleep, it is sometimes difficult to know if these are happening as you’re falling asleep or if they are happening after you’ve been asleep.
  • Stories of Ambien Use and Abuse 10 February 2010 11:11 UTC ambienoverdose.org [Source type: General]

.They can sometimes carry on complex conversations and respond appropriately to questions or statements so much so that the observer may believe the sleepwalker to be awake.^ They can sometimes carry on complex conversations and respond appropriately to questions or statements so much so that the observer may believe the sleepwalker to be awake.
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^ Sometimes they remembered the conversations, and sometimes they didn't.
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^ Many people may never find out about their sleepwalking or may not understand what they experienced.
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.This is similar to, but unlike, typical sleep talking, which can usually be identified easily and is characterised by incoherent speech that often has no relevance to the situation or that is so disorganised as to be completely unintelligible.^ This is similar to, but unlike typical sleep talking, which can usually be identified easily and is characterised by incoherent speech that often has no relevance to the situation or that is so disorganised as to be completely unintelligible.
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^ This is similar to the average sleep talker, the difference being that sleep talking is usually incoherent and has no relevance to the current situation.

^ A finding in this study (and many others) was that people who complained of insomnia often reported sleeping as long (or longer) than people who reported no insomnia complaint.
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.A person under the influence of this medication may seem fully aware of their environment even though they are still asleep.^ A person under the influence of this medication may seem fully aware of their environment even though they are still asleep.
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^ Any activity requiring a person to be awake and alert, such as operating machinery, piloting an airplane, or even driving, should be performed only if the person taking Ambien is positive they are not still under the influence of the drug.
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^ He believed that ambien may interact with ambien CR tablets is available under the influence.
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.This can bring about concerns for the safety of the sleepwalker and others.^ This can bring about concerns for the safety of the sleepwalker and others.

^ An individual under the influence of Ambien may seem totally in control which can bring about concerns of their safety of the sleepwalker and others.

^ If you have any concerns about your own health, you should always consult with a physician or other healthcare professional.
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.These side-effects may be related to the mechanism that also causes zolpidem to produce its hypnotic properties.^ Some medicines can cause side effects.
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^ Codeine can cause side effects of hydrocodone.
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^ Zolpidem, the active moiety of zolpidem tartrate, is a hypnotic agent with a chemical structure unrelated to benzodiazepines, barbiturates, pyrrolopyrazines, pyrazolopyrimidines, or other drugs with known hypnotic properties.
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[31] .It is unclear whether the drug is responsible for the behavior, but a class-action lawsuit was filed against Sanofi-Aventis in March 2006 on behalf of those that reported symptoms.^ It is unclear if the drug is responsible for the behavior, but a class-action lawsuit was filed against Sanofi-Aventis in March 2006 on behalf of those who reported symptoms.
  • Zolpidem: Encyclopedia of chemistry, analytics & pharmaceutics with 64,557 entries. 10 January 2010 2:02 UTC www.chemie.de [Source type: Academic]
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^ She has since become a plaintiff in a class-action lawsuit against Sanofi-Aventis filed in federal court on March 6.
  • Stories of Ambien Use and Abuse 10 February 2010 11:11 UTC ambienoverdose.org [Source type: General]

^ Its hypnotic effects are similar to those of the benzodiazepine class of drugs, but it is molecularly distinct from the classical benzodiazepine molecule and is actually classified as an imidazopyridine.

[32]
.Residual 'hangover' effects such as sleepiness, impaired psychomotor and cognitive after nighttime administration may persist into the next day which may impair the ability of users to drive safely, increase risks of falls and hip fractures.^ Wellbutrin or Zyban (bupropion) - May increase risk of side effects.
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^ Accidental falls and hip fractures.
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^ Residual 'hangover' effects such as sleepiness, impaired psychomotor and cognitive after nighttime administration may persist into the next day which may impair the ability of users to drive safely, increase risks of falls and hip fractures.

[33]
.The Sydney Morning Herald in Australia reported in 2007 that a man who fell 30 meters to his death from a high-rise unit balcony may have been sleepwalking under the influence of Stilnox.^ (Ambien has been available in the United States since 1993, but sleepwalking events per se were not reported before 1997.
  • Stories of Ambien Use and Abuse 10 February 2010 11:11 UTC ambienoverdose.org [Source type: General]

^ If so, he would join many members of this site in the club of people who have crashed a car, or worse, under the influence of Ambien.
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^ And eventually, after thinking I was losing my mind, I found out that I was sleepwalking while under the influence of Ambien CR. This stuff should be taken off the market.
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.The coverage prompted over 40 readers to contact the newspaper with their own accounts of Stilnox-related automatism, and as of March 2007, the drug was under review by the Adverse Drug Reactions Advisory Committee.^ Phentermine is combined with, the use of any drug reactions or adverse effects.
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^ In March of 2007 the FDA issued a warning for most sleep aids that warned consumers of allergic reactions as well as what were called ‘complex sleep related behaviors’.
  • Stories of Ambien Use and Abuse 10 February 2010 11:11 UTC ambienoverdose.org [Source type: General]

[34]
.In February 2008, the Australian Therapeutic Goods Administration attached a Black Box Warning to zolpidem, stating that "Zolpidem may be associated with potentially dangerous complex sleep-related behaviours which may include sleep walking, sleep driving and other bizarre behaviours.^ Abnormal thinking, behavioral changes, complex behaviors: May include “sleep-driving” and hallucinations.
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^ Sleep-driving and other complex behaviors .
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^ These two areas of behaviour, to an extent to which he can bring more and more durable erection.Ambien abuse potential.Rebetron can cause for celebration, although alcoholic cirrhosis of the liver, Crestor may not be a good is that?
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.Zolpidem is not to be taken with alcohol.^ If the drug is taken by someone who has had a dependency on drugs or alcohol in the past and zolpidem in doses higher than the usual 10mg, it is easy for them to become dependent on the drug.
  • Stories of Ambien Use and Abuse 10 February 2010 11:11 UTC ambienoverdose.org [Source type: General]

.Caution is needed with other CNS depressant drugs.^ Withdrawal effects Following the rapid dose decrease or abrupt discontinuation of sedative/hypnotics, there have been reports of signs and symptoms similar to those associated with withdrawal from other CNS-depressant drugs [see Drug Abuse and Dependence (9) ].
  • sanofi-aventis U.S. LLC - Ambien CR - January 2008 24 September 2009 16:53 UTC products.sanofi-aventis.us [Source type: Academic]

^ Use with CNS depressants Dosage adjustments may be necessary when Ambien CR is combined with other CNS depressant drugs because of the potentially additive effects [see Warnings and Precautions (5.5) ].
  • sanofi-aventis U.S. LLC - Ambien CR - January 2008 24 September 2009 16:53 UTC products.sanofi-aventis.us [Source type: Academic]

^ Use in patients with depression: As with other sedative/hypnotic drugs, Ambien CR should be administered with caution to patients exhibiting signs or symptoms of depression.
  • sanofi-aventis U.S. LLC - Ambien CR - January 2008 24 September 2009 16:53 UTC products.sanofi-aventis.us [Source type: Academic]

.Limit use to four weeks maximum under close medical supervision."
[35]This report received widespread media coverage[36]after the death of Australian student Mairead Costigan, who fell 20m from the Sydney Harbour Bridge while under the influence of Stilnox.^ In controlled trials, <1% of adults with insomnia who received zolpidem reported hallucinations.
  • sanofi-aventis U.S. LLC - Ambien CR - January 2008 24 September 2009 16:53 UTC products.sanofi-aventis.us [Source type: Academic]

