To investigate whether zolpidem use is associated with suicide death in adults.
We conducted a case–control study using the National Health Insurance Service‐National Sample Cohort (NHIS‐NSC) database. Cases were adults with a suicide record (ICD‐10 codes; X‐60‐X84, Y87.0) between January 1, 2004 and December 31, 2013. 10 Controls were matched to each case by age, sex, index year, region, income level, and health insurance type. Zolpidem use during 2 years before suicide was quantified. Adjusted odd ratios (aORs) with 95% confidence intervals (CIs) were estimated using conditional logistic regression.
The percentage of zolpidem users was significantly higher in cases (451 of 1,928 [23.4%]) than in controls (832 of 18,404 [4.5%]). After controlling for potential confounders, zolpidem use was significantly associated with suicide (aORs, 2.09; 95% CI, 1.74–2.52). Dose–response relationships were observed (for trend, p < .0001). Consistent findings were observed when analyses were restricted to suicide death (aORs, 2.08; 95% CI, 1.73–2.51) and nonmedication poisoning suicide death cases (aORs, 2.10; 95% CI, 1.74–2.53).
We found a significant and positive association between zolpidem use and suicide. Zolpidem should be prescribed cautiously and with due caution of increased suicide risk.