What Are Some Side Effects of Ambien?
Ambien (generic name: zolpidem tartrate) was designed to provide insomnia relief, without the side effects of barbiturate drugs. Ambien side effects include:
- Rapid heartbeat
- Loss of appetite
- Impaired vision
- Slow breathing rates
- Muscle cramps
- Allergic reactions
- Memory loss
- Inability to concentrate
- Emotional blunting
- Depression and/or suicidal thoughts
Finding a medication that provides satisfying sleep without serious side effects can be challenging.
Many widely used sleep medications, including benzodiazepines like Valium and barbiturates like Nembutal, can cause daytime drowsiness, over-sedation, and chemical dependency. In the 1990s, Ambien, or zolpidem tartrate, was designed to offer the benefits of other hypnotic drugs without some of the more severe side effects. Ambien has since become one of the most popular sleep medications, ranking at number 15 on the list of the most frequently prescribed drugs in the country, according to IMS Health.
At its introduction, Ambien was touted as a safe short-term sleep aid, lacking the risks of narcotic sedatives. But now that Ambien has been available to the public for over 20 years, the more serious side effects of this medication have come to light. Understanding these side effects can help consumers make informed decisions about using hypnotic drugs and may discourage nonmedical users from taking this drug recreationally.
Physical Side Effects
When taken as directed, Ambien calms the activity of the brain and nerves, making it easier for the user to fall asleep. At the same time, Ambien can have serious side effects on the cardiovascular, respiratory, digestive, and sensory systems. Some of the potential reactions to Ambien include:
- Rapid or irregular heartbeat
- Nausea and vomiting
- Abdominal pain
- Appetite loss
- Double vision
- Pinpoint pupils
- Respiratory depression
- Muscle cramps
- Skin rashes
- Abnormal body movements
Some users have had a life-threatening allergic reaction to zolpidem.
Symptoms of an allergic response include hives, shortness of breath, and swelling of the face, lips, mouth, or tongue. An allergic reaction requires emergency medical treatment.
Ambien is categorized as a non-benzodiazepine hypnotic medication. The chemical structure of this drug was designed to reproduce the effects of benzodiazepines on the central nervous system without the potential for abuse or addiction. Like benzodiazepines, Ambien acts on receptor cells in the brain that bind with GABA (gamma-aminobutyric acid), a brain chemical that influences sleep and other neurological activities. Some users have experienced negative cognitive or psychological side effects to Ambien, such as:
- Memory loss
- Difficulty concentrating
- Disorientation to place or time
- Loss of emotional affect
- Loss of pleasure in daily life
- Suicidal thoughts or suicide attempts
- Sleep disturbances
Although Ambien was originally intended to produce less drowsiness than other sleep medications, recent research has shown that at higher doses, the drug can remain active in the individual the morning after it is taken. The U.S. Food and Drug Administration (FDA) recently issued a warning about the possibility of “next-morning” impairment after taking Ambien. The FDA found that in some users, blood tests revealed that there was enough Ambien in the system to cause impairment at tasks that require mental alertness and coordination, such as driving. To reduce the risk of this side effect, the FDA recommends that prescribers limit the dose of the drug, especially for women. Individuals who take Ambien for nonmedical reasons are at risk of experiencing an intensification of adverse side effects, including the following:
- Excessive sedation
- Confusion and disorientation
- Lack of motor coordination
- Slow response times
- Delayed reflex reactions
- Impaired judgment
Although Ambien is classified as a sedative, this drug can give the user a rush of energy and euphoria when it is abused at high doses. However, misusing this drug can result in extreme drowsiness, confusion, and clumsiness, all of which increase the risk of falls, fractures, and other accidental injuries. The National Highway Traffic Safety Administration reports that users who take Ambien to the point of intoxication may experience sedation for up to 16 hours after taking the drug. Taking Ambien with other drugs that depress the central nervous system, such as alcohol, opioid pain medications, or tranquilizers, intensifies the sedative effects of Ambien and heightens the risk of overdose or injury.
Depression and suicidal thoughts have been observed in some individuals who have taken Ambien. The DARU Journal of Pharmaceutical Sciences presents a case report of a young man who became depressed and attempted suicide after taking Ambien. He had no known history of mood disorders or past suicide attempts. The FDA cautions that individuals with a history of depression may experience a worsening of their depressive symptoms and an increase in suicidal thoughts after taking Ambien.
Sleepwalking and Other Activities
After taking Ambien before going to sleep, some individuals have experienced episodes of sleep walking and other unconscious behaviors. These activities include eating, driving, having sex, and holding conversations with other people. In these reported cases, the individuals were unaware of these activities while they were occurring. Case studies published in the Journal of Clinical Sleep Medicine indicate that some patients have experienced a behavior called sleep eating disorder, or night eating disorder, after taking Ambien. These individuals woke to find evidence that they had consumed food during the night, but they had no memory of doing so. Other patients reported having complete conversations, leaving their homes to walk through the neighborhood, or even waking up behind the wheel with no memory of driving. One woman had alarms installed on the doors of her home to alert her family if she tried to leave the house while sleeping.