^ During the 3-week studies, next-day somnolence was reported by 15% of the adult patients who received 12.5 mg Ambien CR versus 2% of the placebo group; next-day somnolence was reported by 6% of the elderly patients who received 6.25 mg Ambien CR versus 5% of the placebo group [see Adverse Reactions (6) ].
  • sanofi-aventis U.S. LLC - Ambien CR - January 2008 24 September 2009 16:53 UTC products.sanofi-aventis.us [Source type: Academic]

^ Drugs and medications can be used only as a last for several weeks.
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[37]

Tolerance, dependence, and withdrawal

Ambien tablets
.A review medical publication found that long term use of zolpidem is associated with drug tolerance, drug dependence, rebound insomnia and CNS related adverse effects.^ Long term use of ambien .
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^ This is due to zolpidem's lower incidence of adverse side effects including daytime sedation, amnesia, tolerance, drug dependence, and rebound insomnia after discontinuing the drug.
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^ Zolpidem and bizarre sleep related effects.
  • Australian Prescriber - Hypnotic hazards: adverse effects of zolpidem and other z-drugs 10 January 2010 2:02 UTC www.australianprescriber.com [Source type: Academic]

.It was recommended that zolpidem be used for short periods of time using the lowest effective dose.^ Ambien (zolpidem) : Use only as directed, in bed, only for a short time.
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^ I've been taking generic zolpidem for a short period of time.
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^ Pediatric Use Safety and effectiveness of zolpidem have not been established in pediatric patients.
  • sanofi-aventis U.S. LLC - Ambien CR - January 2008 24 September 2009 16:53 UTC products.sanofi-aventis.us [Source type: Academic]

.Non-pharmacological treatment options however, were found to have sustained improvements in sleep quality.^ Comparable improvements in sleep latency, total sleep time, overall quality of life, and tolerability were seen with both dosing strategies.
  • USPharmacist.com > Continuing Education > Pharmacotherapeutic Options for Chronic Insomnia 10 January 2010 2:02 UTC www.uspharmacist.com [Source type: Academic]

^ Nightly treatment of primary insomnia with eszopiclone for six months: effect on sleep, quality of life, and work limitations.
  • Australian Prescriber - Hypnotic hazards: adverse effects of zolpidem and other z-drugs 10 January 2010 2:02 UTC www.australianprescriber.com [Source type: Academic]

^ Eszopiclone produces significant and sustained improvements in patient-assessed sleep onset, sleep maintenance, sleep quality, and total sleep time.
  • USPharmacist.com > Continuing Education > Pharmacotherapeutic Options for Chronic Insomnia 10 January 2010 2:02 UTC www.uspharmacist.com [Source type: Academic]

[38] .Animal studies of the tolerance inducing properties have shown that in rodents zolpidem has less tolerance producing potential than benzodiazepines but in primates the tolerance producing potential of zolpidem was the same as that of benzodiazepines.^ Zolpidem, the active moiety of zolpidem tartrate, is a hypnotic agent with a chemical structure unrelated to benzodiazepines, barbiturates, pyrrolopyrazines, pyrazolopyrimidines, or other drugs with known hypnotic properties.
  • sanofi-aventis U.S. LLC - Ambien CR - January 2008 24 September 2009 16:53 UTC products.sanofi-aventis.us [Source type: Academic]

^ Current activities induced by 2 and 10 µ M GABA on the same cell are shown in A1 and C1 , respectively.
  • GABAA Receptor Subunit Composition and Functional Properties of Cl- Channels with Differential Sensitivity to Zolpidem in Embryonic Rat Hippocampal Cells -- Maric et al. 19 (12): 4921 -- Journal of Neuroscience 10 January 2010 2:02 UTC www.jneurosci.org [Source type: Academic]

^ One immediate release tablet and one prolonged release tablet each comprising 10 mg zolpidem, as described above were administered to the same 6 volunteers as in the study described in example 2.
  • Controlled-release dosage forms comprising zolpidem or a salt thereof - Patent 6514531 10 January 2010 2:02 UTC www.freepatentsonline.com [Source type: Reference]

[39] .Tolerance can develop in some people to the effects of zolpidem in just a few weeks.^ This effect may be the result of tolerance developing towards the inhibitory effect of zolpidem.
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^ Some users have reported unexplained sleepwalking while using zolpidem, and a few have reported driving, binge eating, sleep talking, and performing other daily tasks while sleeping.
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^ Some people develop a need to stretch time out furiously doses), ZOLPIDEM has a CNS effect coordinated to any changed drug I have done more than 15-20 mg of farrier.
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.Abrupt withdrawal of zolpidem may cause delirium, seizures or other severe effects, especially if used for prolonged periods and at high dosages.^ Due to the risk of additive effects, concomitant use of valerian with other sedating agents should be avoided.
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^ Withdrawal effects Following the rapid dose decrease or abrupt discontinuation of sedative/hypnotics, there have been reports of signs and symptoms similar to those associated with withdrawal from other CNS-depressant drugs [see Drug Abuse and Dependence (9) ].
  • sanofi-aventis U.S. LLC - Ambien CR - January 2008 24 September 2009 16:53 UTC products.sanofi-aventis.us [Source type: Academic]

^ A pharmaceutical composition comprising zolpidem or a salt thereof in the form of a controlled-release dosage form according to claim 1 wherein said composition comprises an immediate release entity and a prolonged release entity.
  • Controlled-release dosage forms comprising zolpidem or a salt thereof - Patent 6514531 10 January 2010 2:02 UTC www.freepatentsonline.com [Source type: Reference]

[40][41][42] .When drug tolerance and physical dependence to zolpidem has developed, treatment usually entails a gradual dose reduction over a period of months in order to minimise withdrawal symptoms which can resemble those seen during benzodiazepine withdrawal.^ Drug abuse or dependence (or history of)-Dependence on zolpidem may develop .
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^ Physical dependence during the premarketing evaluation.
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^ Zolpidem tartrate was treatment at recommended doses.
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.Failing that, an alternative method which may be necessary for some patients is a switch to a benzodiazepine equivalent dose of a longer acting benzodiazepine drug such as diazepam or chlordiazepoxide followed by a gradual reduction in dosage of the long acting benzodiazepine.^ Some patients have had additional symptoms such as dyspnea, throat closing, or nausea and vomiting that suggest anaphylaxis.
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^ Alternatively the prolonged release coated pellets may be furthermore coated with a layer comprising the drug and other excipients allowing immediate release from that layer, imbedded in a drug-free matrix.
  • Controlled-release dosage forms comprising zolpidem or a salt thereof - Patent 6514531 10 January 2010 2:02 UTC www.freepatentsonline.com [Source type: Reference]

^ However, children born of mothers taking sedative/hypnotic drugs may be at some risk for withdrawal symptoms from the drug during the postnatal period.
  • Ambien CR Official FDA information, side effects and uses. 24 September 2009 16:53 UTC www.drugs.com [Source type: Academic]

