2020 issue 1


Volume 36, issue 1

Review article

Clinical considerations of sleep related amnestic behaviours associated with zolpidem

Agata M. Grzegorzewska1, Jerzy J. Landowski1, Wiesław J. Cubała1
1. Department of Adult Psychiatry, Faculty of Medicine, Medical University of Gdańsk
Farmakoterapia w Psychiatrii i Neurologii 2020, 36 (1), 23–31
Date of publication: 12-06-2020
DOI: https://doi.org/10.33450/fpn.2020.04.001
Keywords: adverse drug reaction, zolpidem, complex amnestic behavior, sleep related amnestic behavior, pharmacoepidemiology


Objective. Zolpidem is a non-benzodiazepine agonist 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, sleepiness, memory deficits as well as hallucinations, sensory 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 amnestic behaviours, or sleep related amnestic behaviours presented in literature.

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

Conclusions. Zolpidem may pose a risk for serious adverse reactions most common dose-dependent and associated with age, gender, concurrent use of medications and concomitant comorbidities. If severe adverse reactions 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 psychotropic medications. Clinicians should adopt a cautious approach prescribing zolpidem and be alert to possible unusual adverse effects of the drug.

Address for correspondence:
Agata Maria Grzegorzewska 
Klinika Psychiatrii Dorosłych, Wydział Lekarski
Gdański Uniwersytet Medyczny
ul. Dębinki 7, 80-211 Gdańsk
email: a.grzegorzewska@gumed.edu.pl