For some users, sleep behaviors can be corrected by reducing the dose of Ambien, but in extreme cases, the drug may have to be discontinued in order to prevent the behavior.
Although Ambien and other sedative-hypnotics are still widely prescribed as short-term treatments for insomnia, the Food and Drug Administration (FDA) changed prescribing guidelines in 2012 to cut the recommended lowest dose in half.
This is after numerous reports of users participating in dangerous activities, including driving, having sex, and eating, while they were reportedly asleep. These instances are sometimes called Ambien blackouts: The person performs activities after they have taken Ambien, although they do not remember them. The clinical term, however, is parasomnia – an activity like walking, eating, talking on the phone, and others, which occurs after a person has gone to sleep.
There are certainly reports of sleepwalking, sleep-eating, and sleep-driving that do not involve Ambien and other prescription sleep aids, but the addition of Ambien appears to induce these behaviors in people who do not normally have them and may potentially make them worse in people who do have parasomnias.
Ambien can induce complex behaviors while asleep. The most famous of these is sleep-driving, which has led to legal problems for people who take Ambien, whether as prescribed or for recreational reasons. The FDA notes that use of alcohol and other drugs that depress the central nervous system (including prescribed opioid painkillers) increases the risk of parasomnias, especially more complex and dangerous ones like sleep-driving. The person will get out of bed, get into their car, and begin driving as normal, without being awake or fully awake; the person will not remember the incident and may only be aware of the incident if they are pulled over and arrested for intoxicated driving.
The National Highway Traffic Safety Administration (NHTSA) reports that the first four or five hours after consuming Ambien involves cognitive and motor coordination impairment, whether the person is asleep or not.
Sleep-eating is another dangerous activity that people may perform while experiencing an Ambien blackout. Without remembering, a person may get out of bed and eat; while this could be harmful for people who are trying to lose weight or who have a regulated diet for other health reasons, sleep-eating is also dangerous because the person may attempt to prepare food on the stove or in the oven, and hurt themselves or cause damage to their house.
A report in the Wisconsin Law Journal from 2006 notes that one woman sued the pharmaceutical company that manufactures Ambien because she ate dangerous items, including raw eggs and uncooked rice, on top of whole loaves of bread, numerous canned goods, and entire bags of chips and candy. She reportedly woke up vomiting from noxious combinations of food, developed an ulcer, and gained an unhealthy amount of weight very quickly.
More on Drug Side Effects
Having Sex while Asleep
Having sex during an Ambien blackout may lead to contracting sexually transmitted infections (STI), including HIV and herpes. While people with partners or spouses are more likely to experience this parasomnia, it is possible that a person may take Ambien, sleepwalk, and initiate sexual contact with a stranger or acquaintance. If prophylactics are not used, then either person could contract an STI.
People who struggle with Ambien abuse and addiction may intentionally mix the drug with other intoxicating substances, such as alcohol, to enhance the euphoric effects. This means that they may experience more blackouts than other people, especially since alcohol can also cause blackouts or large patches of amnesia. During a blackout, people may accidentally harm themselves or others.
Abuse, Addiction, and Withdrawal
Ambien was first developed to provide an effective alternative to other sleep medications, without the potential for abuse or addiction.
However, research has shown that Ambien can produce tolerance, dependency, and withdrawal — all signs of a potentially addictive drug. One of the most serious side effects of using Ambien is the possibility of becoming chemically dependent on the medication, or needing Ambien in order to feel comfortable and function normally.
If Ambien is taken according to a doctor’s orders and used on a short-term basis, chemical dependency and addiction are unlikely to develop. Individuals at risk of addiction include those who take Ambien for longer than a few weeks, those who take more than the recommended dose, and recreational users who abuse the drug for nonmedical reasons. Recreational users often take Ambien in unsafe ways, such as crushing the drug into a powder and mixing it with alcoholic beverages or snorting it. Taking Ambien this way significantly increases the risk of over-sedation, overdose, and addiction.
A case study published in the Journal of Clinical Neuropharmacology describes the experiences of a 43-year-old woman who experienced severe withdrawal symptoms after she stopped taking Ambien. The patient had misused the drug by taking it at excessively high doses. When the drug was discontinued too quickly, she experienced reactions similar to those associated with withdrawal from benzodiazepines, including seizures. This experience, and other studies that followed, indicate that the brain and body can become dependent on Ambien, and that a gradual dose reduction is required to prevent serious reactions after stopping the medication.
Additional withdrawal symptoms may include:
- Muscle cramps
With prescription drug abuse and addiction becoming more common, drug rehab programs have been developed to treat these conditions safely. A detox program for Ambien includes a medically monitored drug taper, in which the dose of the drug is lowered in small increments to prevent extreme physical or neurological reactions. After the detox phase, the therapeutic services of rehab can address the thought patterns and behaviors that underlie addiction.
No matter what an individual’s level of Ambien abuse may be, rehab offers a way to recover physical and psychological health.