SUMAYYA
11 September 2022
Medically reviewed by
Kajal Jain
M. Pharm
Doses and Overdoses of Zolpidem
Table of Contents

With more than 20 million prescriptions written in 2006, Ambien was the tenth most commonly prescribed drug in the United States, earning close to $2 billion.

Post-marketing studies and case reports demonstrated that zolpidem showed complicated, sleep-related behaviors. These included anterograde amnesia, sleep driving, sleep cooking, sleep eating, sleep talking, and, very infrequently, sleep sex.

The FDA asked that specific warnings be added to all sedative-hypnotic drugs as these practices came to light. This law went into force in March 2007.

Zolpidem continued to be the most widely used prescription hypnotic medication and the fourth most frequently prescribed psychiatric drug in 2013.1 It achieves its effects as an agonist of γ-aminobutyric acid (GABA) receptors. 

3.8 million adults aged 18 to 85 reported one or more prescriptions for zolpidem in 2015. The higher dose consumed includes 64.0% of adults 65 years or older and 68.0% of women. 

In 2020, the estimated number of zolpidem prescriptions in the USA was 14,272,253, and 2,592,750 patients used zolpidem. 

What Is Ambien?

Zolpidem is a non-benzodiazepine receptor modulator used in the short-term treatment of insomnia for patients who have trouble falling asleep. It is a controlled medication; Zolpidem is a controlled substance class C IV pharmaceutical.

In patients with transient insomnia, it improves measures of sleep latency, sleep duration, and the number of awakenings. It also improves sleep quality in patients with chronic insomnia and has a slight muscle-relaxing effect. 

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Forms Of Ambien 

Ambien comes in two dosages: a quick-release form that aids sleep initiation and an extended-release in maintaining sleep. 
Zolpidem is available in sublingual, normal-release, extended-release, and oral spray dosage forms.

Dosages Of Ambien 

Tablet, immediate-release:                        

  •  5mg (Ambien)                                 
  • 10mg (Ambien)

Tablet, extended-release:                      

  • 6.25mg (Ambien CR)                            
  • 12.5mg (Ambien CR)

Tablet, sublingual: Schedule IV                          

  • 1.75mg                              
  • 3.5mg                                
  • 5mg                               
  • 10mg 

Oral spray                    

  • 5mg/spray (Zolpimist)

Drug Overdose With Study

The Substance Abuse and Mental Health Services Administration (SAMHSA) reported patients owing to zolpidem adverse medication reactions rose from 6,111 to 19,487 from 2005-2010. The majority of cases were women.

Patients who have used zolpidem for more than a year describe cases of delirium, hallucinations, and strange behavior during sleeping. A severe issue with long-term drug prescriptions is that they may increase the mortality risk of insomniac patients. 

Poison Control Centers reported zolpidem overdose hallucinations lasting several hours. An overdose of Ambien may cause respiratory depression or shallow breathing. Reports of tachycardia or an increase in heart rate above that of repose prevail. 

Symptoms Of Ambien Overdose

An overdose of Ambien occurs when a person takes large doses of Ambien in a short time or mixes it with alcohol or other drugs. It can be accidental or intentional.

Symptoms of overdose:

  • Slowed breathing 
  • Slowed heartbeat
  • Severe drowsiness
  • Confusion
  • Irrational thoughts
  • Loss of consciousness
  • Coma

At What Doses Ambien Cause Overdose?

5-10 mg is the average dosing range for Ambien. Ambien is often highly safe when taken in the recommended dosage. However, going beyond this limit raises the risk of overdose.

At doses of 70 milligrams, people start to experience serious adverse effects from Ambien. Overdosing may occur at doses over this. 

A person is more likely to overdose the more Ambien they consume. 
Furthermore, using Ambien in ways other than those recommended to you, such as snorting or injecting it, can significantly raise your risk of overdosing.

CO-administration of antianxiety medications, other sedatives, or painkillers with Ambien increases the risk of overdosing. Other risk factors for overdose include female gender, age greater than 65, and history of substance abuse. 

Zolpidem Overdose Treatment

In case of a suspected Ambien overdose, seek medical help immediately. Monitor the vital signs such as blood pressure and pulse of the patient.

Provide general symptomatic and supportive measures with immediate gastric lavage. Administer Flumazenil to reduce the sedative effect of zolpidem; however, flumazenil administration may contribute to convulsions. 

Avoid Sedatives following a zolpidem overdose. Administration of intravenous fluids as needed. 

Bottom Line From Practical Anxiety Solutions

An overdose of Ambien is a medical emergency, especially if alcohol or other opioids are involved. Ambien is used to treat insomnia; before consuming the pills, know the facts about the tablet. It will help you to overcome the side effects and to prevent them. Only use Ambien in the recommended therapeutic dose. 

Ask your doctor about the therapeutic uses and cautions about the pills; it will be helpful for you. To address any underlying issues you believe may be causing your insomnia, talk to your doctor and seek medical advice. 

  • Harward, Jonathan L., et al. "Impact of a US Food and Drug Administration drug safety communication on zolpidem dosing: an observational retrospective cohort." The Primary Care Companion for CNS Disorders 17.2 (2015): 27026. From https://doi.org/10.4088/PCC.14m01728 
  • Bouchette D, Akhondi H, Quick J. Zolpidem. [Updated 2022 Oct 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK442008/ Obtain on 11/09/2022
  • Gock, Susan B., et al. "Acute zolpidem overdose—report of two cases." Journal of analytical toxicology 23.6 (1999): 559-562. From https://doi.org/10.1093/jat/23.6.559 Obtain on 11/09/2022
  • Allain, H., and J. Monti. "General safety profile of zolpidem: safety in elderly, overdose and rebound effects." European Psychiatry 12.S1 (1997): 21S-29S. From  https://doi.org/10.1016/S0924-9338(97)80017-X Obtain on 11/09/2022
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