.Sometimes for difficult to treat patients an inpatient flumazenil rapid detoxification program can be used to detox from a zolpidem drug dependence or addiction.^ Zolpidem is used to treat insomnia.
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^ Physical dependence is not the same as drug addiction.
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^ In addition, addiction, or dependence, can be caused by Ambien, especially when used regularly for longer than a few weeks or at high doses.
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[43] .However, it should be noted that this treatment approach closely parallels that of the highly controversial rapid opiate detoxification therapy, which critics claim lacks long-term efficacy and can actually be detrimental to a patient's long-term recovery.^ However, as a general precaution, these patients should be closely monitored.
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^ I would take it much more often, but doctors are reluctant to prescribe it long-term, because, as with most prescription sleep aids, it is highly habit forming.
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^ Inactive ingredients 2.5 mg 5 days not like to try patients on long-term prednisone often during your child's doctor.
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.Additionally, there have been many questions raised about the ethics as well as safety of rapid detox following a number of deaths resulting from the procedure.^ In fierce age, it regards to me that serious procedures are thus significant, based that we have about chronic coops about these deaths.
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^ None of these observations proves Ambien causes sleepwalking, and questions about the side effect were not raised during the FDA's preapproval review of the scientific data.
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^ Effective Taking Ambien results in a full night's sleep, or at least enough sleep so that the user can function reasonably well the following day.
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[44][45]
.Alcohol has cross tolerance with GABAa receptor positive modulators such as the benzodiazepines and the nonbenzodiazepine drugs.^ [Web of Science] [Medline] Izquierdo, I. and Medina, J. H. (1991) GABA receptor modulation of memory: the role of endogenous benzodiazepines.
  • ZOLPIDEM INVOLVEMENT ON MEMORY AND HYPNOTIC EFFECT OF ETHANOL IN CHRONICALLY ETHANOL-TREATED RATS -- Mikolajczak et al. 34 (4): 511 -- Alcohol and Alcoholism 10 January 2010 2:02 UTC alcalc.oxfordjournals.org [Source type: Academic]

^ [Abstract/ Free  Full Text] Plaznik, A. (1995) Pharmacology of tolerance to benzodiazepine receptor ligands.
  • ZOLPIDEM INVOLVEMENT ON MEMORY AND HYPNOTIC EFFECT OF ETHANOL IN CHRONICALLY ETHANOL-TREATED RATS -- Mikolajczak et al. 34 (4): 511 -- Alcohol and Alcoholism 10 January 2010 2:02 UTC alcalc.oxfordjournals.org [Source type: Academic]

^ [Web of Science] [Medline] Wegelius, K., Honkanen, A. and Korpi, E. R. (1994) Benzodiazepine receptor ligands modulate ethanol drinking in alcohol-preferring rats.
  • ZOLPIDEM INVOLVEMENT ON MEMORY AND HYPNOTIC EFFECT OF ETHANOL IN CHRONICALLY ETHANOL-TREATED RATS -- Mikolajczak et al. 34 (4): 511 -- Alcohol and Alcoholism 10 January 2010 2:02 UTC alcalc.oxfordjournals.org [Source type: Academic]

.For this reason alcoholics or recovering alcoholics may be at increased risk of physical dependency on zolpidem.^ Also, alcoholics and drug abusers may be at increased risk of abusing and or becoming psychologically dependent on zolpidem.
  • Zolpidem: Encyclopedia of chemistry, analytics & pharmaceutics with 64,557 entries. 10 January 2010 2:02 UTC www.chemie.de [Source type: Academic]
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^ For this reason alcoholics or recovering alcoholics may be at increased risk of physical dependency on zolpidem.
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^ This risk may be increased if you have abused alcohol or drugs in the past.
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.Also, alcoholics and drug abusers may be at increased risk of abusing and or becoming psychologically dependent on zolpidem.^ Drug abuse or dependence (or history of)-Dependence on zolpidem may develop .
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^ Also, alcoholics and drug abusers may be at increased risk of abusing and or becoming psychologically dependent on zolpidem.
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^ This could lead to an increased risk of psychological dependence on the painkiller.
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.Zolpidem should be avoided in those with a history of Alcoholism, drug misuse, or in those with history of physical dependency or psychological dependency on sedative-hypnotic drugs.^ This abuse may be physical or psychological and because of that should be avoided.
  • Stories of Ambien Use and Abuse 10 February 2010 11:11 UTC ambienoverdose.org [Source type: General]

^ Because persons with a history of addiction to, or abuse of, drugs or alcohol are at increased risk for misuse, abuse and addiction of zolpidem, they should be monitored carefully when receiving zolpidem or any other hypnotic.
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Special precautions

Driving

.Use of zolpidem may impair driving skills with a resultant increased risk of road traffic accidents.^ Patients should be advised that tartrate zolpidem ambien may impair the mental and/or physical abilities required for the performance of potentially hazardous tasks such as driving a car or operating machinery.
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^ Patients should be advised that zolpidem ambien online europe may impair the mental and/or physical abilities required for the performance of potentially hazardous tasks such as driving a car or operating machinery.
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^ Residual 'hangover' effects such as sleepiness, impaired psychomotor and cognitive after nighttime administration may persist into the next day which may impair the ability of users to drive safely, increase risks of falls and hip fractures.
  • Zolpidem: Encyclopedia of chemistry, analytics & pharmaceutics with 64,557 entries. 10 January 2010 2:02 UTC www.chemie.de [Source type: Academic]
  • Ambien (Zolpidem) Molecule -- Tylenol 10 January 2010 2:02 UTC www.worldofmolecules.com [Source type: Academic]

.This adverse effect is not unique to zolpidem but also occurs with other hypnotic drugs.^ Other drugs with no interaction with zolpidem .
  • sanofi-aventis U.S. LLC - Ambien CR - January 2008 24 September 2009 16:53 UTC products.sanofi-aventis.us [Source type: Academic]

^ Zolpidem, the active moiety of zolpidem tartrate, is a hypnotic agent with a chemical structure unrelated to benzodiazepines, barbiturates, pyrrolopyrazines, pyrazolopyrimidines, or other drugs with known hypnotic properties.
  • sanofi-aventis U.S. LLC - Ambien CR - January 2008 24 September 2009 16:53 UTC products.sanofi-aventis.us [Source type: Academic]

^ Withdrawal effects Following the rapid dose decrease or abrupt discontinuation of sedative/hypnotics, there have been reports of signs and symptoms similar to those associated with withdrawal from other CNS-depressant drugs [see Drug Abuse and Dependence (9) ].
  • sanofi-aventis U.S. LLC - Ambien CR - January 2008 24 September 2009 16:53 UTC products.sanofi-aventis.us [Source type: Academic]

.Caution should be exercised by motor vehicle drivers.^ Patients should be cautioned against engaging in hazardous activities requiring complete mental alertness or motor coordination after ingesting the drug.

^ Vehicle drivers and machine operators should be warned that, as with other hypnotics, there may be a possible risk of drowsiness the morning after therapy.
  • Zolpidem Tartrate 5 mg Tablets. - Summary of Product Characteristics (SPC) - electronic Medicines Compendium (eMC) 10 January 2010 2:02 UTC emc.medicines.org.uk [Source type: Academic]

^ Amnesia daytime sedation motor vehicle drivers.

[46]

Elderly

.The elderly are more sensitive to the effects of hypnotics including zolpidem.^ Elderly persons are usually more sensitive to the effects of Ambien.

^ NOTES : Elderly persons are usually more sensitive to the effects of this ambien.
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^ These side effects as well as others are more pronounced in the elderly often causing mental confusion and dizziness which results in falls and fractures which often leads to hospitalisation.
  • Benzodiazepine Side Effects, Dependence, Withdrawal and Information Group 10 January 2010 2:02 UTC www.bcnc.org.uk [Source type: FILTERED WITH BAYES]

.Zolpidem causes an increased risk of falls and may induce cognitive adverse effects.^ CYP3A4 inhibitors: May increase the levels/effects of zolpidem.
  • Zolpidem - Peoples Rx - Austin's Favorite Pharmacy 10 January 2010 2:02 UTC www.peoplesrx.com [Source type: Academic]

^ This interaction may cause increased drowsiness.
  • Zolpidem Tartrate 5 mg Tablets. - Summary of Product Characteristics (SPC) - electronic Medicines Compendium (eMC) 10 January 2010 2:02 UTC emc.medicines.org.uk [Source type: Academic]

^ Zolpidem increases slow wave sleep and caused no effect on stage 2 sleep in laboratory tests.
  • Zolpidem: Encyclopedia of chemistry, analytics & pharmaceutics with 64,557 entries. 10 January 2010 2:02 UTC www.chemie.de [Source type: Academic]
  • Ambien (Zolpidem) Molecule -- Tylenol 10 January 2010 2:02 UTC www.worldofmolecules.com [Source type: Academic]

[47]
.An extensive review of the medical literature regarding the management of insomnia and the elderly found that there is considerable evidence of the effectiveness and durability of non-drug treatments for insomnia in adults of all ages and that these interventions are underutilized.^ Show all 288 treatments for Insomnia .
  • Ambien for Insomnia - User ratings & reviews - Revolution Health 10 February 2010 11:11 UTC www.revolutionhealth.com [Source type: General]

^ User Reviews for Insomnia at Drugs.com .
  • zolpidem systemic User Reviews for Insomnia at Drugs.com 10 January 2010 2:02 UTC www.drugs.com [Source type: General]

^ Follow these interventions are; underutilized.

