Talk:Zolpidem

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"...single-blind, open-label trial..."

These two terms are mutally exclusive. However, I do not have a copy of the text that is referenced. Can anyone who does so please read up on the methods used and adjust it accordingly.

163.1.231.55 19:34, 20 November 2006 (UTC)

I read it and said "What superb writing! Everything you might want to know on one side of A4."

It may seem only technical but it is amply supplied with links which will take any reader in the direction they can cope with.

JK _______

The article, even as a stub, strikes me as far too technical. I have no formal training in the sciences, but consider myself reasonably well-read and am usually able to understand journal articles. Yet I feel like I can barely -- just barely -- grasp what this article is saying about how the drug actually works.

It seems to me that somebody -- a person with better understanding of pharmacology and biology -- should be able to "dumb" the article down to an intelligible level. A degree in biochemistry shouldn't be required to understand an article on Wikipedia.

Hmm...On second thought, I should clarify. I can understand why this information, such as it is, might be of use as a quick reference for an advanced undergrad, or whatever. But I think that an intelligible "translation" should follow, written for the layperson (e.g., me).

Don't know if the chart can be changed, but if Zolpidem is metabloized hepatically (i.e. via the liver), then it is more than likely excreted renally (i.e. via kidneys/urine).

The IUPAC name for Zolpidem is N,N-dimethyl-2-[4-methyl-8-(4-methylphenyl)-6,9-diazabicyclo[4.3.0]nona-2,4,7,9-tetraen-7-yl]-ethanamide shouldn't this be the one listed?Bartimaeus 02:02, 12 December 2005 (UTC)

Contents 1 Can't mention in the article...but... 2 Associated Patents 3 What about Ambien Zombies? 4 Sensations that could lead to abuse 5 Salon.com article 6 Treatment of "Persistent Vegetative State" patients 7 Appropriate content? 8 half-life 9 South African Medical Journal 10 Registration mark (®)

[edit] Can't mention in the article...but...

It might be worth noting that half an Ambien can cause the mentioned effects under the Abuse heading, but will not put the subject to sleep at all, and thus no fighting is required. (I should know; I've done this a number of times.) Cernen Xanthine Katrena 09:24, 22 January 2006 (UTC)

[edit] Associated Patents

The article mentions that there are patents but the specific european/US patents are not linked to or mentioned. Also relevent would be the expiration date of the patent as this would spur introductions of Generic Ambien.

Content specifically relating to Ambien patent 4382938, which is listed on the FDA Orange Book site as expiring on OCT 21,2006, has been added to the article. That patent, is listed for indication "U-74, METHOD OF PROVIDING HYPNOTIC EFFECT."

[edit] What about Ambien Zombies?

17 March 2006 - Ambien Zombies are in the news. Need to have a Wikipedia entry on this.

[edit] Sensations that could lead to abuse

When I took the medication all was well for many weeks, then all of the sudden, I became stubborn and decided it was actually a pleasant sensation to fight off the effects and remain awake. One of the common feelings as the ambien gripped me was the a sensation that can only be described as taut skin or stone skin that made me feel that oh so common side effect of super human. Every time I took it, I would detect a change in my perception of my own shell of skin, and the texture.

Indeed, I found that it causes some alterations of bodily perceptions - this is the "body high". The visual hallucinations and confusion and euphoria were more fun.

Also, I think I should mention that whoever said it causes a 'drug induced psychosis' is WAY off. I've used it hundreds of times and never been paranoid that they were out to get me, just confused. Someone change that, please. 128.250.152.110 04:17, 4 May 2006 (UTC)

I added the bit about Ambien CR®'s street name. I figure that the name "A-" more than likely comes from the imprints the tablets carry. I recently received a prescription for these, and I found out the 6.25 mg tabs are pink, while the 12.5 mg tabs are blue, with both strengths being imprinted with an A~, which looks similar to an A-. --Drewamer 11:26, 22 July 2006 (UTC)

[edit] Salon.com article

This [1] describes a weird effect of Ambien.

Dead link. Nothing on google cache or archive.org. Anyone have it saved? 128.250.152.110 04:19, 4 May 2006 (UTC)

Salon.com must have moved the article (pretty silly for a news site to do) because I was able to find it using their search program, but unable to access it with the above citation. Here it be: [2] captbananas 17:01, 4 May 2006 (UTC)

This is fully 100% true. My brother totaled his Audi in the middle of the night and woke up being shaken by an EMT. He can't remember ever leaving the apartment, but he left his door wide open. Coolgamer 17:11, 20 November 2006 (UTC)

[edit] Treatment of "Persistent Vegetative State" patients

Nature today is reporting an "off label" use for this drug which bizzarely enough allows patients normally unresponsive to stimuli after brain injuries (i.e. in a PVS) to temporarily regain consciousness and communication. See http://www.nature.com/news/2006/060522/full/060522-9.html

  This story is likely to blow up pretty soon, when the "pro-life" people get hold of it and try to stop an incapable patient from having treatment withdrawn.

I think SlashDot deserve a stab at it too.

