How to Wean Off Ambien and Still Sleep

Ambien is a commonly used drug to help those with insomnia. Ambien can be habit forming because many who use it fear they won’t be able to sleep after quitting. Some people also use Ambien recreationally for the pleasant, hypnotic effects of the drug. This can lead to physical and psychological dependence, making quitting difficult.

What is Ambien?

Ambien (zolpidem tartrate) is an addictive prescription drug approved by the U.S. Food and Drug Administration (FDA) for the treatment of insomnia. It is a non-benzodiazepine drug that works in a similar way as benzodiazepines, by mimicking the action of the inhibitory neurotransmitter GABA (gamma-Aminobutyric acid) to block impulses between nerve cells in the brain and induce sleepiness.¹ Ambien is one of the Z-drugs, a group of hypnotic drugs beginning with the letter “Z” (zolpidem, zopiclone, and zaleplon) that cause sedation and are commonly used in the treatment of sleep problems.

What Are the Risks Associated with Z-Drugs?

According to the FDA, the most commonly observed adverse reactions of Ambien are:²

• Dizziness
• Drowsiness
• Diarrhea
• Drugged feelings
• Sleep disturbances (vivid dreams, nightmares)
• Headache

One of the most concerning side effects associated with Ambien is the increased risk of complex sleep behaviors.³ These are complex activities, normally associated with wakefulness, that occur when someone is asleep or in a sleep-like state after taking Ambien. Examples of complex sleep behaviors include sleepwalking, sleep driving, sleep cooking, self-harm, eating food, writing emails, and taking other medicines.^3-4 After awakening the next morning, the individual often has no memory of these activities.⁵ Because the individual is not awake when performing the activities, these are dangerous behaviors that can cause serious harm. Since Ambien was approved in 1992, the FDA has identified at least 20 deaths resulting from cases of complex sleep behaviors.³

Ambien is indicated for the short-term treatment of insomnia, and dependence may develop if patients take this drug for an extended period of time. Chronic use of Ambien often results in an increased tolerance, meaning that higher dosages are needed to fall asleep.⁶ The abrupt discontinuation of Ambien has been shown to cause withdrawal symptoms in some individuals, and these effects are worsened in people with increased tolerance to the drug. Some of the symptoms of Ambien withdrawal include:²

• Insomnia
• Fatigue
• Nausea
• Vomiting
• Flushing
• Lightheadedness
• Sweating
• Uncontrolled crying
• Stomach cramps
• Abdominal discomfort
• Panic attack
• Nervousness
• Tremors
• Convulsions

How to Taper off Ambien

An effective way to reduce the possibility of Ambien withdrawal is to taper off the drug. Your physician will likely suggest a tapered dose regimen that can wean you off the medication. For example, you may initially be instructed to take a smaller dose. It may then be suggested to take this smaller dose every other day rather than every day. The doses may then be spaced out even further, until you are safely weaned off the medication.

Unfortunately, many people who feel dependent on the effects of Ambien will not be able to adhere to these recommendations from their doctor. These situations require treatment from addiction specialists. If you are in such a situation, please know that there is professional assistance available to help you successfully get off Ambien.

Treatment Options

Because the withdrawal symptoms of Ambien are often unpleasant, you may benefit from undergoing an Ambien taper detox program in a rehab facility. Trained professionals will address any withdrawal symptoms to keep you safe and comfortable during the detox process, which can take several weeks as the dosages are gradually decreased and the medication works its way out of your system.

Sources

1. Crestani, F., Martin, J.R., Möhler, H., & Rudolph, U. (2000). Mechanism of action of the hypnotic zolpidem in vivo. British Journal of Pharmacology, 131(7), 1251-1254.
2. U.S. Food and Drug Administration. (2008). Ambien (zolpidem tartrate) tablets: highlights of prescribing information.
3. U.S. Food and Drug Administration. (2019). Taking Z-drugs for Insomnia? Know the Risks.
4. Siddiqui, F., Osuna, E., & Chokroverty, S. (2009). Writing emails as part of sleepwalking after increase in Zolpidem. Sleep Medicine, 10(2), 262-264.
5. Chen, L.F., Lin, C.E., Chou, Y.C., Mao, W.C., Chen, Y.C., & Tzeng, N.S. (2013). A comparison of complex sleep behaviors with two short-acting Z-hypnosedative drugs in nonpsychotic patients. Neuropsychiatric Disease and Treatment, 9, 1159-1162.
6. Wright, B.T., Gluszek, C.F., & Heldt, S.A. (2014). The effects of repeated zolpidem treatment on tolerance, withdrawal-like symptoms, and GABAA receptor mRNAs profile expression in mice: comparison with diazepam. Psychopharmacology, 231(15), 2967-2979.