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Also, a 2012 review found that zolpidem's effectiveness is nearly as much due to psychological effects as to the medication itself, so "increased attention should be directed at psychological intervention of insomnia." A lower-dose version (3.5 mg for men and 1.75 mg for women) is administered as a sub-lingual tablet and used for middle-of-the night awakenings.
It can be taken if there is at least 4 hours between the time of administration and when the person must be awake.
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.
Tolerance to the effects of zolpidem can develop in some people in just a few weeks.
It was recommended that zolpidem be used for short periods of time using the lowest effective dose.
Zolpidem 10 mg is effective in treating insomnia when used intermittently no fewer than three and no more than five pills per week for a period of 12 weeks.
Caution should be exercised by motor vehicle drivers.
The most common side effects for short-term use include headache (reported by 7% of people in clinical trials) drowsiness (2%), dizziness (1%), and diarrhea (1%); the most common side effects of long-term use included dry mouth (3%), allergy (4%), back pain (3%), flu-like symptoms (1%), chest pain (1%), heart palpitations (2%), drowsiness (8%), dizziness (5%), lethargy (3%), drugged feeling (3%), lightheadedness (2%), depression (1%), abnormal dreams (1%), amnesia (1%), sleep disorder (1%), diarrhea (3%), abdominal pain (2%), constipation (2%), sinusitis (4%), sore throat (3%), and rash (2%).
night eating syndrome while asleep, and performing other daily tasks while sleeping.
In February 2008, the Australian Therapeutic Goods Administration attached a boxed warning to zolpidem, stating that "Zolpidem may be associated with potentially dangerous complex sleep-related behaviours that may include sleep walking, sleep driving, and other bizarre behaviours.
Zolpidem is not to be taken with alcoholic beverages. Limit use to four weeks maximum under close medical supervision." A review medical publication found long-term use of zolpidem is associated with drug tolerance, substance dependence, rebound insomnia, and CNS-related adverse effects.