Although the original post does not so much address the question of tolerance to zolpidem
than the question of cross-tolerance between benzo
and benzo-like drugs
, I would like to leave a quick post regarding zolpidem tolerance, just for the record so to speak.
Bobbin, a friend of mine, has been slowly coming off high doses of venlafaxine
XR (600mg/d) a short while ago. He tapered it down at 75mg/d per week, but after going from 75mg/d to 0, he experienced a moderate discontinuation syndrome ("moderate" compared to the horror stories floating around the net of people quitting venlafaxine) for about three to four weeks. One of the symptoms was a quite severe insomnia. He still had a script lying around for 30 x 10mg of zolpidem, which he had been given months earlier when he mentioned occasional mild sleeping problems (undoubtedly due to the high dose of venlafaxine) to his doctor, without actually wanting to get anything prescribed for it. He got the script nonetheless, but didn't take it to a pharmacy because he felt like he didn't need, and didn't want, to take zolpidem. Anyway, now, in venlafaxine discontinuation, he did
need it, so he got the zolpidem. The first night, which was about day 7 of discontinuation syndrome, he started with 5mg before going to bed. He's a big fan of not taking more of a drug
than necessary, so he wanted to see whether 5mg would do the job. It did not, so he switched to 10mg the next day, which did work. One night, in the third week of discontinuation, he even had to take an additional 5mg (so 15mg in total) to get to sleep, so he did develop a slight tolerance during that time.
Eventually, after almost four weeks without venlafaxine, symptoms subsided and he was able to get back to sleeping without a hypnotic. At that point, he started taking an MAOI
, brandname Parnate in the US) as the n-th drug for treating his depression. MAOIs are notorious for causing insomnia, especially during the first weeks after starting it. So, predictably, he newly started to have insomnia a little more than a week into the MAOI. Again, he wondered whether, this time, maybe 5mg would do the job - and they did. He has been taking 5mg of zolpidem at bedtime for the past five days, and it still works.
Thus, my friend concluded that, for him at least, zolpidem tolerance does
build up even within the maximum 14 days of consecutive use that one is supposed to stick to, but tolerance decreases
even faster, to the point where, a little more than a week after stopping to take it, it was like tolerance was completely gone.