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Zolpidem: Difference between revisions
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{{SubstanceBox/Zolpidem}} | {{SubstanceBox/Zolpidem}} | ||
'''Zolpidem '''(also known as '''Ambien''', '''Intermezzo''', '''Edluar''', '''Stilnox''', '''Zolpimist'''<ref name=":0">http://www.drugs.com/zolpidem.html | Zolpidem (Drugs.com)</ref>, and others) is a non-[[benzodiazepine]] [[ | '''Zolpidem '''(also known as '''Ambien''', '''Intermezzo''', '''Edluar''', '''Stilnoct''', '''Stilnox''', '''Zolpimist'''<ref name=":0">http://www.drugs.com/zolpidem.html | Zolpidem (Drugs.com)</ref>, and others) is a non-[[benzodiazepine]] [[hypnotic]] of the [[chemical class::imidazopyridine]] chemical class which is primarily used in the treatment of [[insomnia]].<ref name=":0" /><ref>{{cite journal | vauthors=((Du, B.)), ((Shan, A.)), ((Zhong, X.)), ((Zhang, Y.)), ((Chen, D.)), ((Cai, K.)) | journal=The American Journal of the Medical Sciences | title=Zolpidem Arouses Patients in Vegetative State After Brain Injury: Quantitative Evaluation and Indications | volume=347 | issue=3 | pages=178–182 | date= March 2014 | url=https://linkinghub.elsevier.com/retrieve/pii/S0002962915303827 | issn=00029629 | doi=10.1097/MAJ.0b013e318287c79c}}</ref> | ||
When taken at recreational doses, it reportedly produces powerful and notoriously bizarre atypical [[hallucinogen]]ic, [[ | When taken at recreational doses, it reportedly produces powerful and notoriously bizarre atypical [[psychoactive class::hallucinogen]]ic, [[dissociative]], [[deliriant]] and even [[psychedelic]] effects. | ||
Zolpidem is a member of a family colloquially known as a "Z-drug." Other Z-drugs include [[zaleplon]] (''Sonata'') and [[zopiclone]]. These drugs were initially thought to be less addictive and/or habit-forming than benzodiazepines. However, this evaluation has shifted in the last few years as cases of addiction and habituation have accumulated.{{citation needed}} | Zolpidem is a member of a family colloquially known as a "Z-drug." Other Z-drugs include [[zaleplon]] (''Sonata'') and [[zopiclone]] (Imovane). These drugs were initially thought to be less addictive and/or habit-forming than benzodiazepines. However, this evaluation has shifted in the last few years as cases of addiction and habituation have accumulated.{{citation needed}} | ||
Zolpidem should not be taken on a full stomach and it is recommended on a short-term basis only. Daily or continuous use of the drug is not usually advised. | Zolpidem should not be taken on a full stomach and it is recommended on a short-term basis only. Daily or continuous use of the drug is not usually advised. | ||
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GABA<sub>A</sub>-agonizing imidazopyridines such as zolpidem are often grouped with pyrazolopyrimidines, and cyclopyrrones under the label "nonbenzodiazepines" for their similar effects. | GABA<sub>A</sub>-agonizing imidazopyridines such as zolpidem are often grouped with pyrazolopyrimidines, and cyclopyrrones under the label "nonbenzodiazepines" for their similar effects. | ||
Three syntheses of zolpidem are common. 4-methylacetophenone is used as a common precursor. This is brominated and reacted with 2-amino-5-methylpyridine to give the imidazopyridine. From here the reactions use a variety of reagents to complete the synthesis, either involving thionyl chloride or sodium cyanide. These reagents are challenging to handle and require thorough safety assessments.<ref>{{cite book | veditors=((Johnson, D. S.)), ((Li, J. J.)) | date= 2007 | title=The art of drug synthesis | publisher=Wiley-Interscience | isbn=9780471752158}}</ref> Though such safety procedures are common in industry, they make clandestine manufacture difficult. | |||
A number of major side-products of the sodium cyanide reaction have been characterised and include dimers and mannich products.<ref>{{cite journal | vauthors=((Sumalatha, Y.)), ((Reddy, P. P.)), ((Reddy, R.)), ((Satyanarayana, B.)) | journal=Arkivoc | title=Synthesis and spectral characterization of zolpidem related substances - hypnotic agent | volume=2009 | issue=7 | pages=143–149 | date=7 April 2009 | url=https://www.arkat-usa.org/arkivoc-journal/browse-arkivoc/ark.5550190.0010.714 | issn=1551-7012 | doi=10.3998/ark.5550190.0010.714}}</ref> | |||
