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Ambien Addiction Treatment

Ambien was approved by the U.S. Food and Drug Administration (FDA) in 1993 and the generic version zolpidem was approved in 2007. Other current brand names include Edluar, Intermezzo and Zolpimist. Since its introduction, the drug has become a favorite among insomniacs, shift workers and jet-lagged travelers. The active ingredient in Ambien (zolpidem) affects chemicals in the brain that may be unbalanced in people with insomnia. Although Ambien is not a benzodiazepine, it impacts the same depressive neurotransmitter, gamma-aminobutyric acid (GABA).

After long-term use, the drug should never be stopped abruptly. Some people who are prescribed zolpidem to treat insomnia develop Ambien dependence. They cannot sleep without it and escalating doses may be required. It is important to speak to a physician about other options before quitting. A tapered dosing schedule can help ease the worst side effects of drug withdrawal.

A study conducted by the FDA discovered men metabolize the drug much faster than women. In addition, both men and women who were prescribed the drug complained of high levels of impairment the morning after, creating a dangerous combination when driving or performing activities requiring mental alertness.1 Driving simulation studies on 250 men and 250 women who took 10 mg of Ambien showed there was an increased risk of having a driving accident when zolpidem levels in the blood exceeded 50 ng/mL. Eight hours after dosage, 15% of women and 3% of men exceeded those levels and four had levels exceeding more than 90 ng/mL. An estimated 33% of women and 25% of men had more incidents of elevated zolpidem in the blood when they were taking the 12.5 extended-release pills.2

As a result of these findings, the FDA recommended Ambien dosage for women should be reduced from 10 mg to 5 mg. For extended release formulations, the dosage was reduced from 12.5 mg to 6.25 mg. Although the reduced dosage was not mandated for men, the FDA decided lower doses would be better for both men and women.

Concurrently, the FDA updated Ambien label warnings, indicating the risk of adverse reactions for vehicle drivers and machine operators. The negative side effects include drowsiness, prolonged reaction time, dizziness, sleepiness, blurred/double vision, reduced alertness and impaired driving in the morning after taking the medication.3 Next-day psychomotor impairment, including impaired driving, is more likely to occur if the drug is taken:

  • With less than 7 to 8 hours of remaining sleep
  • At higher than recommended doses
  • With other CNS depressants or alcohol
  • In conjunction with drugs that may alter blood levels of zolpidem

At the time, Sanofi, the manufacturer of Ambien, released a statement saying they believed Ambien was safe according to clinical data and 20 years of use by millions of people.2 Despite that, on their website they issued the following statements:

Complex behaviors such as “sleep-driving” (i.e., driving while not fully awake after ingestion of a sedative-hypnotic, with amnesia for the event) have been reported with sedative-hypnotics, including zolpidem.2

Due to the risk to the patient and the community, discontinuation of Ambien CR should be strongly considered for patients who report a “sleep-driving” episode.2

  1. Ambien Side Effects Risks 2016: Should Women Worry About Sleep Aid? Medical News Daily website. http://www.medicaldaily.com/ambien-side-effects-risks-2016-should-women-worry-about-sleep-aid-394645 Published August 11, 2016. Accessed January 10, 2017.
  2. Why The Ambien Dosage For Women Is Lower. No Sleepless Nights website. http://www.nosleeplessnights.com/ambien-dosage-reduction-angers-insomniacs/ Updated November 18 2016. Accessed January 10, 2017.
  3. FDA Elevates Warning for Psychomotor Impairment With Ambien. Neurology Advisor website. http://www.neurologyadvisor.com/sleep-disorders/fda-elevates-warning-for-psychomotor-impairment-with-ambien/article/516316/  Published August 16, 2016. Accessed January 10, 2017.
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