Ambien (zolpidem) is a sedative-hypnotic drug that primarily treats short-term insomnia by slowing down brain activity to promote sleep. It is a central nervous system depressant that forces the nervous system to relax. It is available as a tablet and an extended-release tablet taken by mouth. Zolpidem also comes in the form of an oral spray and a tablet that is placed under the tongue.
Ambien belongs to a class of nonbenzodiazepines called “Z-drugs” that have been marketed as having the same sleep-inducing properties as benzodiazepines although with a shorter duration of effect and half-life. They have a reduced abuse potential compared to benzodiazepines. However, Ambien possesses negative side effects such as sleep acting, hallucinations and psychosis.
Doctors generally prescribe Ambien for a period of seven to 10 days. Patients who take the drug for a prolonged period of time are at risk of building a tolerance and developing addiction.
Taking Ambien for longer than two weeks may lead to dependence on the drug. Using it long term or failing to follow the prescribing doctor’s orders for dose and frequency can result in addiction.
Ambien abuse is sparse compared to benzodiazepine abuse. However, people with a prior history of substance abuse are more vulnerable to zolpidem addiction. People use Ambien recreationally for its sedative, euphoric and hallucinogenic properties. In fact, the intoxication effects of zolpidem are similar to those of alcohol. High doses of zolpidem cause effects similar to the effects of benzodiazepines.
Signs of an Ambien addiction may include:
The dosage and frequency of Ambien intake is proportional to the decline in judgment and brain function that occur with its use. Some overdose symptoms of Ambien closely resemble the side effects, which may hinder the early detection of addiction to the drug.
Ambien overdose symptoms include:
Ambien is life-threatening when combined with benzodiazepines and other central nervous system depressants, narcotic pain relievers or alcohol. The combination intensifies the drug’s sedative effects and may lead to dangerous side effects.
Drug tests can detect Ambien in the body for several days after you take it. But the detection window can vary depending on the dose, frequency of use and the type of toxicology test used.
A 10 milligram dose of zolpidem can be detected in urine for up to 2.5 days after last use, according to a study published in the journal Forensic Science International. Peak concentrations of the drug were found 12 hours after ingestion.
A study published in the Journal of Analytical Toxicology examined the levels of Ambien in the blood plasma of three healthy volunteers who each took a 10 milligram dose of the medication. The report indicated that zolpidem remained in the blood for more than eight hours.
The Forensic Science International report indicated that zolpidem can be found in the hair three to five weeks after last use. The study authors detected the medication in hair samples collected for two possible criminal cases of sexual assault.
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Ambien is notorious for its sleep-acting side effect, in which people engage in activities such as driving or eating without being fully awake. However, the Food and Drug Administration reported that this side effect was more likely to happen if Ambien was taken with other medications or alcohol.
Other common side effects of Ambien are drowsiness, dizziness, diarrhea and grogginess.
Some side effects of Ambien warrant immediate medical attention.
Call your doctor if you experience any of the following:
Some side effects can result in a trip to the emergency room. The 2014 DAWN Report from the Drug Abuse Warning Network found that zolpidem in combination with other drugs was responsible for 57 percent of all ER visits involving overmedication in 2010.
In 2011, two-thirds of prescriptions dispensed contained zolpidem.
Although the addiction liability associated with Ambien is moderate, withdrawal symptoms may occur if someone abruptly stops using it. In fact, Medline Plus advises patients to consult their doctor to discontinue use of the drug safely. Medical supervision and a gradual tapering of dosage can prevent these serious symptoms.
Ambien’s withdrawal symptoms include:
Ambien withdrawal also may include nervousness and stomach pain. Panic attacks may also occur during withdrawal.
Ambien is a short-term solution for insomnia. Patients who are prescribed Ambien usually regain a normal sleeping schedule after the prescription period. However, individuals who grow dependent on the drug may need to seek treatment if they cannot sleep without it.
The number of zolpidem-related emergency department visits increased by 220 percent from 2005 to 2010.
