Ambien Addiction, Withdrawal, Side Effects, Alternatives, Tapering

This entry was posted in Sedative on September 15, 2021 by Lyle Murphy.

Last Updated on December 8, 2021 by Chris Weatherall

Alternative to Meds Editorial Team
Medically Reviewed by Dr Michael Loes MD

Alternative to Meds has been navigating sedative withdrawal for more than 15 years. We have published evidence regarding our success. Some people can eliminate Ambien dependence fairly easily with proper holistic support. The more complicated cases are typically neurotoxic, which can impair a person’s neurology. We specialize in holistic repair and cleaning up that toxic burden so that the neurochemistry can normalize once again, and resolve problems such as insomnia. The success of this approach is far more sustainable without the complicating side effects of drugging the problem.

You probably are already aware of the spiral this drug can cause. Drug-induced sleep at night is not really sleep, and the zombie-like depersonalization that comes with drugs for insomnia is unbearable.

The video here about neurochemistry was designed for a benzodiazepine conversation, but much of the material applies to Ambien as well. Feel free to call us to get hope about your situation.

Ambien Withdrawal Symptoms

Ambien is a drug that may require inpatient care for proper recovery and safe tapering. Zolpidem has been shown in clinical studies published in the British Journal of Clinical Pharmacology and elsewhere to be prone to dependence and abuse.^12,15,21 Full monitoring of someone who is experiencing Ambien withdrawals is highly recommended and may require 24/7 observation. Withdrawal from Ambien should be managed carefully and slowly especially after long-term use.¹⁵

The Good News About Ambien Withdrawal

Clinical studies show that after withdrawal from long-term use of insomnia drugs, the majority of participants who stopped the drug experienced better sleep quality and less anxiety compared to non-withdrawers at 6 months post-withdrawal follow-up.⁸

Ambien withdrawal symptoms include:

Withdrawal delirium, hallucinations, irrelevant speech, agitated behavior ^11,15
Nightmares, insomnia ¹²
Anxiety, apprehension, sadness, restlessness, irritability ¹⁵
Panic attacks, nervousness ¹⁶
Rebound insomnia* ^15,18
Dysphoria, uncontrolled crying spells ¹⁶
Heart palpitations ¹⁵
Stomach and muscle cramps ¹⁶
Vomiting/nausea ^15,16
Shaking, tremors, convulsions ¹⁶
Fatigue ¹⁶
Lightheadedness ¹⁶
Fever, flushing, sweating ¹⁶
Drug cravings ^15,21

*According to sleepadvisor.org, rebound insomnia occurs when sleep problems worsen when coming off sleeping pills.

Infants and Ambien Withdrawal

The FDA reported on clinical trials showing that Infants born of mothers taking Ambien may experience postnatal withdrawal symptoms.¹⁶

Ambien Withdrawal

Ambien (zolpidem) is a powerful non-benzodiazepine hypnotic sedative.⁶ Though it is not classed as a benzodiazepine, Ambien is thought to share something of a similar mechanism of action that modulates the release of GABA and targets one specific benzodiazepine receptor.¹³ Withdrawal after prolonged use should not be abrupt according to the bulk of medical research found, including a study published in the Journal of Neuropsychiatry and Clinical Neurosciences.¹⁵ The FDA also recommends gradual dose reduction after as little as one or two weeks of use.¹⁶ Ambien withdrawal may require milder sedatives to avoid heart palpitations and other possible health complications due to the rebound effects.¹⁵ More information on the rebound phenomena can be found below.

Ambien has a high potential for daily dependence and overuse.¹³ Coming off the drug without help or proper guidance can be risky to the patient and those around them, as will be discussed further below. Always thoroughly research before starting or stopping a prescription drug.

