The inability to fall asleep or stay asleep is a real problem for thousands of people. The Sleep Health Foundation reports that about 1 in 3 people have at least a mild case of insomnia. Perhaps when many people in this group are tired of tossing and turning in bed using natural remedies that don’t quite seem to work, sleeping pills, such as Ambien, may seem like the only reasonable option to try.
When used in small amounts for a short time, many Ambien users seem to find some relief from their long sleepless nights. But at higher doses, the drug can produce addictive feelings of euphoria that can make it difficult to stop using. The longer it is abused, the harder it is to quit. Once dependence has become the norm, Ambien detox is often the only way to go to get off the merry-go-round.
Ambien, known by its generic name zolpidem tartrate, is a sleeping pill that helps people fall asleep faster, particularly for those that have insomnia. The U.S. Food and Drug Administration (FDA) approved the oral sedative-hypnotic for use in 1992. Its generic form was approved in 2007. Tic tacs, sleepeasies, and zombie pills are all nicknames for Ambien.
Ambien is also called a “Z-drug,” and its effects on the brain are similar to those of benzodiazepines (examples: Xanax, Valium) because they affect the same receptors. Ambien slows down activity in the brain and activates the gamma-aminobutyric acid (GABA) neurotransmitter as it binds it to the GABA receptors. Users start to feel the drug’s effects within 20 minutes. They are calm and relaxed so that they can get to sleep. The company that makes Ambien advises carefully monitoring Ambien users who have a history of addiction or substance abuse. People in this group are at higher risk of forming a dependence on the drug.
When used in lower, therapeutic doses, Ambien can be beneficial. It generally is recommended that the lowest dose is taken for no more than seven to 10 days. Also, Ambien prescriptions should not exceed a one-month supply. The recommended initial dose is five milligrams (mg) for women and either five or 10 milligrams for men, according to Ambien’s Medication Guide. These recommendations may change for users who are older and those who have other conditions, such as liver failure.
A doctor should determine if users will need larger doses of Ambien. Higher doses can help people stay asleep longer, but they also carry high addiction potential. Once users develop a physical and psychological dependence on Ambien, which is indicated by having a high tolerance for it, it can be challenging to end it on their own.
Signs of addiction and dependence manifest when users stop taking the medication. They may be tempted to abruptly end their long-term use, which is never recommended. Once the body becomes dependent on receiving GABA from an outside source, it can trigger a dangerous reaction when the source is taken away. A sudden break in Ambien can lead to chronic depression, intense panic attacks, seizures, increased heart rate, and other life-threatening health risks, especially if these are left untreated.
These withdrawal symptoms are hardly life-threatening, but some of them can be so severe that users who attempt to quit Ambien use without professional help are at risk of ending up in a situation that could have dire consequences. Seizures, though rare, could happen after longtime use is abruptly interrupted. Quitting suddenly can shock the brain’s GABA receptors, which brings on the seizures. Ambien withdrawal could also lead to delirium, which is characterized by confusion and altered wake-sleep patterns.
Relapse is also a possibility as Ambien users who stop drug use suddenly may go back just to relieve uncomfortable withdrawal symptoms. This is yet another important reason to undergo Ambien detox as soon as possible.
To end Ambien dependence properly, medical detoxification that involves a tapering process is recommended. Slowly weaning users off the drug help minimize withdrawal symptoms during this period, which can run three to seven days. A doctor should administer and monitor the tapering process in a clinical setting, such as a hospital or a drug rehabilitation center.
It is important that the taper happens gradually so users can avoid the worst of the withdrawal symptoms, which include rebound insomnia. Rebound insomnia is significantly more intense and harder to deal with than the sleep issues someone in Ambien withdrawal may have experienced prior to using. A person with rebound insomnia may not be able to sleep for days.
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There are several individual factors that shape how the withdrawal period happens. Everyone is different, so the experience varies from person to person.
First 12 hours: Ambien (zolpidem) has a half-life of between two to three hours. The half-life of a drug is the amount of time it takes for it to leave the body. Some users may experience withdrawal symptoms within four hours after their last dose. Irritability may be experienced during this period. Other symptoms may start later in the day.
