The imidazopyridine zolpidem is a short-acting hypnotic chemically distinct from 
benzodiazepines (BZs). According to its peculiar neuropharmacologic activity 
(selectivity for the omega 1-BZ receptors), zolpidem is expected to be a pure 
hypnotic, without the other effects of BZs. In particular, it has been stressed 
that zolpidem is well tolerated in adults and in the elderly, and that 
tolerance, abuse, dependence, rebound insomnia, and other withdrawal effects do 
not develop in relation to zolpidem administration. However, despite these 
assumptions, zolpidem abuse, dependence, and withdrawal effects have been 
recently discussed and reviewed herein. In addition, the case of a 43-year-old 
woman who had an epileptic attack after abrupt interruption of an abused, high 
dose of zolpidem (600 mg/d), is reported and discussed. At the clinical level, 
it is stressed that the subjective effects ofzolpidem are comparable to those of 
other BZs, and that abuse, dependence, and withdrawal seizures cannot be avoided 
simply shifting the regimen of a BZ abuser to zolpidem. At the pharmacologic 
level, it is important to note that zolpidem's clinical effects cannot be 
explained on the basis of the old distinction between omega I and 2 receptors 
because this distinction is no longer valid; the new classification ofGABAA 
receptor subtypes is reported and zolpidem activity at this level is discussed 
herein.