Adverse Effects of Zolpidem

From Wikipedia:

Side effects of Zolpidem at any dose may include:

• Nausea
• Vomiting
• Anterograde amnesia
• Hallucinations, through all physical senses, of varying intensity
• Delusions
• Altered thought patterns
• Ataxia or poor motor coordination, difficulty maintaining balance
• Euphoria and/or dysphoria
• Increased appetite
• Increased or decreased libido
• Amnesia
• Impaired judgment and reasoning
• Uninhibited extroversion in social or interpersonal settings
• Increased impulsivity
• When stopped, rebound insomnia may occur
• Headaches
• Short-term memory loss

Some users have reported unexplained sleepwalking while using zolpidem, and a few have reported driving, binge eating, sleep talking, and performing other daily tasks while sleeping. Research by Australia's National Prescribing Service found these events occur mostly after the first dose taken, or within a few days of starting therapy. Rare reports of sexual parasomnia episodes related to zolpidem intake have also been reported. Sleepwalkers can sometimes perform these tasks as normally as they might if they were awake. They can sometimes carry on complex conversations and respond appropriately to questions or statements, so much so that observers may believe them to be awake. This is similar to, but unlike, typical sleep talking, which can usually be identified easily and is characterised by incoherent speech that often has no relevance to the situation or that is so disorganised as to be completely unintelligible. Those under the influence of this medication may seem fully aware of their environments, though they are still asleep. This can bring about concerns for the safety of the sleepwalkers and others. These side effects may be related to the mechanism that also causes zolpidem to produce its hypnotic properties. It is unclear whether the drug is responsible for the behavior, but a class-action lawsuit was filed against Sanofi-Aventis in March 2006 on behalf of those who reported symptoms. It is possible some users believe they were asleep during these events because they do not remember the events, due to the short-term memory loss and anterograde amnesia side effects.

Residual 'hangover' effects, such as sleepiness and impaired psychomotor and cognitive function, after nighttime administration may persist into the next day, which may impair the ability of users to drive safely and increase risks of falls and hip fractures.

The Sydney Morning Herald in Australia in 2007 reported a man who fell 30 meters to his death from a high-rise unit balcony may have been sleepwalking under the influence of Stilnox. The coverage prompted over 40 readers to contact the newspaper with their own accounts of Stilnox-related automatism, and as of March 2007, the drug was under review by the Adverse Drug Reactions Advisory Committee.
In February 2008, the Australian Therapeutic Goods Administration attached a Black Box 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 alcohol. Caution is needed with other CNS depressant drugs. Limit use to four weeks maximum under close medical supervision." This report received widespread media coverage after the death of Australian student Mairead Costigan, who fell 20 m from the Sydney Harbour Bridge while under the influence of Stilnox.

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