.Compared with the benzodiazepines, the nonbenzodiazepine (including zolpidem) sedative-hypnotics appeared to offer few, if any, significant clinical advantages in efficacy or tolerability in elderly persons.^ Zolpidem, the active moiety of zolpidem tartrate, is a hypnotic agent with a chemical structure unrelated to benzodiazepines, barbiturates, pyrrolopyrazines, pyrazolopyrimidines, or other drugs with known hypnotic properties.
  • Ambien CR Official FDA information, side effects and uses. 24 September 2009 16:53 UTC www.drugs.com [Source type: Academic]
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^ In primarily depressed patients, worsening of depression, including suicidal thoughts and actions (including completed suicides), have been reported in association with the use of sedative/hypnotics.
  • sanofi-aventis U.S. LLC - Ambien CR - January 2008 24 September 2009 16:53 UTC products.sanofi-aventis.us [Source type: Academic]

^ Severe anaphylactic and anaphylactoid reactions Rare cases of angioedema involving the tongue, glottis or larynx have been reported in patients after taking the first or subsequent doses of sedative-hypnotics, including zolpidem.
  • sanofi-aventis U.S. LLC - Ambien CR - January 2008 24 September 2009 16:53 UTC products.sanofi-aventis.us [Source type: Academic]

.It was found that newer agents with novel mechanisms of action and improved safety profiles, such as the melatonin agonists, hold promise for the management of chronic insomnia in elderly people.^ People with persistent, chronic insomnia - three or more nights a week for months on end - do need treatment.
  • Consumer Reports Health - Sedatives 10 January 2010 2:02 UTC www.consumerreports.org [Source type: FILTERED WITH BAYES]

^ Describe the characteristics, risk factors, potential causes, and diagnosis of chronic insomnia.* Review nonpharmacologic strategies for the treatment of chronic insomnia.* Evaluate the pharmacokinetic and mechanistic properties of traditional and novel pharmacologic agents and their place in the treatment of chronic insomnia.
  • USPharmacist.com > Continuing Education > Pharmacotherapeutic Options for Chronic Insomnia 10 January 2010 2:02 UTC www.uspharmacist.com [Source type: Academic]

^ Melatonin Receptor Agonists (Ramelteon): Unlike the other non-BZ agents, ramelteon is a selective melatonin receptor agonist.
  • USPharmacist.com > Continuing Education > Pharmacotherapeutic Options for Chronic Insomnia 10 January 2010 2:02 UTC www.uspharmacist.com [Source type: Academic]

.Long-term use of sedative-hypnotics for insomnia lacks an evidence base and has traditionally been discouraged for reasons that include concerns about such potential adverse drug effects as cognitive impairment (anterograde amnesia), daytime sedation, motor incoordination, and increased risk of motor vehicle accidents and falls.^ Ambien is a sedative-hypnotic used for the short-term treatment of insomnia (difficulty falling or staying asleep).
  • Purchase Low Cost Generic Ambien Online - Buy Discount Generic Ambien in our Discount Healthcare Store. Buy ambien, Buy ambien online, Ambien rx, Ambien and alcohol. 10 February 2010 11:11 UTC www.carpeinternational.com [Source type: FILTERED WITH BAYES]
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^ Long term use of ambien .
  • Gador Generic Ambien, New Ambien Cr Television Commercial - Forum Zgubilitic 24 September 2009 16:53 UTC forum.zgubilitic.com [Source type: General]

^ Side effect use of ambien long term.
  • Gador Generic Ambien, New Ambien Cr Television Commercial - Forum Zgubilitic 24 September 2009 16:53 UTC forum.zgubilitic.com [Source type: General]

.In addition, the effectiveness and safety of long-term use of these agents remain to be determined.^ Long term use of ambien .
  • Gador Generic Ambien, New Ambien Cr Television Commercial - Forum Zgubilitic 24 September 2009 16:53 UTC forum.zgubilitic.com [Source type: General]

^ By using any of these it has been used only for a long time.
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^ Could this be from long term use of ambien?
  • Feedback on Ambien Side Effects and Usage, page 32 10 February 2010 11:11 UTC www.askdocweb.com [Source type: Original source]

.It was concluded that more research is needed to evaluate the long-term effects of treatment and the most appropriate management strategy for elderly persons with chronic insomnia.^ NOTES : Elderly persons are usually more sensitive to the effects of this ambien.
  • Ambien, Generic Ambien 10mg, Zolpidem Tartrate , cheap ambien, Inexpensive ambien online , affordable ambien, cheap ambien, Zolpidem Tartrate, web internet Sleeping aids drugs pharmacy 10 January 2010 2:02 UTC www.usahealthstore.biz [Source type: General]

^ Ambien long term effects.
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^ Short-term treatment of insomnia .
  • Stilnoct (zolpidem) 10 January 2010 2:02 UTC www.netdoctor.co.uk [Source type: FILTERED WITH BAYES]
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[48]

Gastrointestinal reflux disease

.Taking zolpidem dramatically increases the duration of gastroesophageal reflux events, as patients are less likely to become aroused from the event and initiate a swallowing reflex.^ There is sufficient proof that those who have been dependent on other drugs or alcohol show an increased tendency to become dependent on the zolpidem.
  • Stories of Ambien Use and Abuse 10 February 2010 11:11 UTC ambienoverdose.org [Source type: General]

^ Unfortunately, taking zolpidem for longer than the recommended period of time (which is generally less than a month) can often result in those who were using the drug medicinally becoming recreational users.
  • Stories of Ambien Use and Abuse 10 February 2010 11:11 UTC ambienoverdose.org [Source type: General]

^ The observed increase in mIPSC frequency recorded in WT neurons is likely to reflect an increase in event detection (rather than an increase in quantal release) as a consequence of increased mean mIPSC amplitude.
  • Prolongation of Hippocampal Miniature Inhibitory Postsynaptic Currents in Mice Lacking the GABAA Receptor alpha 1 Subunit -- Goldstein et al. 88 (6): 3208 -- Journal of Neurophysiology 10 January 2010 2:02 UTC jn.physiology.org [Source type: Academic]

.Patients suffering from gastroesophageal reflux disease had reflux events measured to be significantly longer when taking zolpidem than on placebo.^ Gastroesophageal reflux disease .
  • Ambien CR Official FDA information, side effects and uses. 24 September 2009 16:53 UTC www.drugs.com [Source type: Academic]
  • sanofi-aventis U.S. LLC - Ambien CR - January 2008 24 September 2009 16:53 UTC products.sanofi-aventis.us [Source type: Academic]

