ARTICLE OVERVIEW: Withdrawal following the rapid dose decrease or abrupt discontinuation of Ambien can include anxiety, tremor, palpitation, or seizure. So, what can you expect as you detox from this hypnotic medication? Is there a preferred method for quitting Ambien? We review here.
TABLE OF CONTENTS
- Who Needs Detox
- Prescribing Guidelines
- What is Detox/Withdrawal?
- Common Symptoms
- Detox At Home?
- Signs Of A Drug Problem
- Questions About Ambien Detox
Who Needs Detox
Anyone who has become physically dependent on Ambien can benefit from a period of decreased dose tapering and/or abstinence. In fact, Ambien is indicated for the short-term treatment of insomnia … but is not meant to be take form more than a few weeks at a time. In fact, the FDA approved label for Ambien reports that the medication has been shown to decrease sleep latency for only up to 35 days in controlled clinical studies. Ambien may not help you get to sleep after that. Even more, doctors are supposed to reevaluate your case if insomnia persists after 7 to 10 days of use.
How does it work?
Although Ambien is a non-benzodiazepine hypnotic, it acts on the central nervous system in ways similar to benzodizaepines. Its main ingredient is zolpidem, a sedative hypnotic that is a short acting inducer of sleep. It is used to treat conciliating insomnia and reconciliation insomnia, or difficulty falling asleep or staying asleep. It works by slowing activity in the brain to allow sleep.
The recommended initial dose is 6.25 mg for women and either 6.25 or 12.5 mg for men, taken only once per night immediately before bedtime with at least 7-8 hours remaining before the planned time of awakening. Why the difference in dosing by gender? Women have been found to have a significantly higher serum Ambien concentration than men at equivalent dosage. In some persons, the higher morning blood levels following use of the 12.5 mg dose increase the risk of next day impairment of driving and other activities that require full alertness.
Some studies demonstrated that sudden discontinuation of Ambien by doses within the normal recommended range 2 to 4 weeks after treatment has not been associated with withdrawal symptoms. Ambien dependence and withdrawal symptoms have been reported in persons with doses between 160 to 2000 mg per day.
Still, dosage adjustment may be necessary when Ambien is taken combined with other central nervous system depressants. In fact, all drugs like Ambien should be used at the lowest effective dose and only after careful assessment of sleep disturbances for:
- Behavioral changes.
- Worsening of psychiatric or physical disorders.
- Withdrawal symptoms.
Ambien is a super-strong, and potentially dangerous drug!
Sleep problems usually improve within 7 to 10 days after you start taking Ambien. However, Ambien should normally be taken for short periods of time. So, if you take Ambien for 2 weeks or longer, Ambien may not help you sleep as well as it did when you first began to take the medication. Nevertheless, what happens when you take Ambien for a period of six (6) weeks or longer (considered long term use)?
What Is Withdrawal?
Withdrawal occurs after you develop physical dependence on the chemicals found in drugs like Ambien. The human brain develops dependence as a state of adaptation; when we take psychoactive drugs, the brain adapts. In this case, it “speeds up” certain functions to account for the sedative effects of zolpidem.
When we experience abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of an antagonist…the brain triggers a specific withdrawal syndrome.
Symptoms of withdrawal can persist for days, weeks, or months after use depending on a few factors:
- The length of time you have used Ambien.
- The dosing amount/frequency of Ambien dosing
- Your general health.
- Your medical history.
To generalize, overall symptoms of Ambien start a few hours to a couple of days after your last dose of Ambien and can last for several weeks after peak symptoms have resolved. In fact, Ambien affects each person differently. People who develop addiction to or extreme dependency on Ambien may experience a more difficult detox process than those who take Ambien for short period of time at low doses.
Sedative/hypnotics have produced withdrawal signs and symptoms following abrupt discontinuation. These reported symptoms range from mild dysphoria, an abnormal state of mood, and insomnia to a withdrawal syndrome that may include abdominal and muscle cramps, vomiting, sweating, tremors, and convulsions. Why such a dramatic list of negative side effects?
Experts do not yet know.
One hypothesis about the reason Ambien withdrawal triggers such symptoms is that long-term doses of zolpidem saturate specific neurotransmitter receptors. Therefore, high-dose Ambien may have a paradoxical effect to decrease anxiety, and abrupt discontinuation of high doses would produce dangerous withdrawal symptoms.