1-2 days: At this stage, which is one to two days after the last dose is taken, Ambien users may experience rebound insomnia. This lack of sleep is more extreme than the initial insomnia being treated. Changes in one’s mental state, mood, or behavior may be noticed. Increased irritability, memory loss, confusion, and delirium may manifest at this stage.
1-2 weeks: The full effects of Ambien withdrawal usually are underway within the first full week after use has stopped. Withdrawal may also peek in the first week, but this also can happen during the second week. Physical and mental symptoms can become more challenging during this period. They include nausea and vomiting, panic attacks, seizures, hallucinations, and nightmares, among others. Rebound insomnia can still linger during this time, and users may deal with uncontrollable crying, chronic depression, and high levels of stress.
First few months: Ambien withdrawal typically runs its course over two weeks, but there are people who may experience symptoms a few months later and even up to a year-plus. This population may be struggling with psychological dependence, which can be addressed in a quality, effective addiction treatment program. Such a program starts with a taper that allows them to adjust their sleep schedules without the help of the drug. Professional psychiatric care is recommended for these cases.
Ambien dependence and addiction are best treated in a professional rehabilitation center where the focus is on recovery. How long the process takes depends on personal factors such as:
After medical detoxification removes all traces of the drug from the body safely and under the 24/7 guidance of medical professionals, the next step is to enter a treatment program that includes the best options for the person in recovery. These options are based on the person’s initial evaluation.
Clients could be placed in residential treatment, intensive outpatient treatment, or partial hospitalization programs. All of these settings give recovering Ambien users much-needed time to address their dependence. These treatment programs can be customized, but they must first meet the individual’s needs. Addiction treatment can include:
While a medical professional could suggest psychiatric medications to treat depression or anxiety due to Ambien withdrawal, there are not many drugs that will manage the actual side effects.
Those struggling with severe anxiety or suicidal thoughts are likely to receive short-term medications for mood-stabilizing reasons.
There is medical research that suggests a drug called quetiapine, which is an antipsychotic used to treat bipolar disorder, schizophrenia, and severe depression. The drug has been shown to help with Ambien withdrawal symptoms.
Those who wish to stop using Ambien are encouraged to talk with a medical professional about possible withdrawal symptoms. The potential for seizures during withdrawal make this a dangerous process, and rather than stopping cold-turkey, individuals are encouraged to taper their dose of Ambien. It will help to prevent seizures or other withdrawal symptoms that may be present.
It is possible to overdose on Ambien, which can lead to respiratory distress that can deprive the brain of vital oxygen that it needs to function. A lack of oxygen flow to the brain can result in permanent injury or death. Overdose is also possible if the drug is abused with others like alcohol or other powerful benzodiazepines. In the event that someone takes too much Ambien and needs prompt medical attention, call emergency services at 911 immediately.
It’s crucial for someone struggling with Ambien addiction to have a solid emotional support crew while they stop using the medication. Ambien is a sedative, and as we’ve mentioned, medical detox is necessary to stop using the substance. Detox, however, is merely a starting point, and you must follow a comprehensive plan to attain long-term sobriety.
Cognitive-behavioral therapy will teach an individual coping skills, and therapy will be helpful when you are working through psychological issues. Group therapy will be another source of emotional support for those struggling with Ambien addiction.
US Food and Drug Administration. (May 2013). “FDA Drug Safety Communication: FDA approves new label changes and dosing for zolpidem products and a recommendation to avoid driving the day after using Ambien CR.” U.S. Food & Drug Administration. Retrieved from https://www.fda.gov/drugs/drugsafety/ucm352085.htm
Substance Abuse and Mental Health Services Administration. (May 1, 2013.) “Emergency Department Visits for Adverse Reactions Involving the Insomnia Medication Zolpidem.” Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/sites/default/files/DAWN079/DAWN079/sr079-Zolpidem.htm
Medical Guide. (n.d.) Ambien. Retrieved May, 2018, at from http://products.sanofi.us/ambien/Ambien_MedGuide.pdf
Quetiapine: MedlinePlus Drug Information. (n.d.). Retrieved from https://medlineplus.gov/druginfo/meds/a698019.html