Last Updated on May 30, 2024 by
Alternative to Meds Editorial Team
Medically Reviewed by Dr Samuel Lee MD
The guidelines below are intended to be discussed with your prescriber. Always seek medical supervision especially for reducing “Z” drugs like Ambien (zolpidem).
We recommend you learn about the many protocols used at Alternative to Meds Center, on our services page. Share this information with your out-patient prescriber if you cannot find inpatient help for Ambien tapering. Our inpatient program will take 2 months on average to complete and could be a better option for you. Do NOT attempt to taper Ambien on your own. Read more below.
Get medical help and support for tapering safely. Don’t try it on your own. Anyone taking Ambien should be aware of the black box warnings and take the necessary precautions to prevent injuries from sleepwalking, sleep driving, or other adverse events.24For “Z” drugs like Ambien, inpatient tapering programs are by far the most comfortable, and safest, but this may not always be possible. If you can, find a nutritional psychiatrist or holistic or integrative medical doctor in your area who is willing to help you. Have persons close to you help you and be able to prevent sleepwalking, sleep-driving, or other adverse events. Don’t take this journey alone.
If you inform those closest to you what you are planning, it may ease their worry.
If you have small children, it could be much easier for them, and for you, to enroll in an inpatient program. This will allow you to focus on your own healing.
Inpatient care is 24/7 at Alternative to Meds Center, so your family or loved ones do not have to worry about your safety.
The following are examples of contributing factors that could contribute to insomnia:
Caffeine is a powerful stimulant that is found in coffee, chocolate, ice cream, energy bars, black tea, diet sodas, some breakfast cereals, energy drinks, and some over-the-counter pain pills. Do not discount the effect of caffeine as a sleep disrupter. Surprisingly, an ounce of espresso has only 63 mg of caffeine compared with a cup of regular java which comes in at a whopping 96 mg. White chocolate contains less caffeine than dark chocolate. Best to skip them all if you are battling insomnia.12,13
Foods containing MSG and glutamate can be highly stimulating. While it is a natural chemical in the body, glutamate is classified as the most excitatory neurochemical in the entire body. Consuming foods (notably processed foods) that are high in glutamate and MSG (which contains glutamate) can be devastating for insomnia sufferers. Read your processed food labels to eliminate glutamate as much as possible.14
The trouble with the artificial sweetener Aspartame© is that it breaks down into two stimulants — aspartate, and phenylalanine. Avoid foods with aspartame as the stimulant effect can be a potent sleep disruptor.15
A fascinating study by Maria Wong et al published in the Journal of Experimental and Clinical Pharmacology describes a bidirectional effect between marijuana use and insomnia. High-THC content marijuana used recreationally was found more frequently associated with insomnia. In contrast, low-THC cannabidiols (CBD) have been found to have therapeutic effects on sleep.9-11,37
Like the chicken and egg dilemma, the researchers were unable to assign absolute cause and effect. However, increased insomnia was associated with increased marijuana use, and a decrease in insomnia was associated with decreased marijuana use. Another study by Kroon et al published in 2020 reports that while PTSD sufferers are apt to use marijuana to assist with sleep problems, marijuana use is also associated with paradoxical anxiety and psychosis effects.11 If recreational marijuana use has become problematic, speak to your doctor about protocols that can help gently reduce and eliminate marijuana use as part of your overall zolpidem tapering plan. We recommend reading up on the research on this important topic. You can find many references in the citations listed below this article.9-11,37
Diet is probably one of the easiest to overlook strategies to improve sleep. However, the positive impacts of a corrected diet are worth spending the time and effort to achieve. Simply omitting sugars and refined flour products, processed foods containing MSG or other excitotoxic chemicals, and avoiding sugar and caffeine-laden drinks and foods all can improve sleep dramatically for the better. Blood sugar spikes and crashes can compromise your waking energy. Napping after a mid-afternoon blood sugar crash followed by using artificial sleep-inducing drugs at night does not successfully compensate for an inadequate diet over the long haul. Correcting these factors can boost your elan vital, give you a spring in your step, and the natural rhythm of sleep can be supported by healthier food choices.16-18
According to Baron et al in their study/review published in the 2013 Journal of Clinical Sleep Medicine, insomnia affects 10-15% of the population and affects more women than men. A correlation between exercise and decreased use of medication was an important finding of the study. Other positive results were getting to sleep faster, and feeling more refreshed on waking after 3 sessions of aerobic exercise per week, over a period of 6 months. Not everyone is going to be ready for such intense exercise, but the study found that regular exercise over time produced significant improvements in sleep quality, duration, and generally improved energy levels.25
Ask your prescriber to help with configuring lowered dosages as you progress through the taper.
