Ambien Withdrawal Symptoms, Timeline & Detox Treatment Options
Zolpidem, sold under the brand name Ambien, is a medication primarily used to treat sleep conditions.
Although this drug is legally prescribed and offers value to select patients who need it, individuals with a history of drug abuse may misuse Ambien. Extended use leads to dependence, and dependence leads to Ambien withdrawal symptoms. These symptoms are similar to other central nervous system depressant drugs.
In recent years, the World Health Organization (WHO) considered the frequency of Ambien abuse and dependence similar to that of benzodiazepine, which is why it was transferred to Schedule IV in 2002. Like other drugs of abuse, once tolerance and dependence develop, Ambien withdrawal symptoms follow.
What Are the Symptoms of Ambien Withdrawal?
As listed on Ambien’s label, when this drug is taken therapeutically and as prescribed, withdrawal symptoms appear in about 1% of people. It is when Ambien is misused that more significant risks develop.
Once a dependence on Ambien develops, Ambien withdrawal symptoms can occur. Hypnotics can produce withdrawal symptoms following abrupt discontinuation, ranging from vomiting to convulsions. During U.S. clinical trials, Ambien withdrawal symptoms developed within 48 hours following the last dose.
These symptoms included the following.
- Stomach cramps
- Panic attacks
- Stomach discomfort
- Uncontrolled crying
Ambien was once viewed as a safe alternative to benzodiazepine. However, emerging clinical evidence shows that Ambien may contribute to seizures, intoxication delirium, and dependence resulting in a complicated withdrawal process.
This process becomes particularly complicated when users combine substances like alcohol and Ambien. One case study found that when a patient was detoxifying for alcohol, they experienced zolpidem withdrawal delirium. This case was severe but rare. However, such cases need to be considered among dual-diagnosis patients.
The combination of Ambien and other depressant drugs remains a crucial concern, as these situations can lead to emergency department visits. As reported by the Substance Abuse and Mental Health Services Administration, between 2005 and 2010, Ambien-related emergency department visits increased by 220%.
Approximately half of these visits involved other pharmaceuticals, including narcotic pain relievers (26%) and other anti-anxiety or insomnia medications (15%). If a situation like this occurs and you continue taking Ambien, it may be time to assess your current dependence on the drug. Psychological dependence is just as dangerous as you continue using Ambien despite the consequences.
Regardless of the scenario, Ambien is not intended for long-term use. This medication should only be taken for a few weeks. It is not a long-term solution to treat insomnia. If a patient still requires Ambien after a few weeks of use, alternative therapy options are recommended.
Among those with a history of drug abuse, taking Ambien can be a slippery slope. Research shows that Ambien may also increase the potential for drug abuse among those without a history of drug abuse at high doses.
Many reports say that Ambien has a low abuse and dependence potential. However, data shows that many cases of Ambien abuse and dependence have been reported throughout the United States and Europe. Again, those with a history of drug abuse may continue taking Ambien to experience a euphoric mood.
Most research on this subject is based on individual case studies. These studies clearly show that some individuals experience Ambien withdrawal symptoms, and in some cases, these symptoms are life-threatening. A case study on a 43-year-old woman showed that following the abrupt discontinuation of Ambien, she experienced an epileptic attack. Such cases show the importance of each individual user based on their health, clinical history, and history of drug or alcohol abuse.
What Causes Ambien Withdrawal?
Central nervous system (CNS) depressants are categorized under benzodiazepines, non-benzodiazepine sedative-hypnotics, and barbiturates. Ambien falls under the “non-benzodiazepine sedative-hypnotics” category.
Misuse is possible with all CNS depressants and occurs when you:
- Take your medication in a way or dose that is not prescribed
- Take someone else’s medication
- Take medication to get high
To diver deeper into Ambien withdrawal, you must first consider its effect on the body and mind. When taking this drug, individuals experience an increase in the brain chemical GABA. As levels of GABA increase, users experience feelings of sedation. These drowsy, calming effects make Ambien suitable for sleep disorders, such as insomnia.
If you continue using Ambien for extended periods, you will develop a dependence. When you suddenly stop taking this drug, Ambien withdrawal symptoms can develop.
In recent years, one of the areas of interest has been the potential link between Ambien and dementia. Although this is not a withdrawal symptom, it may be a potential risk factor related to long-term Ambien abuse.
A large study was conducted in Taiwan, observing 8406 dementia and 16,812 control subjects. After controlling for variables such as sex, age, diabetes, heart disease, depression, and stroke, it was found that Ambien alone or with other underlying diseases was associated with dementia.
Ambien is generally well-tolerated in the short term and showcases a low incidence of adverse effects. However, less is known about the long-term effects. The potential link between extended Ambien use among the elderly and dementia is likely based on the way this drug influences GABA receptors. This research is still in its infancy and requires close follow-up examination.
Regardless, this drug is intended for short-term use only. Long-term use and abuse of Ambien may result in effects that are not yet fully understood. When combined with years of substance abuse, such as alcohol or opiate abuse, the consequences on the body and mind could be significant.
How Long Does Ambien Withdrawal Take?
