Long-Term Effects of Ambien Misuse
Many people suffer from sleeping difficulties, and as a result, several medications have been developed with the intention of treating these conditions. One such medication is Ambien, a brand name formulation of zolpidem.
This page will explain what Ambien is, the potential long-term effects of Ambien misuse, and how to get treatment for Ambien addiction.
What Is Ambien?
The active component of the drug Ambien is zolpidem. Zolpidem is a non-benzodiazepine sedative-hypnotic drug that is prescribed to help people sleep.1
Immediate-release formulations of zolpidem have a fast onset of action and a relatively short half-life, meaning that the medication works quickly and does not remain in a person’s system very long. This makes Ambien primarily useful in helping people fall asleep or to initiate sleep.1
The drug is not prescribed to help people stay asleep or maintain sleep unless the drug is prescribed in an extended- or controlled-release form.1
Some research studies suggest that Ambien can also be used as a muscle relaxant and may even be capable of controlling some seizures, although the dosage required for seizure control would be extremely high. However, the drug is not approved by the FDA for these purposes.2
Zolpidem and similar pharmaceutical agents (e.g., other so called “z-drugs”) were promoted as an alternative to other prescription sedative-hypnotics more likely to cause physical dependence, such as benzodiazepines.
However, the U.S. Drug Enforcement Administration (DEA) currently lists zolpidem as a Schedule IV controlled substance, indicating that, though relatively low, there is some risk of misuse and dependence. Thus, products containing zolpidem can only be obtained with a prescription from a physician.
How Does Ambien Work?
Like benzodiazepines, zolpidem works to increase the activity of the inhibitory neurotransmitter GABA (gamma-aminobutyric acid). GABA is the primary inhibitory neurotransmitter in the brain.
Increased GABA activity is associated with decreased firing rates of neurons within the brain and spinal cord. This accounts for its sedative effects. Though zolpidem appears to be molecularly distinct from benzodiazepines, it influences activity at the GABAA receptor, which is the same receptor that benzodiazepines interact with to exert their effects.
With a similar mechanism of action and physical effects profile as benzos, there is also a risk of overdose on high doses of zolpidem products. The benzodiazepine antagonist drug flumazenil reverses some of the sedative effects of drugs that bind to GABA receptors and can be used in cases of an overdose on both benzodiazepines and zolpidem products.3
Prescription Sleep Aids Like Ambien Are for Short-Term Use
One of the reasons these drugs are only designed to be used in the short-term is that tolerance develops very rapidly and people often need significantly higher amounts of the drug in a short time to get the same effects.4
Sedative-hypnotic drugs like Ambien and benzodiazepines (when indicated for insomnia) are best used as short-term solutions while the person develops behavioral methods to help them initiate and maintain sleep. This could involve the use of:
- Behavioral therapy.
- Relaxation training.
- Diaphragmatic breathing.
- Other non-pharmaceutical methods.
Short-Term Effects of Ambien
The primary therapeutic effects of Ambien include:5
- Initiation of sleep.
Ambien Side Effects
Side effects may include:5
- Memory impairments.
- Insomnia when the drug is discontinued—commonly referred to as rebound insomnia.
- Unusual dreams.
- Parasomnias—abnormal, sometimes complex sleep events.
- In rare cases, hallucinations.
- Nausea and heartburn.
- Light-headedness and/or dizziness.
- Difficulties with balance.
- Unsteady gait.
- Physiological dependence.
Your ability to drive or operate machinery the day after using Ambien may be impaired due to potential problems with attention and decreased reaction time, even if you feel rested and alert.5
Additionally, you may have an increased risk of falls, decreased reaction time, and problems with coordination the day after Ambien use.5
Parasomnias are sleep disorders where individuals engage in activities that they would normally perform while they are awake, but they engage in these activities while they are actually asleep. Zolpidem has been implicated in some cases where people have been:6
- Driving while asleep.
- Eating while asleep.
- Having sex while asleep.
These cases are very rare. The most common manifestation of a parasomnia is sleepwalking.6
The use of Ambien with alcohol can increase the risk of parasomnias and other side effects. Misusing the drug (e.g., using it in excess of prescribed parameters) may also contribute to this risk.6
Use of drugs that increase the activity of GABA, such as benzodiazepines and zolpidem, may be associated with the development of short-term memory problems.7
Zolpidem is recommended for use with caution in the elderly, as they may be at increased risk for more pronounced cognitive effects, including issues with memory for recent events or with forming new memories.8
People who stop using Ambien may find that they have issues with insomnia once they discontinue their use of the drug, especially if they have been using higher than recommended doses or consistently using the medication for long periods of time.9
Rebound insomnia, though troublesome, is usually temporary and may be managed with non-pharmacologically with increased attention on sleep hygiene (e.g., a bedtime routine more conducive to sleep) and other behavioral methods.9
The development of psychotic behaviors and hallucinations as a result of medicinal use of Ambien appears to be rare, but has been observed in a few cases.10
Ambien Potential Long-Term Effects
Although most people who use Ambien on a long-term basis do not report adverse health effects, some people have reported a wide range of negative gastrointestinal, respiratory, cardiovascular, and central nervous system effects.11
Overdose is also possible, with reported effects ranging from markedly diminished levels of consciousness (e.g., somnolence, coma) to cardiovascular and/or respiratory compromise and death.11
Overdose risks may be significantly increased when Ambien is used in combination with alcohol or other CNS depressant substances.
Exacerbation of Gastroesophageal Reflux Disorder
People who have gastroesophageal reflux disorder (GERD) and use Ambien for extended periods of time may experience exacerbations of their symptoms, particularly at night.12
Because zolpidem users may be more likely to sleep through a reflux event, gastric acid could remain in the esophagus for longer periods of time and increase the risk for the development of complications—such as esophageal cancer—in some individuals.12
According to its DEA Scheduling, Ambien has a low potential for dependency and misuse. However, self-medicating or long-term use of Ambien use can result in significant physical and psychological dependence, which increases the risk of withdrawal symptoms when you try to stop using it.5
You should not abruptly quit taking Ambien without consulting your doctor, especially if you have taken it for longer than 2 weeks, as this can result in a withdrawal syndrome with symptoms such as:5
- Stomach and muscle cramps.
- Uncontrollable crying.
- Panic attack.
- Difficulty falling asleep or staying asleep.
- Uncontrollable shaking of a part of your body.
- Seizures (rarely).
Misuse of Zolpidem Products
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), sedative-hypnotic drugs like zolpidem are commonly misused. About 1.1 million people reported misusing (e.g., overuse of a prescription product) zolpidem in 2015.13
People who misuse Ambien may have started out using the drug as prescribed, then progressively increased such use.15 Untreated and chronic substance use disorders are associated with numerous other physical and co-occurring mental health disorders.16
Treatment for Ambien Misuse
If you or someone you care about struggles with compulsive misuse of zolpidem products, professional treatment is available and long-term recovery is possible.
Are you ready to reach out for help and start addiction treatment? Greenhouse Treatment Center is an American Addiction Centers drug rehab near Dallas, and our compassionate team is ready to help you get the treatment you need today. Call us at .
When you call, a caring admissions navigator will answer your questions about the levels of addiction treatment offered, how to pay for rehab, and check your insurance coverage for rehab.
You can also securely now. Please don’t wait another day to get treatment for Ambien misuse.