SUMAYYA
08 September 2022
Medically reviewed by
Freny Menezes
Pharm. D
ambien-cause-hallucinations
Table of Contents

Ambien, also known as "Zolpidem," treats insomnia. Zolpidem is a hypnotic drug with a rapid onset and a short duration of action. It outperforms benzodiazepines in terms of tolerability and has fewer side effects, including less residual sedation and a lower risk of rebound insomnia. It also has a lower risk of dependence.

Although Ambien can improve your sleep, physicians warn that it can cause hallucinations and intestinal issues. Rare reports exist of this zolpidem-induced psychotic phenomenon. The precise mechanism of zolpidem-associated hallucinations remains unknown.

So, is the hallucination caused by Ambien reversible? How long does the hallucination last? Let us find the answers.

What is Ambien?

AMBIEN is a prescription sleep medicine for the short-term treatment of insomnia in adults. It works by reducing brain activity and allowing you to fall asleep sooner.

In 1992, the US Food and Drug Administration (FDA) authorized using Zolpidem. It is the most prescribed hypnotic drug in the world. Due to its potential for abuse and dependence, AMBIEN is listed as a controlled substance under Schedule C-IV.  

Treatment and symptomatic relief for insomnia is trouble falling asleep, frequent nocturnal awakenings, or morning awakenings. Used to treat neurologic conditions and migraine headaches and to relieve stress.

Ambien binds to the GABA-benzodiazepine receptor complex, like benzodiazepines, but is more selective for the omega-1 receptor subtype than are BZs. It slows the brain and makes you fall asleep.

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What Are Hallucinations?

Generally speaking, hallucinations are perception-like experiences without external stimulation of the relevant sensory organ, with clarity and impact similar to real perceptions. Hallucination involves the person who can see, hear, smell, taste, or feel something that is not there.

Does Ambien Cause Hallucinations?

In particular, Ambien causes side effects such as hallucinations and psychosis. When taken at higher doses, it can produce several unpleasant side effects. Ambien inhibits natural brain function, causing intense drowsiness and calmness.

Ambien-induced hallucinations may occur in some individuals, depending on several factors that researchers are still investigating. People who take Ambien in high doses with drugs such as antidepressants, alcohol, benzodiazepines, other sedatives or sleeping pills, or anti-anxiety medications are more likely to experience adverse side effects such as hallucinations. 

How Long Will The Hallucination Last?

There were reports of hallucinations in people taking zolpidem CR. They can last up to 7 hours. It is more likely to occur if you take zolpidem with an SSRI like fluoxetine or sertraline. 

How Do We Avoid Hallucinations?

Psychotherapy for hallucinations involves engaging the patient to be curious about the details of the symptoms, providing psycho-education, exploring plausible reasons for the hallucinations, and normalizing the experience.

Cognitive behavioral therapy targets the ways how the voices are being appraised. Through a collaborative approach, other possible explanations for the origin and meaning of voices are discussed with the patient. The behavioral component involves exploring alternatives to dealing with particular situations and changing how the patient perceives them. 

Treatment for hallucinations depends entirely on their underlying cause. Once the underlying problem has been treated, hallucinations caused by a high fever, extreme dehydration, or infection will go away. 

Psychosocial strategies and antipsychotic drugs are both integral parts of the treatment regime. Education, counseling, and support for the individual and family can assist with understanding, stress management, and medication compliance. 

Antipsychotic drugs: First-generation and second-generation medications help to decrease hallucinations in people with schizophrenia spectrum disorders, bipolar disorder, and major depressive disorder with psychotic features.

Repetitive transcranial magnetic stimulation (rTMS) reduces auditory hallucinations that do not respond to antipsychotic medications. 

Acetylcholinesterase inhibitors reduce hallucinations or delusions in people with Alzheimer’s disease and Parkinson’s disease.

Tips to reduce or stop hallucinations

  • Try to change their environment.
  • Make sure the room has enough light to avoid shadows and dim regions.
  • Keep the person busy with enjoyable pursuits like reading or walking.
  • Try to reassure the person by speaking calmly and letting them know you are aware of their strange experience.
  • Keep a record of your observations and seek trends or patient insights that you might communicate to healthcare providers.
  • Consult a doctor because the medication may occasionally be beneficial.

Warnings

  • Complex sleep behaviors, such as sleep-driving, engaging in other tasks while not fully awake, and sleepwalking, can result in fatal injuries. Immediately stop therapy if a patient exhibits complex sleep behavior.
  • Concomitant administration with other CNS depressants like benzodiazepines, opioids, tricyclic antidepressants, and alcohol increases the risk of CNS depression.
  • Do not use Ambien with other sedative-hypnotics (including other zolpidem products) at bedtime or in the middle of the night.
  • Do not drive or operate heavy machinery while on Zolpidem, as it may cause drowsiness, dizziness, sleepiness, blurred/double vision, and reduced alertness.
  • If you have a history of drug abuse, proceed with caution.
  • Take not more AMBIEN than prescribed.
  • Take AMBIEN only if you can spend the night (7 to 8 hours) in bed.
  • Take AMBIEN only once per night, right before going to bed.

Bottom Line From Practical Anxiety Solutions

Ambien is a sleep-inducing drug used for the occasional treatment of insomnia. Ambien reduces the time it takes to fall asleep and increases sleep duration. As with all sedative-hypnotics, it is necessary to fully understand the potential side effects, warnings, and drug interactions before taking the medication.

In the long run, Ambien use may lead to tolerance, in which the body has adapted to the presence of the drug, requiring a higher dosage to achieve the same effect. It is, therefore, necessary to thoroughly review your medication history before starting your Ambien therapy.

  • Hart, Carl L., et al. "Zolpidem-related effects on performance and mood during simulated night-shift work." Experimental and clinical psychopharmacology 11.4 (2003): 259. From  https://doi.org/10.1037/1064-1297.11.4.259 Obtain on 05/09/2022
  • Asaad, G., & Shapiro, B. (1986). Hallucinations: Theoretical and clinical overview. The American Journal of Psychiatry, 143(9), 1088–1097. From https://doi.org/10.1176/ajp.143.9.1088  Obtain on 05/09/2022
  • Elko, C.J., Burgess, J.L. and Robertson, W.O., 1998. From https://doi.org/10.3109/15563659809028939 Obtain on 05/09/2022
  • Harbourt, Kelly, et al. "Association of eszopiclone, zaleplon, or zolpidem with complex sleep behaviors resulting in serious injuries, including death." Pharmacoepidemiology and drug safety 29.6 (2020): 684-691. From https://doi.org/10.1002/pds.5004 Obtain on 05/09/2022
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