Zolpidem: clinical experience in psychiatric settings

Zolpidem, a new short-acting non benzodiazepine hypnotic with high selectivity for benzodiazepine--1/Omega-I receptors and with lack of tolerance and physical dependence in animal models and lack of withdrawal phenomena even after up to 180 days treatment has recently been introduced. Data from clinical trials show a comparable effectiveness in inducing and maintaining sleep to comparative drugs (benzodiazepines) and besides that, it seems to preserve--even improve sleep-architecture and lastly preserve daytime wakefulness. Very few studies have been conducted in psychiatric patients, but also in this group effectiveness has been shown, and from daily clinical experience, this picture seems to hold. It must be remembered, that psychiatric patients have a high level of symptomatic benzodiazepine and/or alcohol misuse disposing to withdrawal and abstinence states in which zolpidem is less effective presumedly reflecting its selectivity. Having passed the withdrawal states, zolpidem can be used as an effective and safe hypnotic.