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Signs and Symptoms of Ambien Abuse

Like all prescription drugs, Ambien can have negative effects, in particular on the central nervous system. Ambien side effects include:

  • Next-day drowsiness (especially pronounced in extended-release formulations)
  • Fatigue
  • Dizziness
  • Confusion
  • Headache
  • Nausea and vomiting
  • Delusions or hallucinations
  • Nightmares
  • Sleepwalking or sleep-eating behaviors
  • Coordination problems
  • Amnesia or short-term memory loss
  • Sensory disorders affecting all the senses1,2

Some zolpidem users experience rebound insomnia, defined as difficulty initiating or maintaining sleep, worsened in the context of abrupt discontinuation of sleeping pills. This may manifest as complete loss of sleep lasting for hours or sleep patterns worsening over several days. In extreme cases, this can lead to intense fatigue, making driving and similar activities dangerous.3,4

Signs of Ambien Abuse

When taken in higher doses than recommended, users often experience a feeling of drunkenness. Ambien also suppresses a person’s ability to breathe. When abused with alcohol or prescription painkillers, the combination can result in death due to asphyxiation.5

Symptoms of Ambien abuse manifest in behaviors similar to other sedatives used for illicit purposes. In the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, select symptoms of a sedative, hypnotic or anxiolytic use disorder are defined as:

  • Taking the drug for longer than intended
  • Unsuccessful attempts to cut down or cease use
  • Compulsive desire to obtain the substance
  • Abandonment of once-enjoyed activities in favor of obtaining and using the substance
  • Continued use despite negative social, interpersonal, legal or financial consequences caused by Ambien use1

Psychosis and Delirium

In one study, a person with no history of psychosis experienced visual and auditory hallucinations and delusional thoughts as a direct result of zolpidem use. These symptoms resolved after the person stopped taking the drug and withdrawal was complete. Four factors have been reported to increase the risk of delirium or psychosis induced from zolpidem use.2 These include:

  • The use of this drug with selective serotonin reuptake inhibitor medications (SSRIs)
  • Female gender
  • Older age
  • Taking a 10 mg or higher dosage
  1. Ambien Abuse. Drug Abuse website. http://drugabuse.com/library/ambien-abuse/ Accessed January 10, 2017.
  2. Eslami-Shahrbabaki M, Barfeh B, Nasirian M. Persistent Psychosis after Abuse of High Dose of Zolpidem. Addict Health. 2014;6(3-4):159-162.
  3. What Is Rebound Insomnia? How Long Sleep Worsens After Stopping Pills. Very Well website. https://www.verywell.com/rebound-insomnia-how-long-sleep-worsens-after-stopping-pills-3014747 Published January 27, 2016. Accessed January 10, 2017.
  4. Ambien Detox Symptoms, Timeline, Medications and Treatment. Mental Help website. https://www.mentalhelp.net/articles/ambien-detox/ Updated November 24, 2015. Accessed January 10, 2017.
  5. Effects of Ambien Abuse. Narconon website. http://www.narconon.org/drug-abuse/ambien-effects.html Accessed January 10, 2017.
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