Zolpidem is a short-acting hypnotic used for insomnia. Long-term use may be associated with tolerance, dependence and withdrawal upon discontinuation.
Chemical structure: imidazopyridine
Initially zolpidem acts as an agonist at alpha-1 subtype gamma-aminbutyric acid A type (GABAA) receptors, which impacts sleep. With long-term use it acts at other GABBA receptors and starts to act more like a benzodiazepine.
Reasons for abuse: anxiolytic and stimulating activity
Clinical features of discontinuing Zolpidem:
(1) anxiety
(2) restlessness
(3) rebound insomnia
(4) seizures
Risk factors for withdrawal reaction:
(1) prolonged use
(2) high doses
(3) abrupt discontinuation (with other risk factors)
(4) impaired metabolism with accumulation (due to concurrent medications or liver disease)
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