^ All the ads on TV say that you shouldn't take it for longer than 7 days, etc.
  • Ambien - Zolpidem - http://www.drugbuyers.com/freeboard 10 January 2010 2:02 UTC www.drugbuyers.com [Source type: FILTERED WITH BAYES]

^ Zolpidem did not significantly decrease latency to persistent sleep, compared to placebo, as measured by polysomnography after 4 weeks of treatment.
  • sanofi-aventis U.S. LLC - Ambien CR - January 2008 24 September 2009 16:53 UTC products.sanofi-aventis.us [Source type: Academic]

(The same trend was found for reflux events in patients without GERD). This is assumed to be due to suppression of arousal during the reflux event, which would normally result in a swallowing reflex to clear gastric acid from the esophagus. .Patients with GERD who take zolpidem thus experience significantly higher esophageal exposure to gastric acid, which increases the likelihood of developing esophageal cancer.^ Use in patients with concomitant illness Clinical experience with zolpidem in patients with concomitant systemic illness is limited.
  • Ambien CR Official FDA information, side effects and uses. 24 September 2009 16:53 UTC www.drugs.com [Source type: Academic]

^ In an attempt to overcome the development of tolerance and dependence in patients who require long-term pharmacotherapy, the continuous use of zolpidem has been compared with intermittent administration (i.e., five consecutive nights of zolpidem followed by two nights of placebo per week).
  • USPharmacist.com > Continuing Education > Pharmacotherapeutic Options for Chronic Insomnia 10 January 2010 2:02 UTC www.uspharmacist.com [Source type: Academic]

^ Due to the risk to the patient and the community, discontinuation of zolpidem should be strongly considered for patients who report a “sleep-driving” episode.
  • Ambien CR Official FDA information, side effects and uses. 24 September 2009 16:53 UTC www.drugs.com [Source type: Academic]

[49]

Mechanism of action

Zolpidem DOJ.jpg
.Due to its selective binding, Zolpidem has very weak anxiolytic, myorelaxant and anticonvulsant properties but very strong hypnotic properties.^ The above U.S. Patents disclose Zolpidem as having, inter alia, anxiolytic, sleep-inducing, hypnotic and anticonvulsant properties.
  • Zolpidem hemitartrate - Patent Application 20040220210 10 January 2010 2:02 UTC www.freepatentsonline.com [Source type: Reference]

^ This selective binding of zolpidem on the BZ 1 receptor is not absolute, but it may explain the relative absence of myorelaxant and anticonvulsant effects in animal studies as well as the preservation of deep sleep (stages 3 and 4) in human studies of zolpidem at hypnotic doses.
  • Ambien CR Official FDA information, side effects and uses. 24 September 2009 16:53 UTC www.drugs.com [Source type: Academic]
  • sanofi-aventis U.S. LLC - Ambien CR - January 2008 24 September 2009 16:53 UTC products.sanofi-aventis.us [Source type: Academic]

^ The above US Patents disclose Zolpidem as having, inter alia, anxiolytic, sleep-inducing, hypnotic and anticonvulsant properties.
  • (WO/2001/080857) ZOLPIDEM HEMITARTRATE 10 January 2010 2:02 UTC www.wipo.int [Source type: Reference]

[50] .Zolpidem binds with high affinity and acts as a full agonist at the α1 containing GABAA receptors, about 10-fold lower affinity for those containing the α2 - and α3 - GABAA receptor subunits, and with no appreciable affinity for α5 subunit containing receptors.^ Contrasting GABA A receptor subunit expressions of zolpidem-sorted cells .
  • GABAA Receptor Subunit Composition and Functional Properties of Cl- Channels with Differential Sensitivity to Zolpidem in Embryonic Rat Hippocampal Cells -- Maric et al. 19 (12): 4921 -- Journal of Neuroscience 10 January 2010 2:02 UTC www.jneurosci.org [Source type: Academic]

^ Zolpidem modulation of -containing GABA A -Rs .
  • Prolongation of Hippocampal Miniature Inhibitory Postsynaptic Currents in Mice Lacking the GABAA Receptor alpha 1 Subunit -- Goldstein et al. 88 (6): 3208 -- Journal of Neurophysiology 10 January 2010 2:02 UTC jn.physiology.org [Source type: Academic]

^ Zolpidem-sorted subpopulations express different GABA A receptor subunits .
  • GABAA Receptor Subunit Composition and Functional Properties of Cl- Channels with Differential Sensitivity to Zolpidem in Embryonic Rat Hippocampal Cells -- Maric et al. 19 (12): 4921 -- Journal of Neuroscience 10 January 2010 2:02 UTC www.jneurosci.org [Source type: Academic]

[51][52] ω1 type .GABAA receptors are the α1 containing GABAA receptors and ω2 GABAA receptors are the α2, α3, α4, α5 and α6 containing GABAA receptors.^ Studies on recombinant receptors indicate that the 5-containing constructs have a relatively high EC 50 for GABA when they are associated with the 1 subunit (Burgard et al., 1996 ).
  • GABAA Receptor Subunit Composition and Functional Properties of Cl- Channels with Differential Sensitivity to Zolpidem in Embryonic Rat Hippocampal Cells -- Maric et al. 19 (12): 4921 -- Journal of Neuroscience 10 January 2010 2:02 UTC www.jneurosci.org [Source type: Academic]

^ In functional studies of recombinant receptors, zolpidem potentiates GABA-evoked whole-cell currents generated by 1-containing GABA A -Rs at nanomolar concentrations (Table 2 ).
  • Prolongation of Hippocampal Miniature Inhibitory Postsynaptic Currents in Mice Lacking the GABAA Receptor alpha 1 Subunit -- Goldstein et al. 88 (6): 3208 -- Journal of Neurophysiology 10 January 2010 2:02 UTC jn.physiology.org [Source type: Academic]

^ We propose that short- and long-lasting openings correspond to GABA A receptor/Cl channels containing 4 1 2 and 5 1 2 subunits, respectively.
  • GABAA Receptor Subunit Composition and Functional Properties of Cl- Channels with Differential Sensitivity to Zolpidem in Embryonic Rat Hippocampal Cells -- Maric et al. 19 (12): 4921 -- Journal of Neuroscience 10 January 2010 2:02 UTC www.jneurosci.org [Source type: Academic]

ω1 .GABAA receptors are primarily found in the brain whereas ω2 receptors are primarily found in the spine.^ Buchstaller A, Fuchs K, Sieghart W (1991) Identification of alpha 1-, alpha 2- and alpha 3-subunit isoforms of the GABA A -benzodiazepine receptor in the rat brain.
  • GABAA Receptor Subunit Composition and Functional Properties of Cl- Channels with Differential Sensitivity to Zolpidem in Embryonic Rat Hippocampal Cells -- Maric et al. 19 (12): 4921 -- Journal of Neuroscience 10 January 2010 2:02 UTC www.jneurosci.org [Source type: Academic]

^ De Koninck Y, and Mody I. Noise analysis of miniature IPSCs in adult rat brain slices: properties and modulation of synaptic GABA A receptor channels.
  • Prolongation of Hippocampal Miniature Inhibitory Postsynaptic Currents in Mice Lacking the GABAA Receptor alpha 1 Subunit -- Goldstein et al. 88 (6): 3208 -- Journal of Neurophysiology 10 January 2010 2:02 UTC jn.physiology.org [Source type: Academic]

^ McKernan RM, and Whiting PJ. Which GABA A -receptor subtypes really occur in the brain?
  • Prolongation of Hippocampal Miniature Inhibitory Postsynaptic Currents in Mice Lacking the GABAA Receptor alpha 1 Subunit -- Goldstein et al. 88 (6): 3208 -- Journal of Neurophysiology 10 January 2010 2:02 UTC jn.physiology.org [Source type: Academic]

