Wednesday, 15 Aug 2018

You are here

Unsafe Practices with Ambien Use

Ambien (zolpidem) is the most widely used prescription hypnotic sedative since its introduction in 1992 and is currently the fourth most frequently prescribed psychiatric drug (2013).

Recent US Food and Drug Administration Drug Safety Communications suggest limitations on use to reduce adverse effects; these include (1) short-term use because of loss of efficacy; (2) a lower dose of 5 mg/d for those 65 years or older, and the lower starting dose for women because of 45% to 50% higher blood concentrations; and (3) increased risks when combined with other central nervous system (CNS)-depressant drugs.

A study of the Medical Expenditures Survey in 2015 revealed that over 3.8 million adults reported using one or more prescriptions for zolpidem. Women were twice as likely as men and use increased with age. Two-thirds were using higher doses, were over age 65 yrs and were women. 

Zolpidem users were likely (41%) to also be taking other CNS depressants, including 27% narcotics and 20% benzodiazepines. Over three-quarters were not observing 2 or more of the above recommendations on zolpidem use. 

This study did not address observed harms; just patterns of zolpidem use. Nonethelss, these findings suggest that optimal safe use of zolpidem is uncommon. 

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

Weight Loss Lessens Knee Pain in Obese

Obese knee osteoarthritis (OA) patients who lose > 20% of their weight were in significantly less pain, had better function and improved quality of life. 

Blacks Suffer When Pain is Poorly Defined

Racial discrimination was a key feature at a 2-day summit on pain management and the opioid crisis, hosted by the National Institutes of Health on Thursday and Friday.

Asheley Cockrell Skinner, PhD, of the Duke Clinical Research Institute in Durham, North Carolina, provided a broad overview of racial bias in opioid prescribing.

Prescription Drug Monitoring Programs Fail to Deter Opiate Abuse

A systematic review of prescription drug monitoring programs (PDMPs), advocated in the president's Prescription Drug Abuse Prevention Plan, fails to show evidence of efficacy in preventing nonfatal and fatal overdoses.

Measures of Opioid Misuse Predict Future Opioid Overdose and Death

The current issue of Annals of Internal Medicine examines patterns of potential opioid misuse that are associated with subsequent adverse outcomes nationally.

Researchers analyzed a 5% sample of Medicare beneficiaries who had an opioid prescription, without a cancer diagnosis.  Specifically the sought to correlate a diagnosis of opioid overdose with other measures of opioid misuse including:

Opioid Marketing & Meals Tied to Opioid Prescribing

A current study in JAMA Internal Medicine showed that while US physicians who received no opioid-related marketing payments had fewer opioid prescriptions in 2015 compared with 2014, those receiving such payments wrote for more opioid in 2015.