==Pharmacology== | ==Pharmacology== | ||
Zolpidem interacts with the [[GABA]]-BZ [[receptor]] system<ref>Zolpidem, a clinical hypnotic that affects electronic transfer, alters synaptic activity through potential GABA receptors in the nervous system without significant free radical generation | | Zolpidem interacts with the [[GABA]]-BZ [[receptor]] system<ref>{{cite journal | vauthors=((Kovacic, P.)), ((Somanathan, R.)) | journal=Oxidative Medicine and Cellular Longevity | title=Zolpidem, a clinical hypnotic that affects electronic transfer, alters synaptic activity through potential GABA receptors in the nervous system without significant free radical generation | volume=2 | issue=1 | pages=52–57 | date= 2009 | url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2763231/ | issn=1942-0900}}</ref> and shares some of the pharmacological properties of traditional [[benzodiazepines]]. | ||
In contrast to benzodiazepines, which non-selectively bind to and activate all BZ receptor subtypes among others, zolpidem binds to the BZ1 receptor preferentially with a high affinity ratio of the α1/α5 subunits. It's this selective binding in comparison to traditional benzodiazepines that gives zolpidem very weak [[anxiolytic]], [[muscle relaxant]], and [[anticonvulsant]] properties but very strong [[hypnotic]] or [[sedative]] properties.<ref>Clinical pharmacokinetics and pharmacodynamics of zolpidem. Therapeutic implications | In contrast to benzodiazepines, which non-selectively bind to and activate all BZ receptor subtypes among others, zolpidem binds to the BZ1 receptor preferentially with a high affinity ratio of the α1/α5 subunits. It's this selective binding in comparison to traditional benzodiazepines that gives zolpidem very weak [[anxiolytic]], [[muscle relaxant]], and [[anticonvulsant]] properties but very strong [[hypnotic]] or [[sedative]] properties.<ref>{{cite journal | vauthors=((Salvà, P.)), ((Costa, J.)) | journal=Clinical Pharmacokinetics | title=Clinical pharmacokinetics and pharmacodynamics of zolpidem. Therapeutic implications | volume=29 | issue=3 | pages=142–153 | date= September 1995 | issn=0312-5963 | doi=10.2165/00003088-199529030-00002}}</ref> | ||
As the GABA site is the most prolific inhibitory receptor set within the brain, its modulation results in the [[sedating]] (or [[anxiety suppression|calming | As the GABA site is the most prolific inhibitory receptor set within the brain, its modulation results in the [[sedating]] (or [[anxiety suppression|calming)]] effects of zolpidem on the nervous system. | ||
In regards to how the consumption of this compound results in its bizarre hallucinations, the pharmacological mechanics behind this are not understood and do not seem to have been directly studied. It is worth noting, however, that zolpidem may | In regards to how the consumption of this compound results in its bizarre hallucinations, the pharmacological mechanics behind this are not understood and do not seem to have been directly studied. It is worth noting, however, that zolpidem impact on regional activity may overlap with that of other hallucinogenic GABAergic drugs such as [[muscimol]], the active compound within the hallucinogenic [[amanita muscaria]] mushroom. | ||
==Subjective effects== | ==Subjective effects== | ||
The subjective effects of zolpidem seem to vary wildly between individuals with certain users experiencing a complete lack of hallucinations whilst others experience them even at lower dosages. Generally, a recreational zolpidem dose has features comparable to [[DXM]], [[DPH]], [[alprazolam]] and [[psilocin]]. | The subjective effects of zolpidem seem to vary wildly between individuals with certain users experiencing a complete lack of hallucinations whilst others experience them even at lower dosages. Generally, a recreational zolpidem dose has features comparable to [[DXM]], [[DPH]], [[alprazolam]] and [[psilocin]]. It is also quite similar to the hallucinogen [[amanita muscaria]]. | ||