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Ambien Side Effects

Ambien and Ambien CR act swiftly on the central nervous system to induce sleep by way of its “knockout” effect that induces unconsciousness. Some of the side effects of the drug can result in sleep disturbances, physical discomforts, mental distress, and in some instances bizarre and unpredictable reactions. The “knockout” effect diminishes over time, which can result in a prolongation of sleep deprivation and other negative consequences.^1,16

Ambien, and many other drugs, cross the placental barrier and should not be used by nursing mothers.^5,16

When using Ambien, all other CNS depressants including alcohol, opioids, antianxiety meds, antipsychotics and similar should be avoided due to their cumulative effects, particularly psychomotor impairments and risk of coma or death.^3,13

Recommended doses have also been lowered, due to new findings concerning the intense and sometimes bizarre side effects of Ambien, such as sleep-walking, sleep-driving, etc., especially for women and the elderly. Drugmakers put additional black box warnings on the packaging, concerning the risks associated with taking Ambien.^1,2,7,16

Some of Ambien’s side effects from the FDA drug label ^1,16 and elsewhere where indicated:

Suicidal ideation, suicide attempts — note, the FDA recommends prescribing the least amount possible to prevent intentional suicide.
Severe anaphylactic reactions, anaphylactic shock, rash, allergy
Abnormal thinking and behaviors
Next morning impairment, FDA expresses caution for driving or other activities requiring alertness the next day ^7,13,16
Rebound Insomnia: Patients get prescribed Ambien most often as a fast-acting sleep aid. After a short time, however, there is a lessening of the “knockout” effect, where the patient may awaken after an hour or two and be unable to fall back asleep.
Vertigo, increased frequency of falls, injuries, and accidents: Dizziness, a sensation where the room is spinning, a common side effect of Ambien, that can produce an uncomfortable transition to a sleep state. Vertigo can also induce a disturbing waking sensation, which can occur at random times, especially for the extended-release version, which may cause these effects during one’s next workday or while driving or operating machinery.¹⁴
Ataxia, feeling intoxicated, drugged feeling: A condition resembling drunkenness caused by a toxic reaction to medications like Ambien, presents as slurred speech, inability to control voluntary muscles, or an inability to walk without stumbling, difficulty holding or controlling objects in the hand, such as eating utensils, unable to control the body (see DATE RAPE information).
Tachycardia: Racing heart even though at rest, also heart palpitations, or increased blood pressure.
Urticaria: Hives, raised itchy welts, rashes, can impact the airway which can also present as breathing difficulty. If the throat closes the patient must be sent immediately to ER.¹³
Headache
Abdominal disturbances: These are common on Ambien including loss of appetite, diarrhea, flatulence, abdominal pain, nausea, vomiting, constipation, hiccups, acid reflux, and heartburn.
Urinary tract infections
Dryness of the vaginal walls is a common side effect for women taking Ambien.
Flu-like symptoms: These can include sinusitis, throat infections, sore throat, chest pain, respiratory infection, fever, confusion, tinnitus, fatigue.
Asthenia: A sudden loss of physical strength or sudden sensation of overall weakness.
Amnesia: Chunks of time may be missing entirely, or memories may be scrambled and partially obscured for a period of time.
Drug-Induced sleepwalking, somnambulism: The phenomenon of combined wakefulness and sleep which presents as sleepwalking, sleep-driving, sleep-shopping, sleep-cooking, and so on, which the person will typically have no recollection of.⁹
Depression or worsened depression ¹³
Anxiety
Mood swings
Body aches: Especially of the neck, back, arthralgia (aching joints), myalgia (aching muscle or groups of muscles).
Nightmares
Respiratory depression
Hepatic impairment

What Is Ambien Used for?

Ambien is most frequently used in a therapeutic context for the short-term treatment of insomnia. Sleep deprivation can cause many health problems, including neurocognitive consequences.