Here's another article: http://www.guardian.co.uk/medicine/story/0,,1870279,00.html --BillyTFried 01:41, 13 September 2006 (UTC)

I would like to add to this. Stilnox Abuse is done more easily than one thinks. There is in fact no 'fighting to stay awake', Its nothing like that. What Stilnox does is it makes you feel great so that you will go to bed and sleep amazingly. And it does that. It works for me beatifully. Strangely, sometimes I take STilnox and I suddenly find that i'm doing very pro-active things which i asumed this would definetetely not make me do. Its a bit opposit of what I expected! I've been doing some really strange things that I would never have done otherwise, like I decided to make a bookcase out of cardboard for ym studies! --165.146.173.164 23:53, 23 June 2006 (UTC)--165.146.173.164 23:53, 23 June 2006 (UTC)--165.146.173.164 23:53, 23 June 2006 (UTC)Maybe I'll put on the photo of the bookcase I decided to make to get my studues uner ccomplete control

I agree that there is no sleep-promoting effect. There may be a sleep-facilitating effect, but not in the sense that a real "hypnotic" has. What it will do, however, is make you write incoherently, make spelling errors, and do repeated empty edits. Having had the dubious "pleasure" of experiencing brief reactive psychosis, as well as medication-induced psychosis, I would say that zolpidem is not causing psychosis in the true sense of the word. However, it can cause stuff like borderline formal thought disorder along with the vivid multisensory hallucinations, in a dose dependent manner. 80.202.245.183 22:06, 16 February 2007 (UTC)

[edit] Appropriate content?

Is it really a good idea for that to be in a medical article? Seems a little bizarre for people that may come on here to look for real info. Monty2 20:15, 15 August 2006 (UTC)

[edit] half-life

It seems the 2-3 hour half life is different from a couple of kinetics studies I have read, which cite it as much higher (6+ hours). I wonder if anyone can clear this up.

[edit] South African Medical Journal

I added a cite to the South African Medical Journal about its use in PVS, which was the peer-reviewed source for the Guardian and BBC articles. I checked the NEJM article, but it was about a different application. I'll see if it fits into the article.

I wince at a phrase like, "Widespread reproduction of these results would herald a medical revolution in the treatment of PVS." I've seen it before in a lot of drugs that didn't live up to their claims. I usually see this kind of language in drug company press releases, or newspaper articles that copy from those press releases. Would anybody mind if I changed it to something less enthusiastic, or deleted it entirely?

More significantly, what stage of development is it in? Phase I trials, Phase II, Phase III, or approval by the regulatory authorities? Nbauman 13:39, 20 November 2006 (UTC)

Although I've just edited it, I agree with your wincing. This sort of expression of "high hopes" for a drug are often (usually?) misplaced. So I agree that some rewording (hacking?) is in order. Further to the reference you just added, I found the following one on the Web of Knowledge. It's one of 93 so far this year on Zolpidem, but it's the only one I saw that's about PVS.

Clauss R., Nel W. (2006) Drug induced arousal from the permanent vegetative state Neurorehabilitation 21: 23-28

It's not from a journal we get here, but the abstract makes it sound like it should be cited in the main article. Have you come across it before? Cheers, --Plumbago 13:55, 20 November 2006 (UTC)

P.S. For completeness ... --Plumbago 13:55, 20 November 2006 (UTC)

Abstract:Background: Zolpidem is an omega 1 specific indirect GABA agonist that is used for insomnia, but may have efficacy in brain damage. The long term efficacy of zolpidem in the permanent vegetative state is described in three patients.

Method: Two motor vehicle accident patients and one near drowning patient, all of them in the permanent vegetative state for at least three years, were rated according to the Glasgow Coma and Rancho Los Amigos scale before and after zolpidem application. Long term response to daily application of this drug was monitored for 3 - 6 years.

Results: All patients were aroused transiently every morning after zolpidem. Glasgow Coma Scale scores ranged from 6 - 9/15 before to 10 - 15/15 after zolpidem. Rancho Los Amigos Cognitive scores ranged from I - II before to V - VII afterward. Drug efficacy did not decrease and there were no long term side effects after 3 - 6 years daily use.

Conclusion: Zolpidem appears an effective drug to restore brain function to some patients in the permanent vegetative state.

[edit] Registration mark (®)

Can somebody explain to me why you use the registration mark (®)?

Lawyers explained to me that for legal reasons, trademark holders are effectively required to use that symbol every time they use a trademark, in a work that's under their control, or otherwise they could lose the trademark, like Aspirin and Formica did. Other people who are not under the trademark holder's control have no obligation or reason to use the symbol. In fact, medical journals and textbooks never use the symbol if they use the JAMA style sheet. It makes it look like you're under the control of the trademark owner.

Do you want it like this, or would you rather delete it? Nbauman 13:46, 20 November 2006 (UTC)

Beats me. It was in there already when I edited earlier. I've left it in, but it may just be an artifact of someone cutting and pasting from a drug company website. Cheers, --Plumbago 13:55, 20 November 2006 (UTC)