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Assessment of Patterns of Potentially Unsafe Use of Zolpidem

Assessment of Patterns of Potentially Unsafe Use of Zolpidem Zolpidem was the most widely used prescription hypnotic medication and the fourth most frequently prescribed psychiatric drug in 2013.1 It achieves its effects as an agonist of γ-aminobutyric acid (GABA) receptors. However, the prescribing information2 and US Food and Drug Administration (FDA) Drug Safety Communications3 include limitations to reduce adverse effects, including (1) short-term use because of loss of efficacy; (2) a lower dose of 5 mg/d for those 65 years or older, and the lower starting dose for women because of 45% to 50% higher blood concentrations2; and (3) increased risks when combined with other central nervous system (CNS)depressant drugs. These precautions were intended to reduce the risks of next-day impairment, abnormal behavioral changes, and dependency. We compared patterns of reported use with these recommendations in data from the largest publicly available national survey of prescription medication.