Ambien Long-Term Effects

Ambien Short and Long-Term Side Effects

According to the American Academy of Sleep Medicine, up to 30% of adults have trouble sleeping, and 10% of them have insomnia that’s severe enough to impact their daily lives.[1] For these people, sedative or hypnotic drugs like Ambien (zolpidem tartrate) can help them fall asleep, stay asleep, and get more restful sleep.

Ambien is intended as a short-term solution for insomnia, however. Taking Ambien for longer periods than intended – or at higher doses – may lead to tolerance and dependence with long-term side effects.

What Is Ambien?

Ambien is one of several non-benzodiazepine prescription sedatives referred to as “z drugs” that work to depress the central nervous system (CNS) to induce restful sleep.[2] It’s a Schedule IV controlled substance, because even with its valid medical use, Ambien has a potential for physiological dependence.[3]

Ambien comes in immediate-release and extended-release, Ambien CR. The immediate release is intended for people who have trouble falling asleep while Ambien CR are long-acting and help people fall asleep and stay asleep.

Is Ambien Safe?

Ambien is generally safe for short-term use when prescribed. In fact, the drug label itself recommends treatment that’s “as short as possible.”[4] The longer you use Ambien, the more likely you are to develop dependence – particularly if your use of Ambien extends longer than 10 nights.

Combining Ambien with opioids or other CNS depressants like alcohol or benzodiazepines can result in dangerous oversedation.[5] At higher doses, Ambien has more misuse potential than when taken as directed for a short period.

What Are the Side
Effects of Ambien?

Side effects can differ for everyone, but the most common zolpidem tartrate side effects include:[6]

  • Headache
  • Grogginess
  • Daytime drowsiness
  • Vomiting
  • Nausea
  • Falls
  • A feeling like you’ve been drugged

The Ambien CR side effects are generally the same as the immediate-release Ambien. For some, the Ambien side effects the next day are like a “hangover” that includes headaches, memory loss, persistent drowsiness, and mental impairment for several hours after waking.

These are common and mild side effects, but Ambien does carry the risk of serious side effects that can have complications, such as:[7]

  • Complex sleep behaviors like sleepwalking or sleep driving
  • Significant next-day impairment
  • Depression
  • Suicidal thoughts and actions
  • Overdose

Ambien side effects in the elderly (over 65) are more pronounced and have a higher risk of complications.[8]

Long-Term Effects of Ambien

Ambien was designed to work similarly to benzodiazepines with a lower risk of addiction and health effects. It targets the receptor cells in the brain that respond to gamma-aminobutyric acid (GABA), which affects sleep cycles, consciousness, and emotional responses.

Because of this, the Ambien long-term side effects are similar to those of benzodiazepines like Valium or Ativan (lorazepam) and may include:[9]

  • Chronic fatigue
  • Hallucinations
  • Frequent headaches
  • Digestive problems
  • Muscle pain
  • Dry mouth
  • Suicidal ideation
  • Insomnia
  • Poor motor coordination
  • Possible dependency

Is Ambien Dangerous?

Ambien is generally safe when prescribed and supervised by a doctor, but it can cause serious adverse effects and has a potential for dependence. These risks increase with long-term use, which is why Ambien is recommended for short time periods.

Label prescribing information outlines other factors that increase the risk of adverse effects, such as using Ambien at higher doses, taking it for longer periods than intended, and taking it with opioids, benzodiazepines, alcohol, and other CNS depressants.[10] Aside from the effects of the drug itself, Ambien has indirect risks outlined within the prescribing information that relate to complex sleep behaviors like sleep walking, sleep driving, sleep cooking, and sleep sex. All of these activities can cause injuries to oneself or others, so people with a history of complex sleep behaviors shouldn’t take Ambien or other z-drugs without informing their doctor.

Next-day impairment is also a concern, particularly with Ambien CR and its long-acting effects.[11] People on Ambien CR shouldn’t drive or participate in activities that require alertness, since the levels of zolpidem can be high in the body. Zolpidem is eliminated more slowly in women than men, so they’re at a greater risk for next-day impairment.

Overdose is possible with Ambien on its own and in conjunction with other substances, particularly a CNS depressant. It’s more likely to experience an overdose with a higher dose of Ambien than intended.

Ambien Addiction and Withdrawal

Ambien is prescribed for short-term relief of insomnia, but some people take Ambien longer or in higher doses than intended. People with a history of substance use disorder are at a greater risk for Ambien misuse and addiction.

Ambien addiction is rare compared to other substances, but it is possible to become physiologically dependent. With long-term use, the body becomes dependent on Ambien and reducing or stopping use can cause withdrawal symptoms like fatigue, lightheadedness, sleep disturbances, seizures, uncontrollable crying, flushing, and abdominal pain.[12]

If you want to cut back on Ambien use, it’s important to follow the instructions from your healthcare provider to wean yourself off your current dose. If there are any abnormal behaviors, such as suicidal thoughts, complex sleep behaviors, or serious next-day impairment, these should be reported to your doctor.

Once dependence occurs, Ambien use can be hard to stop. If this is the case, you may want to consider addiction treatment, especially if you’ve been taking Ambien for a long period, at high doses, or combine it with other substances like alcohol or opioids.