You may need to combine even fractions of a pill, which your doctor can help you with.
If you have been using a timed-release version of Ambien, realize that if the pills are cut, they lose that extended-release mechanism. Get your doctor to help with these variations to ensure your lowered dosage is accurate.
Many persons who have relied on sleeping pills for a period of time have also been prescribed other medications to compensate for the need to wake up and function during waking hours. Some persons who suffer from depression have been prescribed antidepressants. Some who have suffered from anxiety have been prescribed anti-anxiety medications. The result can be a bit of a puzzle when it comes to how to taper off Ambien while taking multiple medications.
Your prescriber can help design your taper to progress in the best way. It may be more efficient to taper the stimulant-type drugs first, followed by Ambien weaning, as an example. Each person’s situation is unique and requires a personalized plan.
In a controlled setting like Alternative to Meds Center, generally, we would expect that the taper could be successfully done within 8 weeks. But this is not a cookie-cutter program. At ATMC, the first step is to build the person up with nutraceutical support, IVs and oral supplementation, and a corrected diet. Before making reductions we also test for and remove toxic accumulations from the body, to start the process of rehabilitating neurochemistry naturally. This sequence of actions has been found to actually speed up the tapering process, as the preparation steps make the body less prone to complications of Ambien withdrawal.
An outpatient setting is likely to take a little longer, based on an average of cutting 5% – 10% per week, or until any withdrawals settle out. It is important to leave enough time between these reductions for the person to rebalance before the next downward adjustment. We have observed that factors like genetics, lifestyle, and liver and kidney efficacy are all going to play a part in elimination time. A toxic body burden can also contribute to long or protracted withdrawal which is why we address toxic elimination before tapering.
Half-life is an important tool in understanding and predicting emerging withdrawals.28 The half-life of Ambien CR is an astonishingly low 2.8 hours. Tapering Ambien can result in Ambien withdrawal syndrome.29-31 Some of the features of this withdrawal syndrome may overlap with drug side effects and can include some of the following.
It is not uncommon for the last reductions, for instance, less than half of the original dosage, to be the most problematic in medication tapering. Take the time needed to let withdrawals subside before the next cut. The body needs time to reorganize and re-establish normalcy.
For some instances of intolerable withdrawal symptoms, your prescriber may consider using bridge medications, for example, Gabapentin, Trileptal, or Trazodone. Your doctor may provide bridge medications as an option, to help you get through an impasse in tapering Ambien.
Please feel free to review and share the information on our Ambien alternatives page with your prescriber. Many resources and tips are there to help negotiate successfully through a medication taper.
Ambien, sometimes referred to as a “sedative-hypnotic,” or “anxiolytic” drug, shares some characteristics with benzodiazepines but is really in a sedative class of its own. Tapering Ambien is much safer and more predictable with compassionate help, and exact, strategic steps. We know how bad it can get. We have been there, and we found improved health with the right help.
