Central nervous system side effects associated with zolpidem treatment

Zolpidem is one of the newer medications developed for the treatment of ins omnia. It is an imidazopyridine agent that is an alternative to the typical sedative-hypnotic agents. Zolpidem use is gaining favor because of its eff icacy and its side effect profile, which is milder and less problematic tha n that of the benzodiazepines and barbiturates used to treat insomnia. Stil l, side effects are not uncommon with zolpidem use. We report a series of c ases in which the patients developed delirium, nightmares and hallucination s during treatment with zolpidem. We will review its pharmacology, discuss previous reports of central nervous system side effects, examine the impact of drug interactions with concurrent use of antidepressants, examine gende r differences in susceptibility to side effects, and explore the significan ce of protein binding in producing side effects.