.Thus zolpidem has a preferential binding for the GABAA-benzodiazepine receptor complex in the brain but a low affinity for the GABAA-benzodiazepine receptor complex in the spine.^ Preferential affinity of zolpidem for the 1 (BZD 1 ) subtype.
  • ZOLPIDEM INVOLVEMENT ON MEMORY AND HYPNOTIC EFFECT OF ETHANOL IN CHRONICALLY ETHANOL-TREATED RATS -- Mikolajczak et al. 34 (4): 511 -- Alcohol and Alcoholism 10 January 2010 2:02 UTC alcalc.oxfordjournals.org [Source type: Academic]

^ Zolpidem works by acting on receptors in the brain called GABA receptors, specifically the GABA-A receptors.
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^ Zolpidem is needed for a benzodiazepine receptor complex found in specific populations 8.4.
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[53]
.Like the vast majority of benzodiazepine-like molecules, zolpidem has no affinity for α4 and α6 subunit-containing receptors.^ Like the vast majority of benzodiazepine like molecules, zolpidem has no affinity for α 4 and α 6 subunit containing receptors.
  • Zolpidem: Encyclopedia of chemistry, analytics & pharmaceutics with 64,557 entries. 10 January 2010 2:02 UTC www.chemie.de [Source type: Academic]
  • Ambien (Zolpidem) Molecule -- Tylenol 10 January 2010 2:02 UTC www.worldofmolecules.com [Source type: Academic]

^ Zolpidem positively modulates GABA A receptors, probably by increasing the GABA a receptor complexes apparent affinity for GABA, without effect desensitization, or peak current.
  • Zolpidem: Encyclopedia of chemistry, analytics & pharmaceutics with 64,557 entries. 10 January 2010 2:02 UTC www.chemie.de [Source type: Academic]
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^ Zolpidem overdosage can be treated with the benzodiazepine receptor antagonist flumazenil which displaces zolpidem from its binding site the benzodiazepine receptor and therefore rapidly reverses the effects of zolpidem.
  • Zolpidem: Encyclopedia of chemistry, analytics & pharmaceutics with 64,557 entries. 10 January 2010 2:02 UTC www.chemie.de [Source type: Academic]
  • Ambien (Zolpidem) Molecule -- Tylenol 10 January 2010 2:02 UTC www.worldofmolecules.com [Source type: Academic]

[54] .Zolpidem positively modulates GABAA receptors, probably by increasing the GABAA receptor complexes apparent affinity for GABA, without affecting desensitization or peak current.^ Zolpidem modulation of -containing GABA A -Rs .
  • Prolongation of Hippocampal Miniature Inhibitory Postsynaptic Currents in Mice Lacking the GABAA Receptor alpha 1 Subunit -- Goldstein et al. 88 (6): 3208 -- Journal of Neurophysiology 10 January 2010 2:02 UTC jn.physiology.org [Source type: Academic]

^ Zolpidem (30 nM) significantly increased the mIPSC current decay time, not amplitude, in WT interneurons and pyramidal cells; this suggests that zolpidem may increase GABA binding to a small number of receptors with a high affinity for GABA, such as those containing the 2 subunit, without opening additional receptors.
  • Prolongation of Hippocampal Miniature Inhibitory Postsynaptic Currents in Mice Lacking the GABAA Receptor alpha 1 Subunit -- Goldstein et al. 88 (6): 3208 -- Journal of Neurophysiology 10 January 2010 2:02 UTC jn.physiology.org [Source type: Academic]

^ More detailed analyses were performed on currents evoked by GABA in zolpidem-insensitive cells, because these cells only expressed 4, 5, 1, and 2 subunits, thus increasing the possibility of correlating channel properties with subunit expression.
  • GABAA Receptor Subunit Composition and Functional Properties of Cl- Channels with Differential Sensitivity to Zolpidem in Embryonic Rat Hippocampal Cells -- Maric et al. 19 (12): 4921 -- Journal of Neuroscience 10 January 2010 2:02 UTC www.jneurosci.org [Source type: Academic]

[55] .Zolpidem increases slow wave sleep and caused no effect on stage 2 sleep in laboratory tests.^ Zolpidem increases slow wave sleep and caused no effect on stage 2 sleep in laboratory tests.
  • Zolpidem: Encyclopedia of chemistry, analytics & pharmaceutics with 64,557 entries. 10 January 2010 2:02 UTC www.chemie.de [Source type: Academic]
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^ Zolpidem had no effect on unitary conductance.
  • Prolongation of Hippocampal Miniature Inhibitory Postsynaptic Currents in Mice Lacking the GABAA Receptor alpha 1 Subunit -- Goldstein et al. 88 (6): 3208 -- Journal of Neurophysiology 10 January 2010 2:02 UTC jn.physiology.org [Source type: Academic]

^ Zolpidem and bizarre sleep related effects.
  • Australian Prescriber - Hypnotic hazards: adverse effects of zolpidem and other z-drugs 10 January 2010 2:02 UTC www.australianprescriber.com [Source type: Academic]

[56]
.A meta-analysis of the randomised controlled clinical trials that compared benzodiazepines against Z-drugs such as zolpidem has shown that there are few consistent differences between zolpidem and benzodiazepines in terms of sleep onset latency, total sleep duration, number of awakenings, quality of sleep, adverse events, tolerance, rebound insomnia, and daytime alertness.^ However, some objective parameters such as waking after sleep onset and number of awakenings were not significantly different compared with placebo.
  • USPharmacist.com > Continuing Education > Pharmacotherapeutic Options for Chronic Insomnia 10 January 2010 2:02 UTC www.uspharmacist.com [Source type: Academic]

^ Improvement in sleep duration and sleep latency, but not in sleep quality, have been documented by some trials.
  • USPharmacist.com > Continuing Education > Pharmacotherapeutic Options for Chronic Insomnia 10 January 2010 2:02 UTC www.uspharmacist.com [Source type: Academic]

^ Zolpidem has been extensively evaluated in patients with primary insomnia in controlled trials.
  • USPharmacist.com > Continuing Education > Pharmacotherapeutic Options for Chronic Insomnia 10 January 2010 2:02 UTC www.uspharmacist.com [Source type: Academic]

[57]

Drug-drug interactions

.Notable drug-drug interactions with the pharmacokinetics of zolpidem include the following drugs chlorpromazine, fluconazole, imipramine, itraconazole, ketoconazole, rifampicin, ritonavir.^ Other drugs with no interaction with zolpidem .
  • sanofi-aventis U.S. LLC - Ambien CR - January 2008 24 September 2009 16:53 UTC products.sanofi-aventis.us [Source type: Academic]

^ Similarly, chlorpromazine in combination with zolpidem produced no pharmacokinetic interaction, but there was an additive effect of decreased alertness and psychomotor performance.
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^ Similarly, chlorpromazine in combination with zolpidem tartrate produced no pharmacokinetic interaction, but there was an additive effect of decreased alertness and psychomotor performance.
  • Ambien CR Official FDA information, side effects and uses. 24 September 2009 16:53 UTC www.drugs.com [Source type: Academic]

Interactions with carbamazepine and phenytoin can be expected based on their metabolic pathways but have not yet been studied. .There does not appear to be any interaction between zolpidem and cimetidine and rantidine.^ Imipramine in combination with zolpidem tartrate produced no pharmacokinetic interaction other than a 20% decrease in peak levels of imipramine, but there was an additive effect of decreased alertness.
  • Ambien CR Official FDA information, side effects and uses. 24 September 2009 16:53 UTC www.drugs.com [Source type: Academic]