It contains many of the physical and cognitive effects of [[benzodiazepines]] with a moderately [[dissociative#subjective effects|dissociated]] headspace most similar to that of [[DXM]]. This occurs alongside bizarre thought patterns and [[external hallucinations]] similar to those of [[deliriants]] and [[visual distortions]] most similar to those of [[psychedelics]]. Overall, this makes zolpidem an extremely unique and unpredictable [[hallucinogen]] which | It contains many of the physical and cognitive effects of [[benzodiazepines]] with a moderately [[dissociative#subjective effects|dissociated]] headspace most similar to that of [[DXM]]. This occurs alongside bizarre thought patterns and [[external hallucinations]] similar to those of [[deliriants]] and [[visual distortions]] most similar to those of [[psychedelics]]. Overall, this makes zolpidem an extremely unique and unpredictable [[hallucinogen]] which it is strongly recommended to have a [[trip sitter]]. | ||
{{Preamble/SubjectiveEffects}} | {{Preamble/SubjectiveEffects}} | ||
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* '''[[Effect::Sedation]]''' - The sedation present within this compound is significantly stronger than that of other [[GABAergic]] [[depressant]] when proportionally compared to their other effects. This is why zolpidem is commonly prescribed as a sleep aid to those who struggle with insomnia. | * '''[[Effect::Sedation]]''' - The sedation present within this compound is significantly stronger than that of other [[GABAergic]] [[depressant]] when proportionally compared to their other effects. This is why zolpidem is commonly prescribed as a sleep aid to those who struggle with insomnia. | ||
*'''[[Effect::Physical euphoria]]''' - This manifests itself as a warm, soft glow which emanates from the center of the user's body. | *'''[[Effect::Physical euphoria]]''' - This manifests itself as a warm, soft glow which emanates from the center of the user's body. | ||
*'''[[Effect::Appetite enhancement]]''' - Many users of zolpidem report binge eating bizarre mixtures of various foods while they are "asleep" with little or no memory of the activity upon waking up.<ref>Ambien Linked to | *'''[[Effect::Appetite enhancement]]''' - Many users of zolpidem report binge eating bizarre mixtures of various foods while they are "asleep" with little or no memory of the activity upon waking up.<ref>{{Citation | vauthors=((DeNoon, D. J.)) | title=Ambien Linked to “Sleep Eating” | url=https://www.webmd.com/sleep-disorders/news/20060315/ambien-linked-to-sleep-eating}}</ref> This likely occurs as a result of zolpidem's cognitive effects such as [[disinhibition]] and [[amnesia]]. | ||
*'''[[Effect::Changes in felt gravity]]''' - This is not as strong or apparent as it is with [[dissociatives]] or [[salvia]]. | *'''[[Effect::Changes in felt gravity]]''' - This is not as strong or apparent as it is with [[dissociatives]] or [[salvia]]. | ||
*'''[[Effect::Gustatory hallucination]]''' | *'''[[Effect::Gustatory hallucination]]''' | ||
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*'''[[Effect::Visual acuity suppression|Acuity suppression]]''' | *'''[[Effect::Visual acuity suppression|Acuity suppression]]''' | ||
*'''[[Effect::Drifting]]''' - At heavier dosages, this compound may induce the experience of scenery, walls, objects and people appearing to melt and distort in a manner which is comparable to traditional [[psychedelic]]s such as [[psilocin]] or [[LSD]]. | *'''[[Effect::Drifting]]''' - At heavier dosages, this compound may induce the experience of scenery, walls, objects and people appearing to melt and distort in a manner which is comparable to traditional [[psychedelic]]s such as [[psilocin]] or [[LSD]]. | ||
*'''[[Effect::Geometry]]''' - The geometry produced by zolpidem shares similarities with [[DXM]] and | *'''[[Effect::Geometry]]''' - The geometry produced by zolpidem shares similarities with [[DXM]] and generally shifts between jitteriness and static. | ||
