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Zolpidem's use for insomnia.

Abstract Zolpidem is a short-acting non-benzodiazepine hypnotic drug that belongs to the imidazopyridine class. In addition to immediate-release (IR) and extended-release (ER) formulations, the new delivery forms including two sublingual tablets [standard dose (SD) and low dose (LD)], and an oral spray form have been recently developed which bypass the gastrointestinal tract. So far, Zolpidem has been studied in several clinical populations: cases poor sleepers, transient insomnia, elderly and non-elderly patients with chronic primary insomnia, and in comorbid insomnia. Peak plasma concentration (Tmax) of zolpidem-IR occurs in 45 to 60min, with the terminal elimination half-life (t½) equating to 2.4h. The extended-release formulation results in a higher concentration over a period of more than 6h. Peak plasma concentration is somewhat shorter for the sublingual forms and the oral spray, while their t½ is comparable to that of zolpidem-IR. Zolpidem-IR reduces sleep latency (SL) at recommended doses of 5mg and 10mg in elderly and non-elderly patients, respectively. Zolpidem-ER at doses of 6.25mg and 12.5mg, improves sleep maintenance in elderly and non-elderly patients, respectively, 4h after its administration. Sublingual zolpidem-LD (5mg) and zolpidem oral spray are indicated for middle-of-the-night (MOTN) wakefulness and difficulty returning to sleep, while sublingual zolpidem-SD (10mg) is marketed for difficulty falling asleep. With their array of therapeutic uses and their popularity among physicians and patients; this review describes the clinical pharmacology, indications and uses, identifying withdrawal symptoms, abuse and dependence potentials, and adverse drug reactions are discussed.
PMID
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Authors

Mayor MeshTerms
Keywords

Hypnotic drugs

Insomnia disorder

Non-rapid eye movement sleep

Rapid eye movement sleep

Sleep

Zolpidem

Journal Title asian journal of psychiatry
Publication Year Start




PMID- 28262178
OWN - NLM
STAT- MEDLINE
DA  - 20170306
DCOM- 20170313
LR  - 20170313
IS  - 1876-2026 (Electronic)
IS  - 1876-2018 (Linking)
VI  - 25
DP  - 2017 Feb
TI  - Zolpidem's use for insomnia.
PG  - 79-90
LID - S1876-2018(15)30026-5 [pii]
LID - 10.1016/j.ajp.2016.10.006 [doi]
AB  - Zolpidem is a short-acting non-benzodiazepine hypnotic drug that belongs to the
      imidazopyridine class. In addition to immediate-release (IR) and extended-release
      (ER) formulations, the new delivery forms including two sublingual tablets
      [standard dose (SD) and low dose (LD)], and an oral spray form have been recently
      developed which bypass the gastrointestinal tract. So far, Zolpidem has been
      studied in several clinical populations: cases poor sleepers, transient insomnia,
      elderly and non-elderly patients with chronic primary insomnia, and in comorbid
      insomnia. Peak plasma concentration (Tmax) of zolpidem-IR occurs in 45 to 60min, 
      with the terminal elimination half-life (t(1/2)) equating to 2.4h. The
      extended-release formulation results in a higher concentration over a period of
      more than 6h. Peak plasma concentration is somewhat shorter for the sublingual
      forms and the oral spray, while their t(1/2) is comparable to that of
      zolpidem-IR. Zolpidem-IR reduces sleep latency (SL) at recommended doses of 5mg
      and 10mg in elderly and non-elderly patients, respectively. Zolpidem-ER at doses 
      of 6.25mg and 12.5mg, improves sleep maintenance in elderly and non-elderly
      patients, respectively, 4h after its administration. Sublingual zolpidem-LD (5mg)
      and zolpidem oral spray are indicated for middle-of-the-night (MOTN) wakefulness 
      and difficulty returning to sleep, while sublingual zolpidem-SD (10mg) is
      marketed for difficulty falling asleep. With their array of therapeutic uses and 
      their popularity among physicians and patients; this review describes the
      clinical pharmacology, indications and uses, identifying withdrawal symptoms,
      abuse and dependence potentials, and adverse drug reactions are discussed.
CI  - Copyright (c) 2016. Published by Elsevier B.V.
FAU - Monti, Jaime M
AU  - Monti JM
AD  - Department of Pharmacology and Therapeutics, University of the Republic School of
      Medicine, Montevideo, Uruguay. Electronic address: jmonti@mednet.org.uy.
FAU - Spence, David Warren
AU  - Spence DW
AD  - 652 Dufferin Street, Toronto, ON M6K 2B4, Canada.
FAU - Buttoo, Kenneth
AU  - Buttoo K
AD  - Sleep Disorders Center, 601 Harwood Avenue South, Alax, ON L1S 2J5, Canada.
FAU - Pandi-Perumal, Seithikurippu R
AU  - Pandi-Perumal SR
AD  - Somnogen Canada Inc, College Street, Toronto, ON, Canada.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20161012
PL  - Netherlands
TA  - Asian J Psychiatr
JT  - Asian journal of psychiatry
JID - 101517820
RN  - 0 (Hypnotics and Sedatives)
RN  - 0 (Pyridines)
RN  - 7K383OQI23 (zolpidem)
SB  - IM
MH  - Humans
MH  - Hypnotics and Sedatives/administration & dosage/pharmacokinetics/*pharmacology
MH  - Pyridines/administration & dosage/adverse effects/pharmacokinetics/*pharmacology
MH  - Sleep Initiation and Maintenance Disorders/*drug therapy
OTO - NOTNLM
OT  - Hypnotic drugs
OT  - Insomnia disorder
OT  - Non-rapid eye movement sleep
OT  - Rapid eye movement sleep
OT  - Sleep
OT  - Zolpidem
EDAT- 2017/03/07 06:00
MHDA- 2017/03/14 06:00
CRDT- 2017/03/07 06:00
PHST- 2015/10/08 [received]
PHST- 2016/09/11 [revised]
PHST- 2016/10/09 [accepted]
AID - S1876-2018(15)30026-5 [pii]
AID - 10.1016/j.ajp.2016.10.006 [doi]
PST - ppublish
SO  - Asian J Psychiatr. 2017 Feb;25:79-90. doi: 10.1016/j.ajp.2016.10.006. Epub 2016
      Oct 12.

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