The trap of relying on medication for sleep can develop several layers of complexity. Tapering Ambien properly can walk these back, but there are critical points to consider. First to consider is the underlying causes of why a person cannot sleep. There is no full resolution in simply taking a person off sleep medication without taking care of the underlying reasons for the original condition, as without the medication a person will return to their sleep-deprived state. Sleep is not a luxury. It is fundamental to health.18 In addition to the aforementioned, the overwhelm of Ambien withdrawals may introduce considerably more disorder to the situation. And there is the vital action of taking care of the safety of the person whether taking Ambien or during the tapering process. The FDA placed a black box warning on Ambien warning about potential injuries from sleepwalking or other actions that the person may engage in of which they will have no recollection.24
To investigate root causes, what are the factors that need to be addressed?. Are there stressors in life that are contributing to the problem? Is there alcohol or recreational drug use? Are there vitamin and mineral deficiencies? Food allergies? Toxic exposures? Is the sleeping environment conducive to a good night’s rest? Is the person taking multiple medications? When did insomnia start? There are many layers and they are going to be unique to each client. We are experts at untangling all the threads to straighten out the contributing factors, so that medication is now unnecessary.
Sleep deprivation is a serious problem for millions of people. Due to the failure to investigate further, drugs have become a popular “quick-fix.” Drugs are really no cure and can further ruin already compromised health. Drug-induced sleep is not natural sleep. However, for drugmakers, Ambien has become an incredibly profitable product. But for the desperate insomniac, Ambien can literally become your worst nightmare … except that the unwitting person may be completely unaware of their actions while under its influence. These characteristics make close monitoring particularly necessary for both taking and tapering Ambien safely.
This unpredictable drug can literally take over a person’s actions which can become outside their own volitional control. This can lead to not only sleep-walking but “sleep-texting,” “sleep-driving,” “sleep-cooking,” and any manner of odd behaviors, of which the person will have no memory. The drug creates euphoric effects. along with zombie-like after-effects that linger until the next dose. Ambien can easily become addictive both physically and psychologically.29
Ambien dependence has been “re-branded” as a form of mental illness named “sedative, hypnotic or anxiolytic substance use disorder.” 32 Tragically, drug companies have become prone to re-naming observably drug-induced injuries as “mental illness.” This would be almost laughable if it were not for the level of harm so caused. During weaning off Ambien, Do not despair because it is possible to mitigate these reactions using holistic methods.1
Sleeping pills offer only a fake solution to insomnia. It would be far better to seek to find the root causes of one’s sleep difficulties before resorting to heavy drugs. A person using Ambien regularly becomes at high risk for physical dependence. Once a person begins taking it more often than this, any semblance of quality sleep will likely become impossible without it.
In fact, the FDA cautions that Ambien, and drugs like it, should never be taken for more than a few weeks at the absolute outside.2 And even after such a short time, careful Ambien weaning and titration from Ambien are important. Holistic solutions are available for repairing sleep issues. Yet, many have been continuously prescribed for much longer, many years in some cases. That is usually a result of never attempting to discover the root causes of sleep problems, nor making any dietary, lifestyle, or other changes that could have lessened, if not eliminated the problem before resorting to high-powered knock-out type drugs such as Ambien.
Over time, the body builds up accumulated neurotoxic material. The presence of toxic load can be assessed via lab testing. Removal can be achieved in gentle but effective measures. Mercury from dental amalgams, other heavy metals, residues from pesticides, water and air pollution, and food additives are not at all uncommon. Drug residues can also lodge in fatty tissues where they will stay until purged.
Using low-temperature sauna, nebulized glutathione treatments, mineral baths, ionic foot baths and targeted nutrients that convert toxins to water-soluble form are all actions that allow these harmful substances to be cleared out. The use of sauna is particularly helpful as it allows the removal process to bypass the liver and kidneys, so as to avoid negatively impacting these and other vital organs, especially when they may have already been drug-compromised.
