Zolpidem misuse with other medications or alcohol frequently results in intensive care unit admission. Am J Ther 2011 Jul;18(4):305-8
Date
05/12/2010Pubmed ID
20458214DOI
10.1097/MJT.0b013e3181d169edScopus ID
2-s2.0-79960554734 (requires institutional sign-in at Scopus site) 25 CitationsAbstract
Zolpidem (trade name Ambien ®) is commonly prescribed. Case reports and popular media suggest potential dangers exist and may result in unanticipated complications. The primary aim was to determine how commonly zolpidem ingestion results in hospital evaluation and admission. The secondary aim of this study was to determine what patient and clinical characteristics are associated with complications from zolpidem use. A retrospective review of all cases involving zolpidem reported to the Illinois Poison Center between January 1, 2004 and December 31, 2005 was conducted. Data were prospectively entered into a structured clinical database in real time at the Illinois Poison Center. Demographic, co-ingestant, and outcome data for all zolpidem cases was abstracted into a research database and analyzed using descriptive, univariate and multivariate analyses. Six-hundred ninety-two cases met inclusion criteria. Mean age was 34.7 years. Four-hundred sixty three cases (67%) resulted in Emergency Department (ED) evaluation. Only 17% (81/463) of ED patients were discharged home: 44% (203/463) required Intensive Care Unit (ICU) admit, 17% (79/463) medical floor admit, 16% (72/463) psychiatry admit. Associated with ICU admission were co-ingestion of over-the-counter medicines (OR 3.33, 95% CI, 1.93 to 5.76), other prescribed psychotropics (antidepressants or mood stabilizers) (OR 3.11, 95% CI, 2.21 to 4.39), or ethanol (OR 2.12, 95% CI, 1.36 to 3.32). When zolpidem is ingested with other medications or ethanol, admission to the ICU was common in our series. Despite its reported safely, zolpidem overdose often requires ICU admission from the ED, which is associated with ingestion of other pharmaceutical products or alcohol.
Author List
Zosel A, Osterberg EC, Mycyk MBAuthor
Amy Elizabeth Zosel MD Associate Professor in the Emergency Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Aged, 80 and over
Alcohol Drinking
Child
Child, Preschool
Drug Interactions
Drug Overdose
Emergency Service, Hospital
Female
Humans
Hypnotics and Sedatives
Infant
Intensive Care Units
Male
Middle Aged
Nonprescription Drugs
Patient Admission
Poison Control Centers
Psychotropic Drugs
Pyridines
Retrospective Studies
Young Adult