Ambien as a Date Rape Drug

Quite apart from the intended medical or therapeutic uses, Ambien has been used in drug-facilitated sexual assault because of its fast onset and profound memory-obfuscating characteristics. Ambien is also hard to detect on a drug test. The drug is colorless, odorless and tasteless, and easily dissolves in alcohol, making it easy to slip into another’s drink unnoticed. The unsuspecting victim may not remember much, if any of what has happened, making a court conviction against the rapist or other perpetrator much harder to obtain.¹⁹

Ambien Alternative Names and Slang

Ambien®, Edluar®, Intermezzo®, Stilnox® and Zolpimist® are some of the trade names for the generic drug zolpimed tartrate. Ambien CR and zolpidem ER are the time-release versions of this medication. Ambien is sometimes referred to as a “Z” drug, along with other drugs used in the treatment of insomnia including zopiclone, eszopiclone, and zaleplon.²⁰

Ambien FAQs

There is much to learn about a drug that is as unpredictable and powerful as Ambien. Some of the most common questions are covered briefly below. We can provide more information by request on any of these or other important topics.

How Many Hours of Sleep Do You Need for Ambien? How Long Does Ambien Last?

Do not take Ambien if you are not able to stay at rest for at least seven or eight hours after taking the drug, as the sedating effects will last at least that long, and can sometimes linger beyond that time frame, into the next day.

Ambien has a very short half-life of only one to two hours. The active ingredient in Ambien, zolpidem, will reach peak blood levels, after an exceptionally short time, approximately thirty minutes. It is strongly recommended to take Ambien only immediately prior to retiring.

The reason it is so hard to detect Ambien on a drug test is that the drug is unlikely to show up as present in the body after as short a time as one or two days. A urine test may read positive if done within one or two days; however, testing done on a hair sample could be a more reliable method, sometimes that has shown a positive reading for 4-8 weeks according to a large research project in France published in the Journal of Forensic Science International in 2005.²³ .

Is Ambien a Benzodiazepine?

No. Ambien is classified as a non-benzodiazepine hypnotic sedative. Benzodiazepines have a sedating effect. They do share some but not all of the same side effects. Both Ambien and benzos are associated with a risk for abuse and addiction because of their euphoric and muscle-relaxing effects. Clinical trials published in the British Journal of Clinical Pharmacology showed that baboons demonstrated similar “drug-liking” effects for benzodiazepines and zolpidem.²¹

Benzodiazepine drugs are also sometimes prescribed for insomnia, but these two types of drugs act on the central nervous system and brain in different ways. There are certain GABA receptors that Ambien acts on such as the alpha-1 subclass, where benzodiazepines act upon subunits of the GABA alpha-1, alpha-2, alpha-3, and other classes. The fine wiring of the brain is a complex matter. Drug testing will show Ambien distinctly differently than benzodiazepines, or cannabis, or other drugs that are not in the same class.²² We can observe that Ambien and benzodiazepines are similar, but not entirely the same in the effects produced. For instance, both benzodiazepines and Ambien affect sleep, but the benzodiazepine class additionally produces anti-anxiety effects.²

Treatment for Ambien Addiction & Abuse

There is a high risk of acquiring a dependency on sleeping aids such as Ambien as clinical trials show they are clearly habit-forming.²¹ One of the common side effects of the drug is interrupted sleep, even when taking the drug as prescribed, which may lead to taking additional doses or taking it for a longer time than is recommended. Impaired memory is another factor that can lead to dependence, i.e., not remembering if or when one took the drug, leading to overuse.

Since one of the withdrawal effects of Ambien is rebound insomnia, this problem of lack of sleep can become a problematic, repeating loop, especially without proper protocols in place for tapering. There are many reasons one may decide to stop taking a drug like Ambien. The side effects of the drug can be debilitating to the extreme and this can happen after a relatively short time of taking the drug.

However, Alternative to Meds Center offers a holistic, medically monitored model for safely accomplishing Ambien withdrawal. At Alternative to Meds Center, we are committed to safely discontinuing medications, and also finding the root of the problems with sleep that led to prescribing a sleeping pill in the first place. On our services overview page, you will find much information to offer about the comprehensive treatments available in our in-patient retreat-style program for recovering from insomnia, and from the negative effects that were caused or aggravated by dependence on sleeping aids.

In particular, you may be interested in safe tapering protocols, therapeutic massage therapies, personal counseling in many genres, neurotoxin removal protocols, tailored nutritional guidance, and a wealth of other therapeutic services offered to our clients, geared towards authentic health recovery.