In most patients who take Ambien are prescribed, there is no evidence of tolerance developing, even up to six months duration. Overall, this drug has a low potential for abuse. However, individuals who take high doses of Ambien for up to several years can experience tolerance and dependence. Studies show that these individuals often have psychiatric disorders, which require a more comprehensive treatment plan.
Also, those who abuse Ambien are likely to struggle with other substances of abuse. When combining drugs, the Ambien withdrawal process can become more complex. In such cases, medical supervision is required to ensure your safety. There are other medications that increase the sedative effect of Ambien.
These include chlorpromazine (used to treat psychiatric disorders), cimetidine (an antihistamine), and imipramine (an antidepressant). Mixing drugs of any kind, including prescription drugs, is dangerous and increases the complexity of the withdrawal and recovery process.
The timeline for Ambien withdrawal depends on several factors.
- How long a user was taking Ambien. If someone was prescribed Ambien and took the medication for a short period as prescribed, Ambien withdrawal symptoms are less likely. If they do develop, symptoms will likely be mild.
- The dose of Ambien taken. If a user is taking higher doses than prescribed, this will increase the risk of tolerance and resulting dependence. Once a dependence develops, psychological and physical symptoms are more common.
- If Ambien was combined with other drugs to enhance the effect. In this case, withdrawal symptoms can be compounded, increasing the overall complexity of this process.
When taken orally, Ambien is quickly absorbed into the gastrointestinal tract. For users addicted to Ambien, who have taken large doses for extended periods, withdrawal symptoms can begin as early as a few hours after the last dose. When taking 5 mg, the elimination half-life is around 2.6 hours.
When users combine Ambien with benzodiazepines, opiates, alcohol, or antidepressants, symptoms of Ambien withdrawal become more complicated and potentially fatal. Under these circumstances, you should not go through the detoxification period without supervision.
For example, those taking Ambien for extended periods may develop a tolerance. To amplify the sedative effects, they take Ambien with alcohol, which is a central nervous system depressant. This combination not only increases your risk of an overdose but can also encourage the development of a dependence on alcohol.
When detoxifying from alcohol, there is a high risk of seizures compared to other substances of abuse. Again, you should not withdraw from any substance of abuse unsupervised.
Since Ambien has a similar chemical makeup to benzodiazepines, such as Valium or Xanax, the withdrawal symptoms and overall timeline are comparable. Typically, a patient will be symptom-free in two weeks. The worst Ambien withdrawal symptoms will likely be experienced between 3 and 5 days.
If you are still experiencing symptoms after two weeks, these symptoms are referred to as post-acute withdrawal symptoms (PAWS). These symptoms can last up to 24 months. However, the severity of these symptoms, such as anxiety, insomnia, irritability, and lack of concentration, will subside over time.
Symptoms of PAWS are commonly associated with opioids and alcohol as well. Data shows that among opioid users, up to 90% will experience this syndrome, as do 75% of those recovering from alcohol abuse. Researchers believe this may result from the physical changes in the brain during the substance abuse period. As tolerance increases, so does the possibility of recurring symptoms.
Here is a rough timeline, although you may have a different experience based on your medical and drug use history.
- Since Ambien has a short half-life, the initial symptoms of Ambien withdrawal may appear within the first 48 hours. At this time, symptoms are generally mild. However, they can increase in severity over the coming days.
- For most individuals, the worst symptoms develop between 3-5 days. At this point, mood swings and confusion may appear. It may be hard to sleep; you might feel shaky and nauseous as well.
- Once Ambien withdrawal symptoms peak within the first week, symptoms will begin to slowly fade during the second week.
When to Contact a Medical Professional
Since cases of Ambien dependence and addiction are most common among people with a history of drug and alcohol misuse, the detoxification process will differ from one individual to the next. For example, it’s not uncommon to see users mix Ambien and alcohol or Ambien and heroin. Both of these combinations are very dangerous and require a specific approach.
According to the Drug Abuse Warning Network (DAWN) Report, approximately 57% of ER visits and hospitalizations caused by taking too much Ambien involved other drugs. Alcohol and Ambien accounted for 14% of these cases, increasing one’s risk of an overdose.
Such combinations can be deadly, and when withdrawing from more than one drug, symptoms become complex. A holistic approach is needed under these circumstances.
That is why you should seek the support of a professional clinical team.
For those who do experience withdrawal symptoms, it’s important to be monitored, especially if other substances of abuse are involved in the withdrawal process. The Ambien withdrawal process is often more complex than the detoxification period. Although this period is critical to physically rid the body of Ambien, for most, it’s only the beginning.
Working with a dedicated mental health and substance use disorder team will help you develop a personalized treatment plan. The key is to identify any underlying conditions that contribute to your reliance on Ambien.
You may also struggle with insomnia, which is why you began taking Ambien in the first place. Others start abusing Ambien because of ongoing symptoms of anxiety. Ambien does not treat anxiety, and when discontinuing use, anxiety levels may increase. As the Department of Consumer Protection suggested, if you stop taking Ambien and begin to feel anxious or aggressive, it’s essential to speak with your doctor.