SUMAYYA
29 September 2022
Medically reviewed by
Kajal Jain
M. Pharm
can-you-take-gabapentin-and-zolpidem-together
Table of Contents

Can't recall the last time you got a whole relaxing night of tight sleep without awakening in the middle of the night?
You're absolutely not the only one.

Struggling to stay asleep for seven to nine hours indicates one of the most common sleep disorders, insomnia.
And while briefly waking up and immediately rolling over to fall back asleep isn't a big deal, experiencing multiple wakeups throughout the night or being unable to fall back asleep when your rest is interrupted is a problem.

After all, interrupted sleep means the quality of your sleep is suffering. And you'll undoubtedly feel this during the daytime. Ambien is one treatment offered by doctors to make you fall asleep faster and stay asleep for a whole night without those disruptive wakeups. And Gabapentin is one treatment option for seizures/epilepsy.

Partial seizures can occur at any age as a single or repeated episode, accounting for almost 60% of all cases of epilepsy. During the Japan clinical trial, there was a 25% overall gabapentin responder rate, defined as the patients with ≥50% decrease in seizure frequency.

A detailed study of these two drugs, including benefits, side effects, and interactions, is a part of this blog.

What is Zolpidem?

Zolpidem is a short-acting, non-benzodiazepine widely prescribed for the short-term management of insomnia.

Zolpidem has a preferential affinity for GABA-A receptors containing the α1 subunit. It is involved in the reduction of sleep latency and sleep maintenance. 

Indications

  • Indicated for insomnia in adults
  • To treat various neurologic conditions, to relieve stress and migraine headaches
  • It improves measures of sleep duration and minimizes the number of awakenings in individuals with transient insomnia.
  • Act as a minor muscle relaxant
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What is Gabapentin?

Initially used as a muscle relaxant and anti-spasmodic, Gabapentin has been shown to have potential as an anticonvulsant and an adjuvant to more potent anticonvulsants. Additionally, it helps with certain types of neurological pain regulation.

Indications:

  • Seizures
  • Neuropathic pain- diabetic neuropathy, postherpetic neuralgia
  • Trigeminal neuralgia, Multiple sclerosis, Complex regional pain syndrome, Headache syndromes, Spinal injury, HIV neuropathy
  • It also has an off-label use for Fibromyalgia, postmenopausal hot flashes, essential tremors, insomnia, anxiety, irritable bowel syndrome (IBS), postoperative analgesia, nausea and vomiting, social phobia, generalized tonic-clonic seizures, pruritus (itching).
  • Used to treat alcohol withdrawal and other drug dependencies.
  • Gabapentin is used in psychiatric conditions such as bipolar disorder, schizoaffective disorder, and post-traumatic stress disorder.
  • Gabapentin reduces agitation and behavioral disturbances associated with dementia, Lesch–Nyhan syndrome, essential tremor, and restless legs syndrome. The recommended starting dose in neuropathic pain is 300 mg thrice a day with titration if necessary.

How Does Ambien Work?

Zolpidem is a non-benzodiazepine sedative/hypnotic agent that acts on the gamma-aminobutyric acid (GABA), a receptor chloride channel modulator/agonist that increases GABA inhibitory effects leading to sedation. It selectively binds to the α1 subunit of GABA-A receptors, which is involved in sleep regulation. Most of the regions of the brain contain high-affinity alpha-1 subunit-containing receptors that activate the hypnotic effects. The drug upregulates these receptors allowing for the sedative effects leading to the preservation of deep sleep. 

Zolpidem is not recommended for the general population as a first-line treatment because of its high potential for abuse. Drugs like controlled-release Melatonin and doxepin may be used as the first-line therapy in addition to proper sleep hygiene and cognitive behavioral therapy for patients with insomnia.

How Does Gabapentin Work?

Gabapentin does not impede GABA uptake or metabolism and has no direct GABAergic activity. Gabapentin appears to reduce the release of excitatory neurotransmitters in the presynaptic area by having a strong affinity for binding sites across the brain, which corresponds to the existence of voltage-gated calcium channels.

