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Related Experiment Videos

Delirium associated with zolpidem.

M R Brodeur1, A L Stirling

  • 1College of Pharmacy and Allied Health Professions, St. John's University, New York, NY, USA.

The Annals of Pharmacotherapy
|January 17, 2002
PubMed
Summary

Elderly women may experience delirium after taking zolpidem, a common sleep aid. This adverse drug reaction is linked to higher serum concentrations, suggesting cautious use and dosage adjustments in older patients.

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Area of Science:

  • Geriatric Pharmacology
  • Neuroscience
  • Clinical Toxicology

Background:

  • Zolpidem is a widely prescribed sedative-hypnotic medication.
  • Adverse drug reactions, including delirium, can occur with zolpidem use.
  • Elderly individuals, particularly women, may be at higher risk for these reactions.

Observation:

  • An 86-year-old woman developed acute delirium, agitation, and disorientation after a single 5 mg dose of zolpidem.
  • Symptoms emerged approximately two hours post-administration and resolved by hospital day 5.
  • The patient had no recollection of the event, and no rechallenge was performed.

Findings:

  • Pharmacokinetic factors, such as age, female gender, and hypoalbuminemia, may contribute to increased zolpidem serum concentrations and AUC in elderly women.
  • These factors potentially elevate the risk of zolpidem-induced adverse drug reactions.

Implications:

  • This case highlights the importance of cautious zolpidem use in the elderly, especially women.
  • Clinicians should consider potential concentration-dependent adverse effects and may need to reduce dosages in elderly patients and those with hepatic insufficiency.
  • Awareness of gender-specific pharmacokinetic differences is crucial for safe prescribing.

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