Two detoxification methods are available to help people with Ambien addiction or dependency quit the drug safely. The first approach involves slowly tapering the individual off the drug. However, seizures can occur if there is an abrupt reduction in dosage.
The second detoxification method involves substituting Ambien with a different drug possessing a longer half-life and tapering off the new drug until discontinuation. This method lowers the risk of seizures.
Medication-assisted treatment with flumazenil, a GABA receptor antagonist drug, can help people addicted to Ambien during inpatient treatment. A study published in the journal Clinical Pharmacology and Therapeutics examined the ability of flumazenil to block the depressant effects of zolpidem. The researchers concluded flumazenil is a safe and effective treatment to reverse zolpidem overdose.
Cognitive behavioral therapy is advisable as a follow up from detoxification. CBT is a type of psychotherapy that pushes people to be more aware of their thoughts and helps them respond to challenging situations without relapsing. Through this approach, people addicted to Ambien learn how to live a healthier life and manage their sleeping disorder naturally.
A 2014 case study published in JSM Clinical Case Reports showed that cognitive therapy may be helpful after people taper off Ambien. The study examined a 37-year-old Caucasian man who found that cognitive and behavioral therapy after hospitalization helped him sleep as well as he did while taking high doses of Ambien.
Help with a sleep disorder does not have to involve medication. Many people successfully address sleep problems by changing their behaviors before bed and throughout the day.
Having designated times to sleep and wake up conditions the body’s internal clock to be consistent, which promotes better sleep. Sleep experts say a sleep schedule increases the amount of sleep people get at night and improves sleep quality.
Regular exercise can improve a person’s quality of sleep, mood and vitality, according to a study by Northwestern University. The study analyzed the effects of exercise on middle-aged and older adults battling insomnia.
“Insomnia increases with age,” Dr. Phyllis Zee, director of the Sleep Disorders Center at Northwestern Medicine and senior author of the study, said in a press release.
The study showed a correlation between aerobic exercise and an improvement in sleep disorders. The patients’ quality and duration of sleep drastically improved following regular exercise.
“Around middle age, sleep begins to change dramatically. It is essential that we identify behavioral ways to improve sleep,” said Zee. “Now we have promising results showing aerobic exercise is a simple strategy to help people sleep better and feel more vigorous.”
Avoiding caffeinated drinks and chocolate in the evening will allow the body to decompress before sleep. Individuals also are encouraged to have lighter dinners and stay away from spicy or heavy foods to avoid indigestion.
A study published in the journal Appetite found sleep duration is linked to obesity and metabolic dysfunction. Those who showed increased energy intake and a diet limited in variety tended to have shorter sleeping periods. Researchers also found that the types of nutrients consumed influences sleep duration.
Another study, conducted by the University of Minnesota and the Minneapolis Veterans Affairs Medical Center, showed that weight gain from a high-fat diet can impact quality of sleep.
According to a study from Johns Hopkins University School of Medicine, smokers are more likely than nonsmokers to have a sleep disorder. Researchers attribute the sleep disruption to the stimulating effect of nicotine and the nighttime withdrawal that ensues from sleep.
One of the side effects of alcohol is drowsiness. However, when that effect wears off, it is likely to wake the person in the middle of the night. The National Institute on Alcohol Abuse and Alcoholism found that drinking can affect sleeping patterns, and the activity can lead to the development of a sleep disorder. While alcohol can help people fall asleep more quickly, drinking within an hour of bedtime can interrupt sleep later that night, the report found.
The National Sleep Foundation discovered that electronics such as phones, tablets, televisions or computers were disruptive to the sleep cycle. The light emitted from these gadgets stimulates the brain, making it more difficult to relax. In order for the body to condition itself for sleep, it is advisable to avoid electronics an hour before bed.
The 2011 Sleep in America poll showed a correlation between using technology an hour before bedtime and an inability to sleep well. Researchers at the National Sleep Foundation, who conducted the poll, found that 95 percent of people surveyed used electronics within an hour of bedtime at least a few nights each week.
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