Zolpidem vs. Emerging Hypnotics: Neuropsychiatric Effects and Ethical Considerations
CNS & Neurological Disorders - Drug Targets July 16, 2026 Tawqeer Shafi, Zora Singh, Puja Gulati et al.
Zolpidem, a non-benzodiazepine hypnotic used for insomnia, is frequently linked to serious neuropsychiatric adverse effects such as hallucinations, perceptual disturbances, and complex sleep-related behaviors (e.g., sleep-driving and sleep-eating), especially at high doses and in patients with psychiatric comorbidities. Newer hypnotics, such as orexin receptor antagonists, are less associated with these effects, while melatonin-based therapies have better safety profiles but lower efficacy. The review emphasizes careful risk-benefit evaluation when prescribing zolpidem, particularly for women, the elderly, psychiatric patients, and those on multiple medications.