A healthy vibrant state includes being able to sleep soundly and restfully, which provides adequate energy for one’s successful day-to-day living. Alternative to Meds Center can provide Ambien alternatives and the means to help you overcome the challenges that may have impacted your life negatively. There is hope for a safe recovery, restored health, and optimal living. Alternative to Meds Center offers holistically treated Ambien withdrawal so life can be lived well and without further dependence on drugs.

1 (800) 301-3753 for Ambien Withdrawal Help

1. FDA label Ambien CR Approval 1992 [cited 2021 Sept 13]
2. “FDA Requires stronger warnings about rare but serious incidents related to certain prescription insomnia medications” FDA news release issued 2019 Apr 30 [cited 2021 Sept 13]
3. Wilkinson CJ, “The abuse potential of zolpidem administered alone and with alcohol.” Pharmacol Biochem Behav. 1998 May;60(1):193-202. doi: 10.1016/s0091-3057(97)00584-4. PMID: 9610942. [cited 2021 Sept 13]
4. Sleep Advisor authors, “How Do You Get Off Sleeping Pills – Symptoms and What to Expect.” June 7, 2020 [cited 2021 Sept 13]
5. Reichner C, “Insomnia and sleep deficiency in pregnancy.” Obstet Med 2015 Dec; 8(4): 168-171 [published onlin 2015 Sept 21) doi: 10.1177/1753495X15600572 PMID 27512475 [cited 2021 Sept 13]
6. Monti JM, Spence DW, Buttoo K, Pandi-Perumal SR. Zolpidem’s use for insomnia. Asian J Psychiatr. 2017 Feb;25:79-90. doi: 10.1016/j.ajp.2016.10.006. Epub 2016 Oct 12. PMID: 28262178. [cited 2021 Sept 13]
7. FDA, “Questions and Answers: Risk of next-morning impairment after use of insomnia drugs.” Reviewed 2018 [cited 2021 Sept 13]
8. Lähteenmäki R, Neuvonen PJ, Puustinen J, Vahlberg T, Partinen M, Räihä I, Kivelä SL. Withdrawal from long-term use of zopiclone, zolpidem and temazepam may improve perceived sleep and quality of life in older adults with primary insomnia. Basic Clin Pharmacol Toxicol. 2019 Mar;124(3):330-340. doi: 10.1111/bcpt.13144. Epub 2018 Dec 3. PMID: 30295409. [cited 2021 Sept 13]
9. Stallman HM, Kohler M, White J. Medication induced sleepwalking: A systematic review. Sleep Med Rev. 2018 Feb;37:105-113. doi: 10.1016/j.smrv.2017.01.005. Epub 2017 Jan 29. PMID: 28363449. [cited 2021 Sept 13]
10. Westermeyer J, Carr TM. Zolpidem-Associated Consequences: An Updated Literature Review With Case Reports. J Nerv Ment Dis. 2020 Jan;208(1):28-32. doi: 10.1097/NMD.0000000000001074. PMID: 31834190. [cited 2021 Sept 13]
11. 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 2021 Sept 13]
12. Victorri-Vigneau C, Dailly E, Veyrac G, Jolliet P. Evidence of zolpidem abuse and dependence: results of the French Centre for Evaluation and Information on Pharmacodependence (CEIP) network survey. Br J Clin Pharmacol. 2007 Aug;64(2):198-209. doi: 10.1111/j.1365-2125.2007.02861.x. Epub 2007 Feb 23. PMID: 17324242; PMCID: PMC2000636. [cited 2021 Sept 13]
13. Bouchette D, Akhondi H, Quick J. Zolpidem. [Updated 2021 Jul 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK442008/ [cited 2021 Sept 13]