*'''[[Effect::Internal hallucination]]''' (''[[effect::autonomous entities]]''; ''[[effect::settings, sceneries, and landscapes]]''; ''[[effect::perspective hallucinations]]'' and ''[[effect::scenarios and plots]]'') - The internal hallucinations present on this compound can be described as vivid dream-like states similar in style to that of [[deliriants]]. This effect typically occurs briefly and spontaneously at moderate dosages but becomes progressively extended in its occurrence and duration proportional to dosage consumed before eventually becoming all-encompassing. It can be comprehensively described through its [[Visual_effects:_Internal_hallucinations#Variations|variations]] as delirious in believability, interactive in style, equal in new experiences and memory replays in content, autonomous in controllability and solid in style. | *'''[[Effect::Internal hallucination]]''' (''[[effect::autonomous entities]]''; ''[[effect::settings, sceneries, and landscapes]]''; ''[[effect::perspective hallucinations]]'' and ''[[effect::scenarios and plots]]'') - The internal hallucinations present on this compound can be described as vivid dream-like states similar in style to that of [[deliriants]]. This effect typically occurs briefly and spontaneously at moderate dosages but becomes progressively extended in its occurrence and duration proportional to dosage consumed before eventually becoming all-encompassing. It can be comprehensively described through its [[Visual_effects:_Internal_hallucinations#Variations|variations]] as delirious in believability, interactive in style, equal in new experiences and memory replays in content, autonomous in controllability and solid in style. | ||
*'''[[Effect::External hallucination]]''' (''[[effect::autonomous entities]]''; ''[[effect::settings, sceneries, and landscapes]]''; ''[[effect::perspective hallucinations]]'' and ''[[effect::scenarios and plots]]'') - In comparison to other classes of [[hallucinogen]], this effect exclusively occurs at heavy dosages and is comparable to [[deliriant]]s such as [[DPH]] and [[datura]]. This effect can be comprehensively described through its [[Visual_effects:_Internal_hallucinations#Variations|variations]] as delirious in believability, autonomous in controllability and solid in style. The most common themes for these hallucinations include those of both everyday occurrences such as talking to people who are not there and impossible occurrences such as inanimate objects coming to life or [[shadow people]]. | *'''[[Effect::External hallucination]]''' (''[[effect::autonomous entities]]''; ''[[effect::settings, sceneries, and landscapes]]''; ''[[effect::perspective hallucinations]]'' and ''[[effect::scenarios and plots]]'') - In comparison to other classes of [[hallucinogen]], this effect exclusively occurs at heavy dosages and is comparable to [[deliriant]]s such as [[DPH]] and [[datura]]. This effect can be comprehensively described through its [[Visual_effects:_Internal_hallucinations#Variations|variations]] as delirious in believability, autonomous in controllability and solid in style. The most common themes for these hallucinations include those of both everyday occurrences such as talking to people who are not there and impossible occurrences such as inanimate objects coming to life or [[shadow people]]. | ||
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*'''[[Effect::Cognitive euphoria]]''' | *'''[[Effect::Cognitive euphoria]]''' | ||
*'''[[Effect::Psychosis]]''' | *'''[[Effect::Psychosis]]''' | ||
*'''[[Effect::Delusion]]'''<ref>Ambien, delusions, and violence: Is there a link? | https://www.psychologytoday.com/blog/the-measure-madness/201005/ambien-delusions-and-violence-is-there-link</ref><ref> | *'''[[Effect::Delusion]]'''<ref>{{Citation | title=Ambien, delusions, and violence: Is there a link?, Psychology Today | url=https://www.psychologytoday.com/us/blog/the-measure-madness/201005/ambien-delusions-and-violence-is-there-link}}</ref><ref>{{Citation | title=Side Effects of Ambien (Zolpidem Tartrate), Warnings, Uses | url=https://www.rxlist.com/ambien-side-effects-drug-center.htm}}</ref> - At heavier dosages, this effect may become present in a manner which is comparable to traditional deliriants. It is often accompanied by [[external hallucinations]] which tend to reinforce one's belief of the delusion. | ||