While coming off toxic drugs is a wise choice, it would be cruel to do so just to leave the person suffering from the very symptoms that led to taking prescription drugs in the first place. Sleeping pills are no different. Sleep deficiency is a destroyer of health, personal relations, and job efficiency, anything in life can suffer relentlessly. It is possible to repair the factors that are contributing to poor sleep or the inability to get adequate rest. Women at the age of menopause have particular challenges, such as changes in hormones, mood shifts, and many others.4
CBT or cognitive-behavioral counseling has been found effective in treating sleep quality, and other facets of insomnia.34 Repairing gut health by correcting the diet is a proven remedy for many suffering from disordered sleep or other symptoms.35,36 Whether you are a woman suffering from menopause-related sleep issues,5 or a person stuck in a hamster wheel of stress and exhaustion or any combination of life factors that have affected your sleep, these can all be addressed holistically without resorting to drug-based “treatments” that are perhaps needed in a crisis but are not designed to actually cure anything.
At the Alternative to Meds Center we have been helping people from all walks of life, all ages, genders, and backgrounds for over 15 years to improve health and achieve natural mental health. Our Ambien tapering programs can provide the tools you have been searching for to get to your health improvement goals safely, gently, and effectively.
We have been there ourselves, and know that orthomolecular medicine and holistic treatments are clearly under-used in mainstream medicine. We have blended Equine therapy, art therapy, Qigong, environmental medicine, IV treatments, and other evidence-based tools into the foundation of our programs.
Please contact us directly for an in-depth conversation, and find out more about how Ambien tapering inpatient style in our world-class facility can change your life for the better.
1. InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Using medication: What can help when trying to stop taking sleeping pills and sedatives? 2010 Apr 20 [Updated 2017 Aug 10]. [cited 2022 July 25]
2. FDA Label Ambien (zolpidem tartrate) [Internet] 1992 [cited 2022 July 25]
3. Afaghi A, O’Connor H, Chow CM. Acute effects of the very low carbohydrate diet on sleep indices. Nutr Neurosci. 2008 Aug;11(4):146-54. doi: 10.1179/147683008X301540. PMID: 18681982. [cited 2022 July 25]
4. St-Onge MP, Mikic A, Pietrolungo CE. Effects of Diet on Sleep Quality. Adv Nutr. 2016;7(5):938-949. Published 2016 Sep 15. doi:10.3945/an.116.012336 [cited 2022 July 25]
5. NIH National Insitiute on Ageing authors, “Sleep Problems and Menopause – What Can I Do” published online & reviewed May 13 2017 [cited 2022 July 25]
6. Haji Seyed Javadi SA, Hajiali F, Nassiri-Asl M. Zolpidem dependency and withdrawal seizure: a case report study. Iran Red Crescent Med J. 2014;16(11):e19926. Published 2014 Nov 11. doi:10.5812/ircmj.19926 [cited 2022 July 25]
7. Puustinen J, Lähteenmäki R, Nurminen J, et al. Long-term persistence of withdrawal of temazepam, zopiclone, and zolpidem in older adults: a 3-year follow-up study. BMC Geriatr. 2018;18(1):142. Published 2018 Jun 15. doi:10.1186/s12877-018-0829-9 [cited 2022 July 25]
8. Yang X, Knapp DJ, Criswell HE, Breese GR. Action of ethanol and zolpidem on gamma-aminobutyric acid responses from cerebellar Purkinje neurons: relationship to beta-adrenergic receptor input. Alcohol Clin Exp Res. 1998;22(8):1655-1661. [cited 2022 July 25]