^ Similarly, chlorpromazine in combination with zolpidem produced no pharmacokinetic interaction, but there was an additive effect of decreased alertness and psychomotor performance.
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^ Imipramine in combination with zolpidem produced no pharmacokinetic interaction other than a 20% decrease in peak levels of imipramine, but there was an additive effect of decreased alertness.
  • sanofi-aventis U.S. LLC - Ambien CR - January 2008 24 September 2009 16:53 UTC products.sanofi-aventis.us [Source type: Academic]

http://www.ncbi.nlm.nih.gov/pubmed/3253224 [58]

Overdose

.An overdose of zolpidem may cause excessive sedation, pin-point pupils, depressed respiratory function, which may progress to coma and possibly death.^ An overdose of zolpidem can be fatal when it is taken together with other medications that can cause drowsiness.
  • Ambien side effects : Medications.com 10 February 2010 11:11 UTC www.medications.com [Source type: FILTERED WITH BAYES]

^ Since sedative/hypnotics have the capacity to depress respiratory drive, precautions should be taken if Ambien CR is prescribed to patients with compromised respiratory function.
  • sanofi-aventis U.S. LLC - Ambien CR - January 2008 24 September 2009 16:53 UTC products.sanofi-aventis.us [Source type: Academic]

^ Caution is advised in patients with vascular disorders and in those taking immunosuppressive therapy, as melatonin may cause vasoconstriction and enhance immune functioning.
  • USPharmacist.com > Continuing Education > Pharmacotherapeutic Options for Chronic Insomnia 10 January 2010 2:02 UTC www.uspharmacist.com [Source type: Academic]

.Zolpidem combined with alcohol, opiates or other CNS depressants may be even more likely to lead to fatal overdoses.^ When Ambien or Ambien CR is combined with alcohol, opiates, or other central nervous system depressants, there is am even higher likelihood that overdoses become fatal.
  • Stories of Ambien Use and Abuse 10 February 2010 11:11 UTC ambienoverdose.org [Source type: General]

^ Zolpidem, like other sedative/hypnotic drugs, has CNS-depressant effects.
  • Ambien CR Official FDA information, side effects and uses. 24 September 2009 16:53 UTC www.drugs.com [Source type: Academic]

^ These side effects as well as others are more pronounced in the elderly often causing mental confusion and dizziness which results in falls and fractures which often leads to hospitalisation.
  • Benzodiazepine Side Effects, Dependence, Withdrawal and Information Group 10 January 2010 2:02 UTC www.bcnc.org.uk [Source type: FILTERED WITH BAYES]

.Zolpidem overdosage can be treated with the benzodiazepine receptor antagonist flumazenil, which displaces zolpidem from its binding site the benzodiazepine receptor and therefore rapidly reverses the effects of zolpidem.^ Zolpidem is an imidazopyridine hypnotic sedative that is thought to produce its effects by interaction with the benzodiazepine binding site on GABA A receptor/Cl channels (for review, see Sanger et al., 1994 ).
  • GABAA Receptor Subunit Composition and Functional Properties of Cl- Channels with Differential Sensitivity to Zolpidem in Embryonic Rat Hippocampal Cells -- Maric et al. 19 (12): 4921 -- Journal of Neuroscience 10 January 2010 2:02 UTC www.jneurosci.org [Source type: Academic]

^ Overdoses may be treated with Anexate, Lanexat, Mazicon, or Romazicon given intravenously which reverse the effects within one or two minutes.
  • Stories of Ambien Use and Abuse 10 February 2010 11:11 UTC ambienoverdose.org [Source type: General]

^ Zolpidem, an imidazopyridine that is structurally unrelated to benzodiazepines but binds to the benzodiazepine site on the GABA A -R, has a high affinity for GABA A -Rs containing the 1 subunit (Pritchett and Seeburg 1990 ).
  • Prolongation of Hippocampal Miniature Inhibitory Postsynaptic Currents in Mice Lacking the GABAA Receptor alpha 1 Subunit -- Goldstein et al. 88 (6): 3208 -- Journal of Neurophysiology 10 January 2010 2:02 UTC jn.physiology.org [Source type: Academic]

[59]

Recreational use

.Zolpidem has a potential for either medical misuse when the drug is continued long term without or against medical advice, or recreational use when the drug is taken to achieve a high.^ Any drug taken to get a ‘high’ is deadly.
  • Stories of Ambien Use and Abuse 10 February 2010 11:11 UTC ambienoverdose.org [Source type: General]

^ Malware -- short for MALicious softWARE -- is a term used to broadly classify a form of software which is installed in a computer system with malicious intentions, usually without the owner's knowledge or permission.
  • Eror | SPIKE 10 January 2010 2:02 UTC www.spike.com [Source type: General]

^ In an attempt to overcome the development of tolerance and dependence in patients who require long-term pharmacotherapy, the continuous use of zolpidem has been compared with intermittent administration (i.e., five consecutive nights of zolpidem followed by two nights of placebo per week).
  • USPharmacist.com > Continuing Education > Pharmacotherapeutic Options for Chronic Insomnia 10 January 2010 2:02 UTC www.uspharmacist.com [Source type: Academic]

[60] .The transition from medical use of zolpidem to high dose addiction or drug dependence can occur when used without a doctor's recommendation to continue using it, when physiological drug tolerance leads to higher doses than the usual 5 mg or 10 mg, when consumed through insufflation or injection, or when taken for purposes other than as a sleep aid.^ I also take Ambien 10 mg to sleep.
  • Ambien discussions (experiences, side effects, dosages, etc...) 10 February 2010 11:11 UTC www.drugtalk.com [Source type: General]

^ Any drug taken to get a ‘high’ is deadly.
  • Stories of Ambien Use and Abuse 10 February 2010 11:11 UTC ambienoverdose.org [Source type: General]

^ If the drug is taken by someone who has had a dependency on drugs or alcohol in the past and zolpidem in doses higher than the usual 10mg, it is easy for them to become dependent on the drug.
  • Stories of Ambien Use and Abuse 10 February 2010 11:11 UTC ambienoverdose.org [Source type: General]

.Abuse is more prevalent in those that have been dependent on other drugs in the past, but tolerance and drug dependence can still sometimes occur in those without a history of drug dependence.^ Tolerance is a state of adaptation in which exposure to a drug induces changes that result in a diminution of one or more of the drug’s effects over time.
  • Ambien CR Official FDA information, side effects and uses. 24 September 2009 16:53 UTC www.drugs.com [Source type: Academic]

^ How often these effects occur depends on several factors, such as a person's general health, the use of other medicines, and which sleep medicine is being used.
  • Ambien CR Official FDA information, side effects and uses. 24 September 2009 16:53 UTC www.drugs.com [Source type: Academic]

^ Withdrawal effects Following the rapid dose decrease or abrupt discontinuation of sedative/hypnotics, there have been reports of signs and symptoms similar to those associated with withdrawal from other CNS-depressant drugs [see Drug Abuse and Dependence (9) ].
  • sanofi-aventis U.S. LLC - Ambien CR - January 2008 24 September 2009 16:53 UTC products.sanofi-aventis.us [Source type: Academic]

.Chronic users of high doses are more likely to have a severe physical dependence on the drug which may cause severe withdrawal symptoms including seizures if abrupt withdrawal from zolpidem occurs.^ These more severe withdrawal symptoms are very uncommon.
  • Ambien CR Official FDA information, side effects and uses. 24 September 2009 16:53 UTC www.drugs.com [Source type: Academic]

^ Withdrawal effects: Symptoms may occur with rapid dose reduction or discontinuation (5.4 , 9.2) .
  • sanofi-aventis U.S. LLC - Ambien CR - January 2008 24 September 2009 16:53 UTC products.sanofi-aventis.us [Source type: Academic]

