Clinical considerations of sleep related amnestic behaviours associated with zolpidem

Objective
Zolpidem is a non-benzodiazepine ago nist of GABA-A receptor indicated for the short-term insomnia treatment. Over the years, there have been reports in literature on zolpidem abuse complications and neuropsychiatric side effects involving headache, dizziness, nightmares, confusion, depression, sleep iness, memory deficits as well as hallucinations, sen sory distortions, delirium and sleep-related complex behaviours with anterograde amnesia. The aim of this work is to review and highlight the most serious adverse reactions to zolpidem with emphasis on sleep-related amnestic behaviours. We also focus our attention on common traits, patterns and predisposing factors. This paper refers to zolpidem side effects or complex amnes tic behaviours, or sleep related amnestic behaviours presented in literature.

Literature review
A comprehensive search of PubMed and Google Scholar was conducted to find relevant stud ies, case reports and literature reviews addressing the zolpidem use in insomniac patients.

Conclusions
Zolpidem may pose a risk for serious ad verse reactions most common dose-dependent and asso ciated with age, gender, concurrent use of medications and concomitant comorbidities. If severe adverse reac tions occur, the drug should be immediately discontinued or switched to another hypnotic. This review indicates an association between psychotic reactions and complex sleep related behavioural abnormalities in patients using zolpidem alone or in combination with other psycho tropic medications. Clinicians should adopt a cautious approach prescribing zolpidem and be alert to possible unusual adverse effects of the drug.