9. Wong MM, Craun EA, Bravo AJ, Pearson MR; Protective Strategies Study Team. Insomnia symptoms, cannabis protective behavioral strategies, and hazardous cannabis use among U.S. college students. Exp Clin Psychopharmacol. 2019;27(4):309-317. doi:10.1037/pha0000273 [cited 2022 July 25]
10. Bonnet U, Preuss UW. The cannabis withdrawal syndrome: current insights. Subst Abuse Rehabil. 2017;8:9-37. Published 2017 Apr 27. doi:10.2147/SAR.S109576 [cited 2022 July 25]
11. Kroon E, Kuhns L, Hoch E, Cousijn J. Heavy cannabis use, dependence and the brain: a clinical perspective. Addiction. 2020;115(3):559-572. doi:10.1111/add.14776 [cited 2022 July 25]
12. Meadows A, “Foods with caffeine” published by Sleep.org March 8, 2021 [cited 2022 July 25]
13. Frary CD, Johnson RK, Wang MQ. Food sources and intakes of caffeine in the diets of persons in the United States. J Am Diet Assoc. 2005 Jan;105(1):110-3. doi: 10.1016/j.jada.2004.10.027. Erratum in: J Am Diet Assoc. 2008 Apr;108(4):727. PMID: 15635355. [cited 2022 July 25]
14. Quines CB, Rosa SG, Da Rocha JT, Gai BM, Bortolatto CF, Duarte MM, Nogueira CW. Monosodium glutamate, a food additive, induces depressive-like and anxiogenic-like behaviors in young rats. Life Sci. 2014 Jun 27;107(1-2):27-31. doi: 10.1016/j.lfs.2014.04.032. Epub 2014 May 5. PMID: 24802127. [cited 2022 July 25]
15. Choudhary, Arbind & Lee, Yeong Yeh. (2017). Neurophysiological symptoms and aspartame: What is the connection?. Nutritional Neuroscience. 21. 1-11. 10.1080/1028415X.2017.1288340. [cited 2022 July 25]
16. Hormone Health Network authors, “Non-Diabetic Hypoglycemia.” [published online in 2021 [cited 2022 July 25]
17. Aucoin M, Bhardwaj S. Generalized Anxiety Disorder and Hypoglycemia Symptoms Improved with Diet Modification. Case Rep Psychiatry. 2016;2016:7165425. doi:10.1155/2016/7165425[cited 2022 July 25]
18. Lichtenstein GR. The Importance of Sleep. Gastroenterol Hepatol (N Y). 2015;11(12):790. [cited 2022 July 25]
19. Sharma A, Madaan V, Petty FD. Exercise for mental health. Prim Care Companion J Clin Psychiatry. 2006;8(2):106. doi:10.4088/pcc.v08n0208a [cited 2022 July 25]
20. Petit J, Sansone RA. A case of interdose discontinuation symptoms with venlafaxine extended release. Prim Care Companion CNS Disord. 2011;13(5):PCC.11l01140. doi:10.4088/PCC.11l01140 [cited 2022 July 25]
21. Harris J B, Blain P G, Correspondence to Professor John B Harris, “Neurotoxicology: What the neurologist needs to know.” , Chemical Hazards and Poisons Division, Health Protection Agency, Wolfson Unit, Faculty of Medical Sciences Newcastle upon Tyne, NE2 4 AA [cited 2022 July 25]
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23. Chesson AL Jr, Anderson WM, Littner M, Davila D, Hartse K, Johnson S, Wise M, Rafecas J. Practice parameters for the nonpharmacologic treatment of chronic insomnia. An American Academy of Sleep Medicine report. Standards of Practice Committee of the American Academy of Sleep Medicine. Sleep. 1999 Dec 15;22(8):1128-33. doi: 10.1093/sleep/22.8.1128. PMID: 10617175. [cited 2022 July 25]
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25. Baron KG, Reid KJ, Zee PC. Exercise to improve sleep in insomnia: exploration of the bidirectional effects. J Clin Sleep Med. 2013;9(8):819-824. Published 2013 Aug 15. doi:10.5664/jcsm.2930 [cited 2022 July 25]
26. Bagheri Hosseinabadi M, Khanjani N, Ebrahimi MH, Haji B, Abdolahfard M. The effect of chronic exposure to extremely low-frequency electromagnetic fields on sleep quality, stress, depression and anxiety. Electromagn Biol Med. 2019;38(1):96-101. doi: 10.1080/15368378.2018.1545665. Epub 2018 Dec 14. PMID: 30547710. [cited 2022 July 25]