*'''[[Effect::Delusions|Delusions of sobriety]]''' - This is the false belief that one is perfectly sober despite obvious evidence to the contrary such as severe cognitive impairment and an inability to fully communicate with others. It most commonly occurs at heavy dosages. Experience reports indicate that zolpidem may provoke these delusions in equal or greater strength than benzodiazepines. | *'''[[Effect::Delusions|Delusions of sobriety]]''' - This is the false belief that one is perfectly sober despite obvious evidence to the contrary such as severe cognitive impairment and an inability to fully communicate with others. It most commonly occurs at heavy dosages. Experience reports indicate that zolpidem may provoke these delusions in equal or greater strength than benzodiazepines. | ||
*'''[[Effect::Disinhibition]]''' | *'''[[Effect::Disinhibition]]''' | ||
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{{#ask: [[Category:Zolpidem]][[Category:Experience]]|format=ul|Columns=1}} | {{#ask: [[Category:Zolpidem]][[Category:Experience]]|format=ul|Columns=1}} | ||
Additional experience reports can be found here: | Additional experience reports can be found here: | ||
* [https://www.erowid.org/experiences/subs/exp_Pharms_Zolpidem.shtml Erowid Experience Vaults: Zolpidem] | |||
*[https://www.erowid.org/experiences/subs/exp_Pharms_Zolpidem.shtml Erowid Experience Vaults: Zolpidem] | |||
==Toxicity and harm potential== | ==Toxicity and harm potential== | ||
Zolpidem has a [[Toxicity::low toxicity]] relative to dose.<ref> | {{Further|Responsible use#Hallucinogens}} | ||
Zolpidem has a [[Toxicity::low toxicity]] relative to dose.<ref>{{Citation | vauthors=PubChem | title=Zolpidem | url=https://pubchem.ncbi.nlm.nih.gov/compound/5732}}</ref> However, it is [[Toxicity::potentially [[respiratory depression|lethal]] when mixed with [[depressants]] like [[alcohol]] or [[opioids]]]]. | |||
Zolpidem has been reported to cause [[psychosis]], [[delusions]] and delirium at a significantly higher rate than other [[hallucinogens]] like [[LSD]], [[ketamine]], or [[DMT]]. There are a large number of experience reports online which describe states of delirium, amnesia, bizarre behavior,<ref>/r/ambien (reddit) | https://www.reddit.com/r/ambien/top/</ref> sleep walking,<ref>Zolpidem-Induced Sleepwalking, Sleep Related Eating Disorder, and Sleep-Driving: Fluorine-18-Flourodeoxyglucose Positron Emission Tomography Analysis, and a Literature Review of Other Unexpected Clinical Effects of Zolpidem | Zolpidem has been reported to cause [[psychosis]], [[delusions]] and delirium at a significantly higher rate than other [[hallucinogens]] like [[LSD]], [[ketamine]], or [[DMT]]. There are a large number of experience reports online which describe states of delirium, amnesia, bizarre behavior,<ref>/r/ambien (reddit) | https://www.reddit.com/r/ambien/top/</ref> sleep walking,<ref name="Hoque2009">{{cite journal | vauthors=((Hoque, R.)), ((Chesson, A. L.)) | journal=Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine | title=Zolpidem-Induced Sleepwalking, Sleep Related Eating Disorder, and Sleep-Driving: Fluorine-18-Flourodeoxyglucose Positron Emission Tomography Analysis, and a Literature Review of Other Unexpected Clinical Effects of Zolpidem | volume=5 | issue=5 | pages=471–476 | date=15 October 2009 | url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2762721/ | issn=1550-9389}}</ref> driving while impaired<ref name="Hoque2009" /><ref>http://www.nhcriminaldefense.com/auto_accident_injury.html</ref> and other serious consequences after abusing the drug. In many cases this has resulted in hospitalization, arrests,<ref>{{Citation | title=Passengers recount horror as Air Force vet threatens to bring down transatlantic Delta flight | url=https://www.nydailynews.com/news/national/passengers-recount-horror-air-force-vet-threatens-bring-transatlantic-delta-flight-article-1.169677}}</ref> car crashes,<ref>{{Citation | vauthors=((News, A. B. C.)) | title=Kerry Kennedy Says Ambien “Overtook” Her, Causing Car Crash | url=https://abcnews.go.com/US/kerry-kennedy-ambien-overtook-causing-car-crash/story?id=22679672}}</ref> lengthy court cases and even death.<ref>{{Citation | year=2014 | title=The Disturbing Side Effect Of The No. 1 Prescription Sleep Aid | url=https://www.huffpost.com/entry/ambien-side-effect-sleepwalking-sleep-aid_n_4589743}}</ref> | ||
It is strongly recommended that one use [[responsible drug use|harm reduction practices]] and have a [[trip sitter]] when using this drug. | It is strongly recommended that one use [[responsible drug use|harm reduction practices]] and have a [[trip sitter]] when using this drug. | ||
