Korean J Med.  2013 Jun;84(6):804-809.

Incidence of and Risk Ractors for Zolpidem-Induced Delirium

Affiliations
  • 1Department of Internal Medicine, Dankook University Hospital, Dankook University Medical College, Cheonan, Korea. ykjee@dankook.ac.kr
  • 2Department of Neurology, Dankook University Hospital, Dankook University Medical College, Cheonan, Korea.

Abstract

BACKGROUND/AIMS
Zolpidem is a safe and effective drug for the treatment of insomnia. However, there are some reports of adverse effects, such as delirium, after administration of zolpidem. The aim of this study was to evaluate the incidence of and risk factors for zolpidem-induced delirium.
METHODS
This retrospective study enrolled 481 patients who were admitted to hospital and received zolpidem between January and May 2011. We analyzed the incidence and risk factors associated with zolpidem-induced delirium.
RESULTS
Zolpidem-induced delirium occurred in 19 of 481 (4.0%) patients. Zolpidem-induced delirium was significantly associated with old age (> or = 65 years; odds ratio [OR] = 4.35, 95% confidence interval [CI] = 1.52-12.44, p = 0.006) and co-administration of benzodiazepine (OR = 4.30, 95% CI = 1.52-12.12, p = 0.006). When males > 65 years-old took both benzodiazepine and zolpidem simultaneously, the incidence of delirium was notably elevated (OR = 6.04, 95% CI = 1.80-20.20, p = 0.003). Other factors, including dosage, did not influence the occurrence of delirium.
CONCLUSIONS
Old age and co-administration of benzodiazepine were independent risk factors for zolpidem-induced delirium. Therefore, a detailed medical history should be taken before prescribing zolpidem to an older person, and zolpidem should be used cautiously, with careful monitoring, in these patients.

Keyword

Benzodiazepines; Delirium; Dyssomnias; Zolpidem

MeSH Terms

Benzodiazepines
Delirium
Dyssomnias
Humans
Incidence
Male
Odds Ratio
Pyridines
Retrospective Studies
Risk Factors
Sleep Initiation and Maintenance Disorders
Benzodiazepines
Pyridines
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