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 Studies in younger drivers have also shown a link between Ambien,
known generically as zolpidem, and motor vehicle collisions, said
lead author John N. Booth III, of the University of Alabama at
Birmingham.
The new data, however, extend the findings to show that “older
adults, specifically women older than 80 years, have significantly
higher odds of motor vehicle collisions while talking zolpidem,”
Booth told Reuters Health by email.
The researchers used information from a study of 2,000 current
drivers age 70 or older living in Alabama.
The drivers reported their gender, race, marital status, retirement
status, current occupation or occupation prior to retirement,
alcohol and tobacco intake and chronic medical conditions via
questionnaires. They also completed a driving habits questionnaire
and brought any prescription or over-the-counter medications to a
clinical visit so researchers could review the pill bottles.
About 4 percent of participants were using zolpidem. These
individuals tended to have more chronic health conditions, more
falls over the previous year, to be taking more medications, and to
drive fewer miles annually than the rest of the group.
Using accident police reports from the previous five years, the
researchers found that overall, motor vehicle collision rates were
similar for zolpidem users and nonusers when other factors were
accounted for. But specifically among women, crashes were 61 percent
more likely for zolpidem users. And among drivers over age 80, those
using zolpidem were more than twice as likely to have been in a car
accident in the last five years, the authors reported in Sleep
Medicine.
When men and women take the same dose of zolpidem, the women tend to
have higher concentrations of the drug in their plasma, which may
help explain the results, Booth said.
“Like motor vehicle collisions, sleep problems are a significant
health problem for older adults,” Booth said. “Balancing the risks
associated with elevated motor vehicle rates with the adverse health
outcomes associated with poor sleep is a complicated issue that must
take into account the broader perspective of a patient’s overall
health.”
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A spokeswoman for Sanofi, Ambien’s manufacturer, said the company
treats zolpidem reports with the highest degree of importance, and
patients should only take the medication as directed by a physician.
“We stand behind the robust clinical data that have demonstrated the
safety and efficacy of this product since its approval in the U.S.
in 1992, representing more than 20 years of real-world use and 24
billion nights of patient therapy worldwide,” the spokeswoman told
Reuters Health by email. “The U.S. FDA-approved label states do not
take zolpidem unless you are able to stay in bed a full night (7-8
hours) before you must be active again.”
Other sedative hypnotic medications such as trazodone (Oleptro) and
temazepam (Restoril) have also been associated with higher car
accident risk, Booth said.
“In 2013 the FDA recommended that physicians prescribe low doses of
sedative hypnotics,” he said. “This was a response to recent
findings that high concentrations of this type of medication can
remain in the bloodstream after awakening in the morning to
interfere with driving.”
For older people taking zolpidem, being aware of the side effects
could minimize motor vehicle risk, he said.
“For persons taking zolpidem, driving after they have been awake for
an extended period of time can help the sedative to become
metabolized and have a lower concentration in the blood,” Booth
said.
SOURCE: http://bit.ly/1Q3dmF2 Sleep Medicine, online December 29,
2015.
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