===Tolerance and addiction potential=== | ===Tolerance and addiction potential=== | ||
Zolpidem is [[Addiction potential::moderately addictive]]. A review of 36 human case reports found that reported dependence to zolpidem was lower than that of benzodiazepines.<ref>Abuse and dependence potential for the non-benzodiazepine hypnotics zolpidem and zopiclone: a review of case reports and epidemiological data | Zolpidem is [[Addiction potential::moderately addictive]]. A review of 36 human case reports found that reported dependence to zolpidem was lower than that of benzodiazepines.<ref>{{cite journal | vauthors=((Hajak, G.)), ((Müller, W. E.)), ((Wittchen, H. U.)), ((Pittrow, D.)), ((Kirch, W.)) | journal=Addiction | title=Abuse and dependence potential for the non-benzodiazepine hypnotics zolpidem and zopiclone: a review of case reports and epidemiological data: Abuse and dependence of zolpidem and zopiclone | volume=98 | issue=10 | pages=1371–1378 | date= October 2003 | url=http://doi.wiley.com/10.1046/j.1360-0443.2003.00491.x | issn=09652140 | doi=10.1046/j.1360-0443.2003.00491.x}}</ref> | ||
Withdrawal symptoms or rebound symptoms may occur after ceasing usage abruptly following a few weeks or longer of steady dosing, and may necessitate a gradual dose reduction.<ref>Zolpidem at | Withdrawal symptoms or rebound symptoms may occur after ceasing usage abruptly following a few weeks or longer of steady dosing, and may necessitate a gradual dose reduction.<ref name="Sethi2005">{{cite journal | vauthors=((Sethi, P. K.)), ((Khandelwal, D. C.)) | journal=The Journal of the Association of Physicians of India | title=Zolpidem at supratherapeutic doses can cause drug abuse, dependence and withdrawal seizure | volume=53 | pages=139–140 | date= February 2005 | issn=0004-5772}}</ref> For more information on tapering from zolpidem in a controlled manner, please see [http://www.benzo.org.uk/manual/bzcha02.htm this guide] while keeping in mind it is intended for benzodiazepines. | ||
Although dependence builds up more slowly than in benzodiazepines, discontinuation from regular recreational doses of zolpidem appear to be as difficult as [[Benzodiazepine#Discontinuation|benzodiazepine discontinuation]];<ref | Although dependence builds up more slowly than in benzodiazepines, discontinuation from regular recreational doses of zolpidem appear to be as difficult as [[Benzodiazepine#Discontinuation|benzodiazepine discontinuation]];<ref name="Sethi2005" /> it is potentially life-threatening for individuals using regularly to discontinue use without tapering their dose over a period of weeks. There is an increased risk of [[hypertension]], [[seizures]], and death.<ref>{{cite journal | vauthors=((Lann, M. A.)), ((Molina, D. K.)) | journal=The American Journal of Forensic Medicine and Pathology | title=A fatal case of benzodiazepine withdrawal | volume=30 | issue=2 | pages=177–179 | date= June 2009 | issn=1533-404X | doi=10.1097/PAF.0b013e3181875aa0}}</ref> Drugs which lower the seizure threshold such as [[tramadol]] should be avoided during withdrawal. | ||
===Dangerous interactions=== | ===Dangerous interactions=== | ||
Although many drugs are safe on their own, they can become dangerous and even life-threatening when combined with other substances. The list below contains some common potentially dangerous combinations, but may not include all of them. Certain combinations may be safe in low doses of each but still increase the potential risk of death. [https://www.google.com/ Independent research] should always be done to ensure that a combination of two or more substances is safe before consumption. | Although many drugs are safe on their own, they can become dangerous and even life-threatening when combined with other substances. The list below contains some common potentially dangerous combinations, but may not include all of them. Certain combinations may be safe in low doses of each but still increase the potential risk of death. [https://www.google.com/ Independent research] should always be done to ensure that a combination of two or more substances is safe before consumption. | ||
