Zolpidem - Inebriant Neurotoxic Poisons

 Zolpidem

Zolpidem is an imidazopyridine derivative which is a sedative-hypnotic with rapid onset of action and short half-life. It binds selectively to the benzodiazepine w-1 receptor subtype in the central nervous system.

Therapeutic doses have produced the following side effects: dizziness or light-headedness, somnolence, headache, and gastrointestinal upset. Several reports of somnambulism have occurred. Visual and tactile hallucinations, confusion, nightmares, delirium and agitation have been reported in some individuals with symptoms beginning within 30 minutes of a single 10 mg dose.

Overdose is characterised by coma and pinpoint pupils, preceded by vertigo, vomiting, tremor, myoclonic jerks, and diplopia. Pulmonary oedema has been reported.

One patient developed slurred speech, confusion, loss of co-ordination, and sleepiness after ingesting an unknown amount of zaleplon (a related drug). He was amnestic for the events after recovering from the overdose.

Chronic use of zolpidem can cause tremors, sweats, chills, and headache. Sudden withdrawal has been reported to cause convulsions.

Treatment of acute overdose involves stomach wash, activated charcoal, and supportive measures. Flumazenil (repeated doses) is said to be effective in reversing the coma.