^ Drug withdrawal symptoms--Lyrica?
  • Ambien discussions (experiences, side effects, dosages, etc...) 10 February 2010 11:11 UTC www.drugtalk.com [Source type: General]

[61]
.One case history report involved a woman detoxing off a high dose of zolpidem experiencing a generalized seizure, with clinical withdrawal and dependence effects reported to be similar to the benzodiazepine withdrawal syndrome.^ The effects of zolpidem for the first dose.
  • Forum: BayShip and Yacht - recommendation 10 January 2010 2:02 UTC www.synfo.com [Source type: General]

^ Withdrawal effects Following the rapid dose decrease or abrupt discontinuation of sedative/hypnotics, there have been reports of signs and symptoms similar to those associated with withdrawal from other CNS-depressant drugs [see Drug Abuse and Dependence (9) ].
  • sanofi-aventis U.S. LLC - Ambien CR - January 2008 24 September 2009 16:53 UTC products.sanofi-aventis.us [Source type: Academic]

^ How often these effects occur depends on several factors, such as a person's general health, the use of other medicines, and which sleep medicine is being used.
  • Ambien CR Official FDA information, side effects and uses. 24 September 2009 16:53 UTC www.drugs.com [Source type: Academic]

[62]
.In the U.S., recreational use of zolpidem is becoming more common.^ Unfortunately, taking zolpidem for longer than the recommended period of time (which is generally less than a month) can often result in those who were using the drug medicinally becoming recreational users.
  • Stories of Ambien Use and Abuse 10 February 2010 11:11 UTC ambienoverdose.org [Source type: General]

.Recreational users claim that "fighting" the effects of the drug by forcing themselves to stay awake will sometimes cause vivid visuals and a body high.^ Ambien (zolpidem) : This drug helped me stay sleep and get to sleep but the after effects were horrible.
  • zolpidem systemic User Reviews for Insomnia at Drugs.com 10 January 2010 2:02 UTC www.drugs.com [Source type: General]

^ I gave birth to my newborn and was unable to care for her or even myself while experiencing the side effects caused by this hellish drug.
  • Ambien side effects : Medications.com 10 February 2010 11:11 UTC www.medications.com [Source type: FILTERED WITH BAYES]

^ You have any side effect, is to 5 mg tablets given drug or so can cause death.
  • Forum: BayShip and Yacht - recommendation 10 January 2010 2:02 UTC www.synfo.com [Source type: General]

.January 2009" style="white-space:nowrap;">[citation needed] Some users report decreased anxiety, mild euphoria, perceptual changes, visual distortions, and hallucinations.^ Visual and auditory hallucinations have been reported as well as behavioral changes such as bizarre behavior, agitation and depersonalization.
  • sanofi-aventis U.S. LLC - Ambien CR - January 2008 24 September 2009 16:53 UTC products.sanofi-aventis.us [Source type: Academic]

^ Some of these changes may be characterized by decreased inhibition (e.g.
  • sanofi-aventis U.S. LLC - Ambien CR - January 2008 24 September 2009 16:53 UTC products.sanofi-aventis.us [Source type: Academic]

^ Visual and auditory hallucinations have been reported as well as behavioral changes such as bizarre behavior, agitation, and depersonalization.
  • Ambien CR Official FDA information, side effects and uses. 24 September 2009 16:53 UTC www.drugs.com [Source type: Academic]

[63]
Zolpidem can be used to facilitate sexual assault.[64][65]
.Zolpidem and other sedative hypnotic drugs are detected frequently in cases of people suspected of driving under the influence of drugs.^ Hypnotic hazards: adverse effects of zolpidem and other z-drugs .
  • Australian Prescriber - Hypnotic hazards: adverse effects of zolpidem and other z-drugs 10 January 2010 2:02 UTC www.australianprescriber.com [Source type: Academic]

^ Zolpidem belongs to a class of drugs called sedative/hypnotics.
  • Zolpidem Oral : Uses, Side Effects, Interactions, Pictures, Warnings & Dosing - WebMD 10 January 2010 2:02 UTC www.webmd.com [Source type: General]
  • Ambien Oral : Uses, Side Effects, Interactions, Pictures, Warnings & Dosing - WebMD 10 February 2010 11:11 UTC www.webmd.com [Source type: General]

^ Zolpidem, like other sedative/hypnotic drugs, has CNS-depressant effects.
  • Ambien CR Official FDA information, side effects and uses. 24 September 2009 16:53 UTC www.drugs.com [Source type: Academic]

.Other drugs including the benzodiazepines and zopiclone are also found in high numbers of suspected drugged drivers.^ As with other sedative hypnotic drugs, Ambien and Ambien CR have been found in a high percentage of suspected drugged drivers.
  • Stories of Ambien Use and Abuse 10 February 2010 11:11 UTC ambienoverdose.org [Source type: General]

^ Zolpidem, the active moiety of zolpidem tartrate, is a hypnotic agent with a chemical structure unrelated to benzodiazepines, barbiturates, pyrrolopyrazines, pyrazolopyrimidines, or other drugs with known hypnotic properties.
  • Ambien CR Official FDA information, side effects and uses. 24 September 2009 16:53 UTC www.drugs.com [Source type: Academic]
  • sanofi-aventis U.S. LLC - Ambien CR - January 2008 24 September 2009 16:53 UTC products.sanofi-aventis.us [Source type: Academic]

^ Zolpidem is similar to those drugs including the benzodiazepines.

.Many drivers have blood levels far exceeding the therapeutic dose range suggesting a high degree of excessive-use potential for benzodiazepines, zolpidem and zopiclone.^ Zolpidem, an imidazopyridine that is structurally unrelated to benzodiazepines but binds to the benzodiazepine site on the GABA A -R, has a high affinity for GABA A -Rs containing the 1 subunit (Pritchett and Seeburg 1990 ).
  • Prolongation of Hippocampal Miniature Inhibitory Postsynaptic Currents in Mice Lacking the GABAA Receptor alpha 1 Subunit -- Goldstein et al. 88 (6): 3208 -- Journal of Neurophysiology 10 January 2010 2:02 UTC jn.physiology.org [Source type: Academic]

^ It is useful to patients because high blood pressure elevator.
  • Prescription drugs online - ambien 10 February 2010 11:11 UTC drugs.atwiki.com [Source type: FILTERED WITH BAYES]

^ WebMD User, reviews are NOT the weight in my back pain high blood glucose levels.
  • Forum: BayShip and Yacht - recommendation 10 January 2010 2:02 UTC www.synfo.com [Source type: General]

[66] .U.S. Congressman Patrick J. Kennedy says that he was using Zolpidem (Ambien) and Phenergan when caught driving erratically at 3AM. [67] "I simply do not remember getting out of bed, being pulled over by the police, or being cited for three driving infractions," Kennedy said.^ Ambien (zolpidem) : Use only as directed, in bed, only for a short time.
  • zolpidem systemic User Reviews for Insomnia at Drugs.com 10 January 2010 2:02 UTC www.drugs.com [Source type: General]

^ Ambien CR (zolpidem) : I have been using Ambien CR for 3 years.
  • zolpidem systemic User Reviews for Insomnia at Drugs.com 10 January 2010 2:02 UTC www.drugs.com [Source type: General]

^ Ambien (zolpidem) : I have been using Ambien for several years.
  • zolpidem systemic User Reviews for Insomnia at Drugs.com 10 January 2010 2:02 UTC www.drugs.com [Source type: General]

See also

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  67. ^ [http://wcco.com/national/Rep.Patrick.Kennedy.2.267357.html Kennedy To Enter Drug Rehab After Car Crash; Congressman Wrecked Car Near Capitol]

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