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Drug alert: Zolpidem linked to suicide attempt by Iranian man

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In breaking health news released today (December 20, 2013) in the DARU Journal of Pharmaceutical Sciences, a team of researchers report the suicide attempt of a previously healthy Iranian man who had just increased his dose of zolpidem to 20 milligrams. Zolpidem is the generic name for the imidazopyridine drug marketed as a sleep aid under the names of Ambien (by Wolters Kluwer), Intermezzo (by Purdue Pharma), Stilnox (by sanofi), Sublinox (by Orexo), and Zolsana (by KRKA and Synthon). Zolpidem is generally believed to be less hazardous than benzodiazepines, but this case report indicates that the drug is not without risks.

Earlier this year, the FDA lowered the recommended dose of zolpidem (from 10 mg to 5 mg for immediate-release products and from 12.5 mg to 6.25 mg for extended-release products) in a safety alert. The rationale behind this lowering was that blood levels of the drug might be high enough in the morning to impair significantly users' ability to operate a motor vehicle or perform other alertness-requiring tasks. Potential suicidal ideation was not mentioned in the January 2013 safety alert.

However, reported side effects to include hallucination, nightmares, and agitation, as noted in the aforementioned journal article. The individual profiled in the article is a 27-year-old man without any other neuropsychological health issue who took increasing dosages of zolpidem over the course of a year, beginning with 5 mg and gradually increasing to 15 mg as the drug's desired effect of somnolence was more and more difficult to attain. One night, he took a 20-mg dose and very shortly thereafter found himself considering taking his remaining four pills in order to end his life. He sought treatment instead.

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