*'''[[Depressants]]''' (''[[1,4-Butanediol]], [[2-methyl-2-butanol]], [[alcohol]], [[barbiturates]], [[GHB]]/[[GBL]], [[methaqualone]], [[opioids]], [[benzodiazepines]]'')- This combination can result in dangerous or even fatal levels of [[respiratory depression]]. These substances potentiate the [[muscle relaxation]], [[sedation]] and [[amnesia]] caused by one another and can lead to unexpected loss of consciousness at high doses. There is also an increased risk of vomiting during unconsciousness and death from the resulting suffocation. If this occurs, users should attempt to fall asleep in the [[recovery position]] or have a friend move them into it. | *'''[[Depressants]]''' (''[[1,4-Butanediol]], [[2-methyl-2-butanol]], [[alcohol]], [[barbiturates]], [[GHB]]/[[GBL]], [[methaqualone]], [[opioids]], [[benzodiazepines]]'')- This combination can result in dangerous or even fatal levels of [[respiratory depression]]. These substances potentiate the [[muscle relaxation]], [[sedation]] and [[amnesia]] caused by one another and can lead to unexpected loss of consciousness at high doses. There is also an increased risk of vomiting during unconsciousness and death from the resulting suffocation. If this occurs, users should attempt to fall asleep in the [[recovery position]] or have a friend move them into it. | ||
*'''[[Dissociatives]]''' - This combination can result in an increased risk of vomiting during unconsciousness and death from the resulting suffocation. If this occurs, users should attempt to fall asleep in the [[recovery position]] or have a friend move them into it. | *'''[[Dissociatives]]''' - This combination can result in an increased risk of vomiting during unconsciousness and death from the resulting suffocation. If this occurs, users should attempt to fall asleep in the [[recovery position]] or have a friend move them into it. | ||
*'''[[Stimulants]]''' - It is dangerous to combine zolpidem with [[stimulant]]s due to the risk of excessive intoxication. Stimulants decrease the [[sedation|sedative]] effect of zolpidem, which is the main factor most people consider when determining their level of intoxication. Once the stimulant wears off, the effects of zolpidem will be significantly increased, leading to intensified [[disinhibition]] as well as [[Zolpidem#Subjective effects|other effects]]. If combined, one should strictly limit themselves to only dosing a certain amount of zolpidem | *'''[[Stimulants]]''' - It is dangerous to combine zolpidem with [[stimulant]]s due to the risk of excessive intoxication. Stimulants decrease the [[sedation|sedative]] effect of zolpidem, which is the main factor most people consider when determining their level of intoxication. Once the stimulant wears off, the effects of zolpidem will be significantly increased, leading to intensified [[disinhibition]] as well as [[Zolpidem#Subjective effects|other effects]]. If combined, one should strictly limit themselves to only dosing a certain amount of zolpidem every few hours at minimum. This combination can also potentially result in severe dehydration if hydration is not monitored. | ||
==Legal status== | ==Legal status== | ||
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*'''Australia:''' Zolpidem is only available by prescription.{{citation needed}} | *'''Australia:''' Zolpidem is only available by prescription.{{citation needed}} | ||
*'''Canada:''' Zolpidem is only available by prescription.{{citation needed}} | *'''Canada:''' Zolpidem is only available by prescription.{{citation needed}} | ||
*'''Germany:''' Zolpidem is a controlled substance under Anlage III of the BtMG. It can only be prescribed on a narcotic prescription form. There is an exception for oral preperations, containing up to 8,5mg zolpidem per unit, which can be prescribed on a regular prescription form.<ref>http://www.gesetze-im-internet.de/btmg_1981/anlage_iii.html</ref> | *'''China:''' Zolpidem is a controlled Class II psychotropic substances.<ref>《麻醉药品和精神药品品种目录（2023版）》-国有资产管理处 (tjnu.edu.cn)</ref> Prescriptions for psychotropic substances in Class II are generally limited to a 7-day supply.<ref>卫生部关于印发《麻醉药品、精神药品处方管理规定》的通知 麻醉药品、精神药品处方管理规定__2006年第28号国务院公报_中国政府网 (www.gov.cn)</ref> | ||