Medical detox is often the first step for Ambien addiction treatment, especially if there are other depressant substances involved. This allows the body to rid itself of Ambien under the supervision of medical professionals to keep you safe and comfortable.

Ambien withdrawal and detox can last for weeks, but it may not be enough on its own. Some people benefit from entering an addiction treatment program after detox to address the Ambien dependence and address the underlying insomnia or other psychological causes.[13]

Addiction treatment programs can look different for everyone, from the level of care to the specific therapies. With insomnia, inpatient treatment may be the best choice to give you a safe, quiet place to sleep comfortably, but some people prefer to attend outpatient treatment and sleep in their own bed.

Frequently Asked Questions

01

What Happens If You Take Ambien for Years?

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Ambien is only intended for short-term use – typically under 10 weeks. Taking Ambien for longer periods increases the risks of adverse effects, long-term complications, and dependency.

02

Can Ambien Cause Depression?

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Ambien has a risk of serious side effects that are less common, including depression. The FDA identified a link between Ambien and depression, even in people who never experienced depression before, and suicidal thoughts or actions.[14]

03

Does Ambien Cause Memory Loss?

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In controlled studies, adults taking Ambien didn’t experience next-day memory impairment. One study did reveal a decrease in next-morning recall that was presented during the drug’s peak effects, which is retrograde amnesia.[15] The study also provided evidence that anterograde amnesia, which prevents new memories from forming, may occur at high doses (above 10mg).

04

Does Ambien Make You Groggy?

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With regular use of Ambien, headache, grogginess, drowsiness, and other mild symptoms are common. While unpleasant, these side effects aren’t serious or life threatening.

05

How Safe Is Ambien?

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Ambien is generally safe and effective when used as prescribed, but there are risks of serious side effects that can lead to injury or death. Long-term Ambien use or Ambien abuse side effects are more dangerous, including depression, suicidal thoughts and actions, and complex sleep behaviors.

Sources
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[01]

Insomnia. (n.d.-f). Retrieved from https://aasm.org/resources/factsheets/insomnia.pdf on 2023, July 9.

[02]

Highlights of prescribing information need to be evaluated for comorbid … (n.d.-f). Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/019908s40s044s047lbl.pdf on 2023, July 9.

[03]

Drug scheduling. DEA. (n.d.-a). Retrieved from https://www.dea.gov/drug-information/drug-scheduling on 2023, July 9.

[04]

Highlights of prescribing information need to be evaluated for comorbid … (n.d.-f). Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/019908s40s044s047lbl.pdf on 2023, July 9.

[05]

Licata, S. C., Mashhoon, Y., Maclean, R. R., & Lukas, S. E. (2011, April). Modest abuse-related subjective effects of zolpidem in drug-naive volunteers. Behavioural pharmacology. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3077937/ on 2023, July 9.

[06]

Zolpidem Tartrate (Ambien, Ambien CR, Edluar Zolpimist) (n.d.-f). Retrieved from https://portal.ct.gov/-/media/DCP/drug_control/PMP/pdf/zolpidempdf.pdf on 2024, February 15.

[07]

Review of Various Trials using zolpidem at Higher Doses … (2007, May). Retrieved from https://www.pbm.va.gov/PBM/vacenterformedicationsafety/Appendix1Detailsofhighdosezolpidemtrials.pdf on 2024, February 15.

[08]

Highlights of prescribing information need to evaluate for comorbid … (n.d.-f). Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/019908s40s044s047lbl.pdf on 2023, July 9.

[09]

Is Ambien safe for long-term use? … (2023, May). Retrieved from https://www.drugs.com/medical-answers/ambien-safe-long-term-3573886/ on 2024, February 15.

[10]

Highlights of prescribing information need to evaluate for comorbid … (n.d.-f). Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/019908s40s044s047lbl.pdf on 2023, July 9.

[11]

Questions and Answers: Risk of next-morning impariment after use of insomnia drugs … (2018, February 13). Retrieved from https://www.fda.gov/drugs/drug-safety-and-availability/questions-and-answers-risk-next-morning-impairment-after-use-insomnia-drugs-fda-requires-lower on 2024, February 15.

[12]

Mattoo, S. K., Gaur, N., & Das, P. P. (2011). Zolpidem withdrawal delirium. Indian journal of pharmacology43(6), 729–730. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3229797/ on 2024, February 15.

[13]

Mayo Foundation for Medical Education and Research. (2023, April 5). Insomnia treatment: Cognitive behavioral therapy instead of Sleeping Pills. Mayo Clinic. Retrieved from https://www.mayoclinic.org/diseases-conditions/insomnia/in-depth/insomnia-treatment/art-20046677 on 2023, July 9.

[14]

Kripke, D. F. (2016, May 19). Hypnotic drug risks of mortality, infection, depression, and cancer: But lack of benefit. F1000Research. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4890308/ on 2023, July 9.

[15]

Highlights of prescribing information need to evaluate for comorbid … (n.d.-f). Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2022/019908s40s044s047lbl.pdf on 2023, July 9.

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