14. Joester J, Vogler CM, Chang K, Hilmer SN. Hypnosedative use and predictors of successful withdrawal in new patients attending a falls clinic: a retrospective, cohort study. Drugs Aging. 2010 Nov 1;27(11):915-24. doi: 10.2165/11584480-000000000-00000. PMID: 20964465. [cited 2021 Sept 13]
15. Aggarwal A, Sharma D, “Zolpidem Withdrawal Delirium – A Case Report” Journal of Neuropsychiatry and Clinical Neurosciences https://doi.org/10.1176/jnp.2010.22.4.451.e27 [online] [cited 2021 Sept 13]
16. FDA label Ambien (zolpidem tartrate) tablets [online] [cited 2021 Sept 13]
17. Sharan P, Bharadwaj R, Grover S, Padhy SK, Kumar V, Singh J. Dependence syndrome and intoxication delirium associated with zolpidem. Natl Med J India. 2007 Jul-Aug;20(4):180-1. PMID: 18085123. [cited 2021 13]
18. Hajak G, Clarenbach P, Fischer W, Rodenbeck A, Bandelow B, Broocks A, Rüther E. Rebound insomnia after hypnotic withdrawal in insomniac outpatients. Eur Arch Psychiatry Clin Neurosci. 1998;248(3):148-56. doi: 10.1007/s004060050032. PMID: 9728734.[cited 2021 Sept 13]
19. Anilanmert B, Çavuş F, Narin I, Cengiz S, Sertler Ş, Özdemir AA, Açikkol M. Simultaneous analysis method for GHB, ketamine, norketamine, phenobarbital, thiopental, zolpidem, zopiclone and phenytoin in urine, using C18 poroshell column. J Chromatogr B Analyt Technol Biomed Life Sci. 2016 Jun 1;1022:230-241. doi: 10.1016/j.jchromb.2016.03.040. Epub 2016 Apr 9. PMID: 27107852. [cited 2021 Sept 13]
20. Brandt J, Leong C. Benzodiazepines and Z-Drugs: An Updated Review of Major Adverse Outcomes Reported on in Epidemiologic Research. Drugs R D. 2017;17(4):493-507. doi:10.1007/s40268-017-0207-7 [cited 2021 Sept 13]
21. Victorri-Vigneau C, Dailly E, Veyrac G, Jolliet P. Evidence of zolpidem abuse and dependence: results of the French Centre for Evaluation and Information on Pharmacodependence (CEIP) network survey. Br J Clin Pharmacol. 2007;64(2):198-209. doi:10.1111/j.1365-2125.2007.02861.x [cited 2021 Sept 13]
22. Piergies AA, Sainati S, Roth-Schechter B. Lack of cross-reactivity of Ambien (zolpidem) with drugs in standard urine drug screens. Arch Pathol Lab Med. 1997 Apr;121(4):392-4. PMID: 9140309. [cited 2021 Sept 13]
23. Chèze M, Duffort G, Deveaux M, Pépin G. Hair analysis by liquid chromatography-tandem mass spectrometry in toxicological investigation of drug-facilitated crimes: report of 128 cases over the period June 2003-May 2004 in metropolitan Paris. Forensic Sci Int. 2005 Oct 4;153(1):3-10. doi: 10.1016/j.forsciint.2005.04.021. PMID: 15922526. [cited 2021 Sept 13]

Originally Published Oct 2, 2018 by Lyle Murphy, Founder

This content has been reviewed and approved by a licensed physician.

Dr. Michael Loes, M.D.

Dr. Michael Loes is board-certified in Internal Medicine, Pain Management and Addiction Medicine. He holds a dual license in Homeopathic and Integrative Medicine. He obtained his medical doctorate at the University of Minnesota, Minneapolis, MN, 1978. Dr. Loes performed an externship at the National Institute of Health for Psychopharmacology. Additionally, he is a well-published author including Arthritis: The Doctor’s Cure, The Aspirin Alternative, The Healing Response, and Spirit Driven Health: The Psalmist’s Guide for Recovery. He has been awarded the Minnesota Medical Foundation’s “Excellence in Research” Award.

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Lyle Murphy

Lyle Murphy is the founder of the Alternative to Meds Center, a licensed residential program that helps people overcome dependence on psychiatric medication and addiction issues using holistic and psychotherapeutic methods.

Ambien Addiction, Withdrawal, Side Effects, Alternatives, Tapering

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