Long-term, non-nightly administration of zolpidem in the treatment of patients with primary insomnia

Michael L. Perlis, William Vaughn McCall, Andrew D. Krystal, James K. Walsh

Research output: Contribution to journalArticle

113 Citations (Scopus)

Abstract

Introduction: While it is common practice that hypnotics are used on a non-nightly basis, few investigations have been undertaken to evaluate the efficacy of the intermittent dosing strategy. The present study was designed to further evaluate this issue within a large scale, double-blind, placebo-controlled, long-term trial. Method: Patients who met DSM-IV criteria for primary insomnia participated in the study from January 2000 through October 2001. Patients were randomly assigned to 1 of 2 treatment groups (zolpidem 10 mg or placebo) for a period of 12 weeks. Ten pills were provided in foil packs on an every-other-week basis, and patients were instructed to take no fewer than 3 and no more than 5 pills per week. Sleep was evaluated daily with sleep diaries. Pill use was recorded in the sleep diaries. Results: 199 patients (mean ± SD age = 41.0 ± 12.8 years; 71% female) were randomly assigned to treatment. On mean, patients receiving zolpidem exhibited (vs. baseline) a 42% decrease in sleep latency, a 52% reduction in number of awakenings, a 55% decrease in wake time after sleep onset, and a 27% increase in total sleep time. These positive clinical gains did not diminish with time and were not associated with dose escalation. There was also no evidence of rebound insomnia. Conclusions: Over a period of 12 weeks of intermittent treatment with zolpidem, sleep continuity was significantly improved, the clinical gains were sustained, and there was no evidence of subjective rebound insomnia between doses or increases in the amount of medication used during the study interval.

Original languageEnglish (US)
Pages (from-to)1128-1137
Number of pages10
JournalJournal of Clinical Psychiatry
Volume65
Issue number8
DOIs
StatePublished - Aug 1 2004
Externally publishedYes

Fingerprint

Sleep Initiation and Maintenance Disorders
Sleep
Therapeutics
Placebos
zolpidem
Hypnotics and Sedatives
Diagnostic and Statistical Manual of Mental Disorders

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Long-term, non-nightly administration of zolpidem in the treatment of patients with primary insomnia. / Perlis, Michael L.; McCall, William Vaughn; Krystal, Andrew D.; Walsh, James K.

In: Journal of Clinical Psychiatry, Vol. 65, No. 8, 01.08.2004, p. 1128-1137.

Research output: Contribution to journalArticle

Perlis, Michael L. ; McCall, William Vaughn ; Krystal, Andrew D. ; Walsh, James K. / Long-term, non-nightly administration of zolpidem in the treatment of patients with primary insomnia. In: Journal of Clinical Psychiatry. 2004 ; Vol. 65, No. 8. pp. 1128-1137.
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