Sedative hypnotics like Ambien produce withdrawal signs and symptoms following abrupt discontinuation. These reported symptoms range from mild dysphoria and insomnia to a full blown withdrawal syndrome with symptoms like:
- Abdominal and muscle cramps.
- Panic attack.
- Uncontrolled crying
In primarily depressed people treated with sedative-hypnotics, worsening of depression, and suicidal thoughts and actions, including completed suicides, have been reported. Suicidal tendencies may be present in such persons and protective measures may be required. Intentional over dosage is more common in this group of people. Furthermore, this 2011 study published in the Indian Journal of Pharmacology found that zolpidem use in and by psychiatric patients has led to abuse, dependence, and complications like delirium during withdrawal.
Detox At Home?
Never come off Ambien cold turkey or unsupervised. Ambien detox can cause adverse or serious side effects. This is why any Ambien detox requires medical supervision. In fact, the safest way to detox from Ambien is under medical supervision.
Your doctor can help you first taper down your doses of Ambien over the period of a few weeks (or more) and set up an alternative plan for dealing with problems sleeping. Additionally, medical supervision helps identify and treat problems as they occur.
Do not stop taking zolpidem without talking to your doctor, especially if you have taken it for longer than 2 weeks.
Furthermore, Ambien abuse, dependence, and withdrawal syndrome can be all mixed up. In fact, concerns about addiction are increasing in the recent years due to increased number of reported cases. Overprescription may be the cause. Or, use of this drug outside of its therapeutic goals and its short half-life predisposes adverse events.
Still, Ambien is one of the top 3 drugs prescribed to people with sleeping disorders. It is recommended that you use it at the lowest effective dose for only a period of a few weeks, or less. In fact, behavioral therapy for insomnia is preferred to prescription Ambien. The American College of Physicians released 2016 clinical practice guidelines on the management of chronic insomnia disorder in adults. Recommendations include cognitive behavioral therapy for insomnia as the initial treatment for chronic insomnia disorder .
Dependence vs. Addiction
Ambien is classified as a Schedule IV controlled substance by federal regulation. This is because it can be both abused AND can cause physical dependence. But the two issues are distinct. What’s the difference?
Dependence is a state of adaptation in which exposure to a drug induces changes to the brain. This can include tolerance, a diminution of one or more of the drug effects over time. Tolerance may occur to both desired and undesired effects of drugs and may develop at different rates for different effects.
Abuse is characterized by misuse of the drug for non-medical purposes, often in combination with other psychoactive substances. Abuse often leads to addiction, a primary, chronic, neurobiological disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving. Drug addiction is a treatable disease, using a multidisciplinary approach, but relapse is common.
Signs of a Drug Problem
KNOW THIS: Drug problems are not moral problems. If you are misusing Ambien, you are not alone. Medical professionals can help you overcome your dependency. The first step is accepting you have a drug problem. If you are willing to admit a problem, help is out there!
How do you know you have a problem with Ambien?
First, if you think you have a problem, you probably do. Second, most drug problems involve intention. If you are taking Ambien to get high, this is a problem. But if you are taking Ambien therapeutically as prescribed, be aware of its ability to cause dependence and tolerance. Do not take Ambien for more than a few weeks at a time. And, look for behavioral changes to treat your insomnia.
If you are using Ambien to achieve euphoria and stimulation and not for sedation…speak with a medical professional. Or, if you are taking Ambien in the daytime or in ANY WAY OTHER THAN PRESCRIBED, you may need professional help. Other signs of an Ambien problem include:
- Losing control of drug use, or taking more Ambien more often than you wanted.
- Continued use despite negative consequences to health, home, or work.
- Quitting but not being able to stay quit.
Finally, if any of these symptoms occur, you may need special attention. Speak with your doctor if you notice any of the following symptoms while taking Ambien:
- Abnormal extroversion.
- Mood disorders.
- Aggressive behavior.
- Loss of personal identity.
- Strange behavior.
- Suicidal thoughts.
- Worsening depression.
Questions about Ambien Detox
Do you still have questions about Ambien detox? Please ask your questions in the comments section below and we will get to you promptly.
Reference Sources: FDA: Ambien label
NIH: Zolpidem withdrawal delirium
NIH: Zolpidem Dependency and Withdrawal Seizure: A Case Report Study
All of the information on this page has been reviewed and verified by a licensed medical professional.