27. Anderson E, Shivakumar G. Effects of exercise and physical activity on anxiety. Front Psychiatry. 2013;4:27. Published 2013 Apr 23. doi:10.3389/fpsyt.2013.00027 [cited 2022 July 25]
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29. Haji Seyed Javadi SA, Hajiali F, Nassiri-Asl M. Zolpidem dependency and withdrawal seizure: a case report study. Iran Red Crescent Med J. 2014;16(11):e19926. Published 2014 Nov 11. doi:10.5812/ircmj.19926 [cited 2022 July 25]
30. Mattoo SK, Gaur N, Das PP. Zolpidem withdrawal delirium. Indian J Pharmacol. 2011 Nov;43(6):729-30. doi: 10.4103/0253-7613.89838. PMID: 22144786; PMCID: PMC3229797. [cited 2022 July 25]
31. Bain KT. Management of chronic insomnia in elderly persons. Am J Geriatr Pharmacother. 2006 Jun;4(2):168-92. doi: 10.1016/j.amjopharm.2006.06.006. PMID: 16860264. [cited 2022 July 25]
32. DSM-5 – fact sheets [2021] Psychiatry.org online [cited 2022 July 25]
33. Kawada T, Katsumata M, Suzuki H, Li Q, Inagaki H, Nakadai A, Shimizu T, Hirata K, Hirata Y. Insomnia as a sequela of sarin toxicity several years after exposure in Tokyo subway trains. Percept Mot Skills. 2005 Jun;100(3 Pt 2):1121-6. doi: 10.2466/pms.100.3c.1121-1126. PMID: 16158698. [cited 2022 July 25]
34. Haynes J, Talbert M, Fox S, Close E. Cognitive Behavioral Therapy in the Treatment of Insomnia. South Med J. 2018 Feb;111(2):75-80. doi: 10.14423/SMJ.0000000000000769. PMID: 29394420. [cited 2022 July 25]
35. Stiemsma LT, Nakamura RE, Nguyen JG, Michels KB. Does Consumption of Fermented Foods Modify the Human Gut Microbiota? J Nutr. 2020 Jul 1;150(7):1680-1692. doi: 10.1093/jn/nxaa077. PMID: 32232406; PMCID: PMC7330458. [cited 2022 July 25]
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37. Kaul M, Zee PC, Sahni AS. Effects of Cannabinoids on Sleep and their Therapeutic Potential for Sleep Disorders. Neurotherapeutics. 2021 Jan;18(1):217-227. doi: 10.1007/s13311-021-01013-w. Epub 2021 Feb 12. PMID: 33580483; PMCID: PMC8116407.[cited 2024 May 30]
Originally Published Jul 23, 2020 by Diane Ridaeus
Dr. Samuel Lee is a board-certified psychiatrist, specializing in a spiritually-based mental health discipline and integrative approaches. He graduated with an MD at Loma Linda University School of Medicine and did a residency in psychiatry at Cedars-Sinai Medical Center and University of Washington School of Medicine in Seattle. He has also been an inpatient adult psychiatrist at Kaweah Delta Mental Health Hospital and the primary attending geriatric psychiatrist at the Auerbach Inpatient Psychiatric Jewish Home Hospital. In addition, he served as the general adult outpatient psychiatrist at Kaiser Permanente. He is board-certified in psychiatry and neurology and has a B.A. Magna Cum Laude in Religion from Pacific Union College. His specialty is in natural healing techniques that promote the body’s innate ability to heal itself.
Diane is an avid supporter and researcher of natural mental health strategies. Diane received her medical writing and science communication certification through Stanford University and has published over 3 million words on the topics of holistic health, addiction, recovery, and alternative medicine. She has proudly worked with the Alternative to Meds Center since its inception and is grateful for the opportunity to help the founding members develop this world-class center that has helped so many thousands regain natural mental health.
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