AMBIEN

	AMBIEN Description / Definitions Abuse Addiction / Dependence Side Effects Withdrawal Symptoms Treatment

DESCRIPTION / DEFINITIONS: Ambien® (zolpidem tartrate) is an Anxiolytic, Sedative & Hypnotic drug prescribed for the short-term management of insomnia associated with difficulties with sleep initiation.  Because of its indicated use being short-term, According to its label, “The clinical trials performed in support of efficacy were 4–5 weeks in duration with the final formal assessments of sleep latency performed at the end of treatment.” 

ABUSE: According to its label, "Sedative/hypnotics have produced withdrawal signs and symptoms following abrupt discontinuation."  Ambien is a Schedule IV Controlled Subtance.

ADDICTION / DEPENDENCE: Half Life and Metabolism.

SIDE EFFECTS: Nausea, vomiting, abnormal thinking , behavior changes, decreased inhibition  (see list below).

WITHDRAWAL SYMPTOMS: Headache, nausea, vomiting, amnesia, falls  (see list below).

TREATMENT: Medical detoxification.

DESCRIPTION / DEFINITIONS

Ambien® (zolpidem tartrate) is an Anxiolytic, Sedative & Hypnotic drug prescribed for the short-term management of insomnia associated with difficulties with sleep initiation. According to its label, “Because sleep disturbances may be the presenting manifestation of a physical and/or psychiatric disorder, symptomatic treatment of insomnia should be initiated only after a careful evaluation of the patient. The failure of insomnia to remit after 7 to 10 days of treatment may indicate the presence of a primary psychiatric and/or medical illness that should be evaluated.”

The label also states, “Subunit modulation of the GABAA receptor chloride channel macromolecular complex is hypothesized to be responsible for sedative, anticonvulsant, anxiolytic, and myorelaxant drug properties.”

ABUSE

According to its label, "Sedative/hypnotics have produced withdrawal signs and symptoms following abrupt discontinuation."  Ambien is a Schedule IV Controlled Subtance.

ADDCTION / DEPENDENCE

HALF LIFE AND METABOLISM

The biological half life of a substance is the time it takes for a drug to lose half of its pharmacologic activity. This is significant because it affects how soon withdrawal symptoms may appear.

The half life of Ambien is between 1.4-4.5 hours. 

Ambien is mainly metabolized through the P450 pathway in the liver and the enzyme primarily handling the metabolism is CYP3A but it is not clear how much of the metabolism is done by other enzymes.

The CYP enzymes are the major enzymes involved in drug metabolism, and since many drugs may increase or decrease the activity of various CYP isozymes, this is a major source of adverse drug interactions, since changes in CYP enzyme activity may affect the metabolism and clearance of various drugs. For example, if one drug inhibits the CYP-mediated metabolism of another drug, the second drug may accumulate within the body to toxic levels, possibly causing an overdose.

SIDE EFFECTS

The following information is taken from the Ambien label:

abdominal pain abnormal accommodation abnormal dreams abnormal gait abnormal hepatic function abnormal thinking abnormal thinking abscess herpes simplex herpes zoster acne acute renal failure aggressive reaction agitation allergic reaction allergy allergy aggravated altered saliva amnesia anaphylactic shock anemia angina pectoris angioedema anorexia anxiety apathy appetite increased arrhythmia arteritis arthralgia arthritis arthrosis asthenia ataxia back pain behavior changes bilirubinemia bizarre behavior breast fibroadenosis breast neoplasm breast pain bronchitis bronchospasm bullous eruption cerebrovascular disorder chest pain circulatory failure CNS-depressant effects completed suicides confusion conjunctivitis constipation corneal ulceration coughing cystitis daytime drowsiness decreased cognition decreased inhibition decreased libido delusion dementia depersonalization depersonalization depression dermatitis detached diarrhea difficulty concentrating diplopia dizziness drugged feelings dry mouth dysarthria dyspepsia dysphagia dysphasia dyspnea

dysuria edema emotional lability enteritis epistaxis eructation esophagospasm euphoria extrasystoles eye irritation eye pain face edema falling falls fatigue feeling strange fever flatulence flushing furunculosis gastritis gastroenteritis glaucoma gout hallucination headache hemorrhoids hiccup hot flashes hypercholesteremia hyperglycemia hyperhemoglobinemia hyperlipidemia hypertension hypertension aggravated hypoesthesia hypokinesia hypotension hypotonia hypoxia hysteria illusion impotence increased alkaline phosphatase increased BUN increased ESR increased saliva increased SGOT increased SGPT increased sweating infection influenza-like symptoms injection-site inflammation insomnia intestinal obstruction intoxicated feeling lacrimation abnormal laryngitis leg cramps lethargy leucopenia lightheadedness lymphadenopathy macrocytic anemia malaise manic reaction menstrual disorder micturition frequency migraine muscle weakness myalgia myocardial infarction nausea nervousness

neuralgia neuritis neuropathy neuro-psychiatric symptoms neurosis nocturia otitis externa otitis media pain pallor palpitation panic attacks paresis paresthesia parosmia periorbital edema personality disorder pharyngitis phlebitis photopsia photosensitivity reaction pneumonia polyuria postural hypotension pruritus pulmonary edema pulmonary embolism purpura pyelonephritis rash rectal hemorrhage renal pain restless legs rhinitis rigors sciatica scleritis sinusitis sleep disorder sleep-driving sleeping (after daytime dosing) somnambulism speech disorder stupor suicidal thoughts and actions suicide attempts syncope tachycardia taste perversion tendinitis tenesmus tetany throat closing thrombosis tinnitus tolerance increased tooth caries trauma tremor upper respiratory infection urinary incontinence urinary retention urinary tract infection urticaria vaginitis varicose veins ventricular tachycardia vertigo vision abnormal visual and auditory hallucinations vomiting weight decrease worsening of depression yawning

WITHDRAWAL SYMPTOMS

Ambien can be a very difficult drug to stop taking.

amnesia daytime drowsiness dizziness

falls headache

nausea vomiting

TREATMENT

Withdrawal from Ambien should only be done under the care of a health practitioner. The safest way is to withdraw at an inpatient medical detox facility. At a inpatient medical detox facility with a protocol that includes hydration, vitamins and supplements, most patients can safely stop taking Ambien in about seven days. Patients can withdraw from Ambien on an outpatient basis but it will normally take at least four weeks.