Monday, April 25, 2016

Zolpidem (Ambien) Increases Fracture Risk In Men and Women with Osteoporosis

People break bones when they fall. In fact, falling is the number one cause of fractures especially in the elderly. It therefore makes sense that people with osteoporosis should avoid taking medications that increase their risk of falling. That is exactly what a recent study published in Osteoporosis International concluded. Park et al. conducted a large (1,092,925 participants) systematic review and meta-analysis and concluded that Zolpidem (Ambien), a medication often prescribed for insomnia, was associated with increased risk for fracture. The study noted that the increased fracture rate was especially pronounced for hip fractures.

This finding makes total sense when you realize that Ambien, a short-acting nonbenzodiazopine hypnotic, can cause ataxia, poor motor control, difficulty maintaining balance, dizziness, and sleepwalking. The last thing a person with fragile bones needs to be doing is dizzily walking around in their sleep . The kicker here is that a 2012 NIH study published in the British Medical Journal concluded that much of Zolpidem's effectiveness is psychological...in other words, a placebo effect. The study concluded that greater caution should be used when prescribing Ambien to individuals at risk for fracture and that "increased attention should be directed at psychological intervention of insomnia".

Park, S.M. et al.  2016. Zolpidem use and risk of fractures: a systematic review and meta-analysis. Osteoporosis International April 22.

Huedo-Medina, T.B. et al. 2012. Effectiveness of non-benzodiazopine hypnotics in treatment of adult insomnia: meta-analysis of data submitted to the Food and Drug Administration. BMJ (Clinical Research ed.) 345:e8343.
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