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Imidazopyridine / Z-Drug·Neurology - Sedatives & Hypnotics
Short-term treatment of insomnia (specifically difficulty falling asleep)
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Max Dose
10 mg/day
Half-life
2.5 h
High risk: Parasomnias
CRITICAL
Sleep Onset
RAPID
Avoid / Cautions
History of complex sleep behaviors after taking Z-drugs, severe respiratory failure, Myasthenia Gravis. Pregnancy Category B3.
Overview
Non-benzodiazepine 'Z-Drug' hypnotic. Highly selective for the sleep-inducing subunit of the GABA receptor. Excellent for putting patients to sleep, but terrible at keeping them asleep.
Clinical Focus
Notorious for causing bizarre, complex sleep behaviors (sleep-walking, sleep-eating, sleep-driving) with zero memory of the event.
Bottom Line
Zolpidem is a Z-drug hypnotic for short-term insomnia management, but causes complex sleep behaviours (sleep-driving, sleep-eating) and should only be used for 2-4 weeks maximum.
Brand Names
Stilnox, Somidem
Oral Routes
Tablets (10 mg). CR Tablets (12.5 mg - Stilnox CR).
Prescribing & PBS
Authority Required (PBS). S4 (but frequently monitored like an S8).
Primary
Short-term treatment of insomnia (specifically difficulty falling asleep).
Clinical Place
Step 2 for ward insomnia (after melatonin or simple measures). Maximum duration of use should be 4 weeks.
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