Table 1.
Zolpidem-Associated Psychiatric Reactions Reported in the Literature
| Case | Study | Age, y/Gender | Dose (mg/d) | SymptomOnset | Psychotic Symptoms | Onset TimeAfter ZolpidemIntake | Duration | Therapy/Recovery | Amnesia | Concomitant Drugs | Psychiatric Diagnosis |
| 1 | Toner et al4 | 20/Male | 5–10 | Third day | Vivid nightmares, frightened | … | … | Discontinued | … | … | … |
| 2 | Toner et al4 | 24/Female | 10 | First time | Visual hallucinations, confusion | 3 h | 6 h | Discontinued | – | Paroxetine | Depression, delirium |
| 3 | Toner et al4 | 26/Female | 10 | First time | Visual hallucinations | 20 min | 30 min | Fell asleep | … | … | Delirium |
| 4 | Hajak et al7 | 27/Female | 10 | First time | Visual illusions/distortion | 30 min | 30 min | … | + | … | … |
| 5 | Hajak et al7 | 26/Female | 10 | First time | Visual hallucinations | 20 min | 15 min | … | + | Alprazolam (0.25 mg) | … |
| 6 | Iruela et al9 | 20/Female | 10 | First time | Visual hallucinations/distortion | 20 min | A few minutes | Changed hypnotic | – | … | Anxiety, depression |
| 7 | Katz10 | 16/Female | 10 | First time | Hallucinations, disoriented | 60 min | 4 h | Discontinued | + | Paroxetine (20 mg) | Depression, delirium |
| 8 | Pies11 | 34/Female | 5–10 | First time | Sensory distortion | 20 min | … | Discontinued | – | … | … |
| 9 | Markowitz and Brewerton12 | 30/Female | 5–10 | First time | Visual hallucinations, terrified state | 20 min | 10 min | Fell asleep | + | Paroxetine (20 mg) | Bulimia, depression |
| 10 | Markowitz and Brewerton12 | 36/Female | 20 | 2 mo | Auditory hallucinations, delusions | … | … | Discontinued + haloperidol | … | Fluoxetine (40 mg) | Anorexia, depression |
| 11 | van Puijenbroek et al13 | 47/Female | 10 | 2 mo | Visual hallucinations | 15 min | … | Fell asleep | + | Omeprazole (20 mg) | … |
| 12 | van Puijenbroek et al13 | 30/Female | 10 | First time | Visual hallucinations, agitated | 2 h | Several hours | … | + | Fluvoxamine (150 mg) | Depression |
| 13 | Canaday 14 | 46/Male | 5 | … | Amnesia | Immediately | … | Fell asleep | + | Alcohol | … |
| 14 | Elko et al15 | 20/Female | 10 | Fourth day | Hallucinations, disoriented | 15 min | 4–7 h | Spontaneous | … | Fluoxetine | … |
| 15 | Elko et al15 | 27/Female | 10 | Second day | Visual hallucinations | 45 min | 2 h | Lorazepam | … | Venlafaxine (37.5 mg) | … |
| 16 | Elko et al15 | 25/Female | 10 | Sporadic | Visual hallucinations | 30 min | 3–4 h | Spontaneous | … | Desipramine | … |
| 17 | Elko et al15 | 60s/Male | 20 | Second day | … | 1 h | 1–2 h | Fell asleep | … | Sertraline | … |
| 18 | Elko et al15 | 17/Male | 60 | First time | Visual hallucinations/distortion | … | 3–4 h | Fell asleep | … | Bupropion (450 mg) | … |
| 19 | Huang et al16 | 50/Female | 10 | First time | Visual perception distortion | 20 min | 30 min | Fell asleep | + | … | … |
| 20 | Kito and Koga17 | 82/Female | 10 | Third day | Visual hallucinations | 30 min | 30 min | Discontinued | + | Fluvoxamine (150 mg) | Depression |
| 21 | de Haas et al18 | 32/Male | 10 | First time | Visual hallucinations | 20 min | 2 h | Spontaneous | – | … | … |
| 22 | Markowitz et al19 | 71/Female | 20 | First time | Visual hallucinations, confusion | 30 min | Several hours | Discontinued | + | Trazodone (100 mg) | Depression, delirium |