*'''Russia:''' In Russia, since 2013, zolpidem is a Schedule III controlled substance.<ref>Постановление Правительства РФ от 04.02.2013 N 78 | https://www.consultant.ru/cons/cgi/online.cgi?req=doc&base=LAW&n=141744&dst=100002&date=02.12.2019</ref> | *'''Germany:''' Zolpidem is a controlled substance under Anlage III of the BtMG. It can only be prescribed on a narcotic prescription form. There is an exception for oral preperations, containing up to 8,5mg zolpidem per unit, which can be prescribed on a regular prescription form.<ref>{{Citation | title=Anlage III BtMG - Einzelnorm | url=http://www.gesetze-im-internet.de/btmg_1981/anlage_iii.html}}</ref> | ||
*'''Netherlands:''' Zolpidem is only available by prescription.{{citation needed}} | |||
*'''Russia:''' In Russia, since 2013, zolpidem is a Schedule III controlled substance.<ref>{{Citation | title=Постановление Правительства РФ от 04.02.2013 N 78 “О внесении изменений в некоторые акты Правительства Российской Федерации” - КонсультантПлюс | url=https://www.consultant.ru/cons/cgi/online.cgi?req=doc&base=LAW&n=141744&dst=100002&date=02.12.2019}}</ref> | |||
*'''Switzerland''': Zolpidem is a controlled substance specifically named under Verzeichnis B. Medicinal use is permitted.<ref>{{cite web|url=https://www.admin.ch/opc/de/classified-compilation/20101220/index.html|title=Verordnung des EDI über die Verzeichnisse der Betäubungsmittel, psychotropen Stoffe, Vorläuferstoffe und Hilfschemikalien|publisher=Bundeskanzlei [Federal Chancellery of Switzerland]|access-date=January 1, 2020|language=de}}</ref> | *'''Switzerland''': Zolpidem is a controlled substance specifically named under Verzeichnis B. Medicinal use is permitted.<ref>{{cite web|url=https://www.admin.ch/opc/de/classified-compilation/20101220/index.html|title=Verordnung des EDI über die Verzeichnisse der Betäubungsmittel, psychotropen Stoffe, Vorläuferstoffe und Hilfschemikalien|publisher=Bundeskanzlei [Federal Chancellery of Switzerland]|access-date=January 1, 2020|language=de}}</ref> | ||
*'''United Kingdom:''' Zolpidem has been a class C drug in the UK since 2003.<ref>The Misuse of Drugs Act 1971 (Modification) Order 2003 | *'''The Netherlands''': Zolpidem is a List 2 substance of the Opium Law.<ref>{{Citation|title=Opiumwet, Lijst II (Dutch) | year=2023|url=https://wetten.overheid.nl/BWBR0001941/2023-09-12#BijlageII}}</ref> | ||
*'''United Kingdom:''' Zolpidem has been a class C drug in the UK since 2003.<ref>{{Citation | title=The Misuse of Drugs Act 1971 (Modification) Order 2003 | url=https://www.legislation.gov.uk/uksi/2003/1243/contents/made}}</ref> It is illegal to possess (without a legitimate prescription), supply, produce or import.{{citation needed}} | |||
*'''United States:''' Zolpidem is listed as a Schedule IV drug due to evidence that the drug has addictive properties similar to [[benzodiazepines]].{{citation needed}} | *'''United States:''' Zolpidem is listed as a Schedule IV drug due to evidence that the drug has addictive properties similar to [[benzodiazepines]].{{citation needed}} | ||
==See also== | ==See also== | ||
* [[Responsible use]] | |||
* [[Hallucinogens]] | *[[Responsible use]] | ||
* [[Deliriants]] | *[[Hallucinogens]] | ||
* [[Zopiclone]] | *[[Deliriants]] | ||
*[[Zopiclone]] | |||
==External links== | ==External links== | ||
* [https://en.wikipedia.org/wiki/Zolpidem Zolpidem (Wikipedia)] | |||
* [https://www.erowid.org/pharms/zolpidem/zolpidem.shtml Zolpidem (Erowid Vault)] | *[https://en.wikipedia.org/wiki/Zolpidem Zolpidem (Wikipedia)] | ||
* [https://isomerdesign.com/PiHKAL/explore.php?id=3360 Zolpidem ( | *[https://www.erowid.org/pharms/zolpidem/zolpidem.shtml Zolpidem (Erowid Vault)] | ||
* [http://ambien.blogspot.com/2010/12/ambien-walrus-collection.html The Ambien Walrus Collection] | *[https://isomerdesign.com/PiHKAL/explore.php?id=3360 Zolpidem (Isomer Design)] | ||
*[https://go.drugbank.com/drugs/DB00425 Zolpidem (DrugBank)] | |||
*[https://www.drugs.com/zolpidem.html Zolpidem (Drugs.com)] | |||
*[http://ambien.blogspot.com/2010/12/ambien-walrus-collection.html The Ambien Walrus Collection] | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
[[Category: | |||
[[Category:Imidazopyridine]] | |||
[[Category:Depressant]] | [[Category:Depressant]] | ||
[[Category:Hallucinogen]] | [[Category:Hallucinogen]] | ||
[[Category:GABAergic hallucinogens]] | [[Category:GABAergic hallucinogens]] | ||
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