The Carlat Psychiatry Podcast

The Carlat Psychiatry Podcast


Ambien in Older Adults: The Benefits [60 Sec Psych]

June 12, 2020

1 out of 3 zolpidem ─ Ambien ─ tablets are dispensed to older adults, but how safe and effective is it in the elderly? This review by Flavio Machado and colleagues pulled together 32 studies – half of which were randomized placebo-controlled trials ─ to look for answers. Study referenced: Machado FV, Louzada LL, Cross NE, Camargos EF, Dang-Vu TT, Nóbrega OT. More than a quarter century of the most prescribed sleeping pill: Systematic review of zolpidem use by older adults. Exp Gerontol. 2020;110962. [Link]


Published On: 6/12/2020


Duration: 1 minute, 50 Seconds


Transcript:


1 out of 3 zolpidem ─ Ambien ─ tablets are dispensed to older adults, but how safe and effective is it in the elderly? This review by Flavio Machado and colleagues pulled together 32 studies – half of which were randomized placebo-controlled trials ─ to look for answers.  They found that zolpidem is a little more potent in the elderly, both its risks and benefits. I’ll start with the benefits.




  • Zolpidem helped older adults fall asleep 5 to 45 minutes faster than a placebo and increased their sleep time by about 30-120 minutes. Those are bigger numbers than what we see in adults.




  • Zolpidem did not improve or worsen sleep architecture, and in the usual dose range there was no withdrawal or rebound insomnia after stopping it.




  • Zolpidem ─ or perhaps just getting better sleep ─ even had health advantages. In one study people recovered better from surgery when taking it.




  • Not only was there no tolerance with zolpidem, but in some studies it worked better the longer it was taken. And, those benefits continued to improve even after the drug was stopped, suggesting it may entrain a sleep rhythm.




Tune in next time for the risks.



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