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Ambien: Insomnia Treatment Option

A Hypnotic, Ambien Can Help Initiate and Maintain Sleep

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Updated January 22, 2014

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The pharmaceutical drug zolpidem -- sold under the brand names of Ambien and Ambien CR -- is a commonly prescribed hypnotic used to initiate sleep.

Uses of Ambien

Ambien is a hypnotic drug that has direct effects on the central nervous system, specifically the brain. It causes drowsiness and is safe and effective for initiating and maintaining sleep. It is used to treat insomnia or acute insomnia.

You may be prescribed a standard or controlled-release (CR) formulation of the drug. These vary slightly in how long it takes the body to metabolize them, but their effects are the same.

How Does Ambien Work?

Ambien promotes the activity of GABA receptors, a special type of neurotransmitter. Neurotransmitters are chemicals that serve as messengers between nerve cells (neurons). The additional activity of the GABA receptors inhibits neuron activity that contributes to insomnia.

Who Should Not Use Ambien?

Fortunately, the risk of tolerance or dependence with extended use of Ambien is less than with other benzodiazepines. The medication should not be taken with alcohol or with other drugs that suppress the central nervous system or respiratory system, as it may slow or stop your breathing.

It may not be the best drug to use if you have a history of alcohol abuse, drug abuse, depression, psychiatric disorders, lung, or liver problems. It should be used with caution in the elderly or debilitated.

What Are Common Side Effects of Ambien?

There are many potential side effects of any drug. At high doses, Ambien may cause amnesia (memory loss), suppression of REM sleep, or breathing difficulties. Abrupt cessation of the medication at higher doses may also cause rebound insomnia. Although an individual likely won't experience most side effects associated with the drug -- and may indeed not have any of them -- some that commonly occur include:

  • Headache
  • Drowsiness, lethargy, or a "drugged" feeling
  • Dizziness, lightheadedness
  • Constipation or diarrhea
  • Back pain
  • Allergic reactions
  • Sinusitis (sinus infection)
  • Pharyngitis (sore throat)
  • Dry mouth
  • Flu-like symptoms
  • Palpitations (irregular heartbeat)
  • Depression
  • Rash

What Are Potential Serious Reactions of Ambien?

With the use of any drug, there are also risks of serious side effects. These occur more rarely, but include:

  • Worsening depression
  • Suicidal thoughts
  • Aggressive behavior
  • Complex sleep-related behaviors (such as doing activities while asleep)
  • Hallucinations
  • Amnesia (memory loss)
  • Anaphylaxis (allergic reaction such as throat swelling and difficulties breathing)
  • Withdrawal after stopping the drug abruptly

What Safety Precautions Need to Be Taken With Ambien?

Ambien should be avoided in pregnancy and with breastfeeding. Certain individuals, as mentioned above, should use the medication with caution or not at all. There is no monitoring necessary with Ambien's use. If you experience any difficulties, you should be in close contact with your primary health provider.

Sources:

“Ambien.” Epocrates Rx Pro. Version 2.90, 2009. Epocrates, Inc. San Mateo, California.

Cooper, D.H. et al. The Washington Manual of Medical Therapeutics. 32nd edition, 2007. 14. Lippencott, Williams & Wilkins. New York.

Katzung, B.G. Basic & Clinical Pharmacology. 9th edition, 2004. 134-140. The McGraw-Hill Companies, Inc. New York.

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