Chronic Abuse of Zolpidem

To the Editor.  —The imidazopyridine zolpidem has only recently been marketed as a rapid-onset, short-acting hypnotic. It has been assumed that zolpidem has a lower potential for abuse than benzodiazepines because of its unpleasant adverse effects at higher doses. However, in baboons the drug had a higher reinforcing efficacy than any benzodiazepine tested and self-injection rates were similar to those maintained by pentobarbital or secobarbital.¹A 33-year-old man with known major depression since the age of 26 years was admitted to our hospital for evaluation of an unprovoked generalized tonic-clonic seizure that occurred 14 hours after the reported ingestion of 60 to 80 mg of zolpidem. The seizure was self-limited. Anterograde amnesia was present and memory returned to normal only after 4 to 5 days. An electroencephalogram showed increased photoreactivity 7 days after the acute event; another 8 days later a 24-hour recording, which included photosensitivity testing, was completely