Additionally, it decreases the excitability of brain neurons, which affects the transmission of pain signals and plays a part in seizures. Gabapentin mimics the soothing actions of GABA on overexcited neurons.

Studies Related To Zolpidem And Gabapentin In Sleep-related Disorders

Studies suggest that by utilizing a model of occasionally disturbing sleep, low-dose Gabapentin (250 mg and 500 mg) can enhance objective and subjective measures of sleep in adults. Although the precise mechanism is unknown, it may be due to its well-characterized binding affinity to the voltage-activated calcium channel α2δ subunit and subsequent modulatory effects on neurotransmitter release.

According to a study by Darcourt G, zolpidem is widely prescribed in clinical practice for short-term management of insomnia and is generally safe and well tolerated. 

In the study by Galitz, when taken simultaneously, the pharmacokinetic properties of Gabapentin 500 mg and zolpidem tartrate 10 mg remained as it is, compared with each treatment taken alone. All medications in the study subjects were well tolerated, whether used singly or in combination. 

Most doctors prescribe 100-1400 mg of Gabapentin for insomnia. This should be taken once daily, immediately before going to bed. Sometimes, a doctor might prescribe the lowest initial dose and adjust it as per the requirement. Do not alter your dosage without consulting with your doctor.
Zolpidem and Gabapentin should be avoided in case of hypersensitivity to any ingredient in the product. Also, the emergence of new behavioral signs of concern requires immediate evaluation. Any side effects observed should be discussed with the concerned medical practitioner. The risk of substance abuse and dependence is more significant in patients with an alcoholism or substance abuse history, so these medications should be taken with extreme caution.
You should not drink alcohol with Ambien or Gabapentin. Ambien and alcohol can cause sleepiness or dizziness and increase the side effects risk. Similarly, drinking alcohol while taking Gabapentin can cause dizziness, drowsiness, and difficulty concentrating. Patients are advised to avoid alcohol or limit the use of alcohol while taking these medications due to the likelihood of these side effects. Keep your doctor informed of your alcohol use so that they can monitor any possible side effects specific to you.

Can You Take Gabapentin And Zolpidem Together?

Using zolpidem and Gabapentin simultaneously may increase side effects such as dizziness, drowsiness, confusion, and difficulty concentrating. In the elderly, it may affect thinking, judgment, and motor coordination. 

In a study by Fernandes, they utilized Gabapentin to treat zolpidem dependence. Investigating Gabapentin as a potential treatment for Zolpidem detoxification may be worthwhile. 

People who take both Gabapentin and Zolpidem have reported drug interactions, with pneumonia among females and chronic renal disease among males being the most frequent.

The phase IV clinical study analyzes drug interactions of people who take Gabapentin and Zolpidem. According to eHealthMe, based on reports from the FDA, 7,722 people take Gabapentin and Zolpidem together.

Possible Side Effects

Common Side Effects Of AmbienCommon Side Effects Of Gabapentin
HeadacheDizziness
DrowsinessHeadache
DizzinessAtaxia
DiarrheaFatigue
Dry MouthSomnolence
HallucinationFever
Muscle PainTremor
PalpitationsDiarrhea
Poor ConcentrationConstipation
Trouble BreathingWeight gain
Memory LossNausea and vomiting
Abnormal Thoughts And BehaviorMemory loss

Bottom Line From Practical Anxiety Solutions

Doctors prescribe Ambien for insomnia and Gabapentin to control seizures, treat RLS, and reduce nerve pain. Its adequate dosage depends on the condition of the individual and other factors. Both medicines are highly effective individually.

But when they ought to be given in combination, a doctor can best advise about drug interactions and other safety considerations. Using Ambien with Gabapentin may increase side effects or result in drug interactions. Always seek medical advice before initiating any therapy. If you experience any unusual symptoms, immediately contact your doctor.

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