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.
- 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
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.
- 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.
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 Ambien||Common Side Effects Of Gabapentin|
|Trouble Breathing||Weight gain|
|Memory Loss||Nausea and vomiting|
|Abnormal Thoughts And Behavior||Memory 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.
Goa, K.L., Sorkin, E.M. Gabapentin. Drugs 46, 409–427 (1993). https://doi.org/10.2165/00003495-199346030-00007 Obtain On 29/09/2022
Connie Y. Chang, Chaitanya K. Challa, Janki Shah, Jean Daniel Eloy, "Gabapentin in Acute Postoperative Pain Management", BioMed Research International, vol. 2014, Article ID 631756, 7 pages, 2014. https://doi.org/10.1155/2014/631756 Obtain On 29/09/2022
Yasaei R, Katta S, Saadabadi A. Gabapentin. [Updated 2022 May 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK493228/ Obtain On 29/09/2022
- Fernandes WH, Pereira Yda S, O' Tereza S. A case of Zolpidem dependence successfully detoxified with Gabapentin. Indian J Psychiatry. 2013 Jul;55(3):290-2. doi: 10.4103/0019-5545.117152. PMID: 24082253; PMCID: PMC3777354.Obtain On 29/09/2022
- Darcourt G, Pringuey D, Sallière D, Lavoisy J. The safety and tolerability of zolpidem--an update. J Psychopharmacol. 1999;13(1):81-93. doi: 10.1177/026988119901300109. PMID: 10221362.
- Galitz LA, Jayawardena S, Furey SA. Pharmacokinetic effects of simultaneous administration of single-dose Gabapentin 500 mg and zolpidem tartrate 10 mg in healthy volunteers: a randomized, open-label, crossover trial. Drugs R D. 2015 Mar;15(1):71-7. doi: 10.1007/s40268-014-0079-z. PMID: 25567214; PMCID: PMC4359180.
- Darcourt G, Pringuey D, Sallière D, Lavoisy J. The safety and tolerability of zolpidem--an update. J Psychopharmacol. 1999;13(1):81-93. doi: 10.1177/026988119901300109. PMID: 10221362.Darcourt G, Pringuey D, Sallière D, Lavoisy J. The safety and tolerability of zolpidem--an update. J Psychopharmacol. 1999;13(1):81-93. doi: 10.1177/026988119901300109. PMID: 10221362.