| 23 | Inami et al20 | 31/Female | 10 | First time | Visual hallucinations | 10–15 min | … | Fell asleep | + | Paroxetine (10 mg) | Depression |
| 24 | Brodeur and Stirling21 | 86/Female | 5 | First time | Delirium | 2 h | … | Haloperidol | + | … | … |
| 25 | Tsai et al27 | 34/Female | 10 | First time | Compulsive behavior | 10–20 min | … | Discontinued | + | Trazodone (50 mg) | … |
| 26 | Tsai et al27 | 40/Female | 15 | … | Uncontrolled eating | … | … | Discontinued | + | … | … |
| 27 | Tsai et al27 | 50/Female | 10 | Several times | Compulsive behavior | … | … | Discontinued | + | … | … |
| 28 | Yang et al29 | 50s/Male | 10 | Third day | Sleepwalking, agitated | 1 h | 3 h | Fell asleep | + | … | Alcoholism |
| 29 | Mendelson30 | 20/Male | 10 | First time | Sleepwalking | … | … | … | + | … | … |
| 30 | Harazin and Berigan31 | 46/Male | 10 | Fourth day | Nocturnal eating, sleepwalking | … | 24 min | Fell asleep | + | … | Previous depression |
| 31 | Morgenthaler and Silber32 | 54/Female | 10 | Several times | Nocturnal eating, sleepwalking (3 y) | … | … | Discontinued | + | Paroxetine, dopamine agonist | Restless legs syndrome |
| 32 | Morgenthaler and Silber32 | 56/Male | 15–30 | Several times | Nocturnal eating (14 y) | … | … | Discontinued | + | Alprazolam, bupropion | Restless legs syndrome, obstructive sleep apnea |
| 33 | Morgenthaler and Silber32 | 66/Male | 5–10 | Several times | Nocturnal eating (2 y) | … | … | Discontinued | + | Amitriptyline, gabapentin | Restless legs syndrome, obstructive sleep apnea |
| 34 | Morgenthaler and Silber32 | 67/Male | 10–20 | Several times | Nocturnal eating (2 y) | … | … | Discontinued | + | Trazodone, fluoxetine | Restless legs syndrome, obstructive sleep apnea |
| 35 | Morgenthaler and Silber32 | 64/Female | 10 | Several times | Nocturnal eating (8 y) | … | … | Discontinued | + | Pramipexole | Restless legs syndrome |
| 36 | Morgenthaler and Silber32 | 47/Female | 5 | Second day | Sleepwalking | 30 min | 1 h | Fell asleep | + | Citalopram, valproic acid | Borderline personality disorder |
| 37 | Sharma and Dewan34 | 19/Male | 10 | A few days | Sleepwalking | … | … | Discontinued | + | Olanzapine (15 mg), venlafaxine (150 mg) | Schizoaffective disorder |
| 38 | Sansone and Sansone35 | 51/Female | 10 | … | Sleepwalking, nocturnal eating | … | … | … | + | Citalopram (40 mg) | Depression |
| 39 | Hoque and Chesson38 | 51/Female | 10 | First time | Sleepwalking, nocturnal eating, driving | 1–2 h | … | Discontinued | + | … | … |
| 40 | Najjar39 | 46/Female | 6.25 | 3 wk | Nocturnal eating | 1–1.5 h | … | Discontinued | + | Trazodone, paroxetine, lamotrigine | Sleep apnea syndrome, depression |
| 41 | Yun and Ji40 | 45/Male | 10 | Sometimes | Nocturnal eating | 2 h | 20–30 min | Discontinued | … | … | Restless legs syndrome |
| 42 | Tsuji et al42 | 66/Female | 10 | Sometimes | Nocturnal eating | … | … | Discontinued | + | Paroxetine (10–20 mg) | Adjustment disorder |
| 43 | Tsuji et al42 | 33/Female | 10 | 4 wk later | Nocturnal eating | … | … | Discontinued | + | Fluvoxamine (150 mg) | Bipolar disorder |
| 44 | Tsuji et al42 | 73/Female | 5 | … | Nocturnal eating | … | … | Discontinued | + | … | … |
Symbols: + = yes, – = no, … = no data.