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By Kajal Jain

M. Pharm

01 January 2023
Medically reviewed by
IS AMBIEN A BENZODIAZEPINE
Table of Contents

Benzodiazepines and anxiolytics are medications that belong to the class of central nervous system (CNS) depressants that induce a state of drowsiness, sedation, drowsiness, impaired memory formation, and relaxation.

These effects depend on the specific drug and formulation used. They are habit-forming drugs. Individuals can become addicted to them, even if they take them as their doctor has prescribed. Common benzodiazepines include Diazepam, Alprazolam, Lorazepam, Clonazepam, and Temazepam.

Ambien (Zolpidem) is a sedative/hypnotic drug that shares some characteristics within the family of sedative-hypnotic medications. However, it has a specific selectivity that lessens anti-seizure and muscle relaxant effects and increases its sedative effect. Thus, it is used primarily as a medication for sleep.

Ambien is generally considered to be less addictive than common benzodiazepines. It also has a lower potential for abuse and overdose. In this blog, let us learn more about Ambien and benzodiazepines.

What Is Ambien?

Ambien (Zolpidem) is a non-benzodiazepine, non-barbiturate prescription drug for the short-term treatment of insomnia (1 to 2 weeks or fewer) in adults. It belongs to the class of sedative-hypnotics and is available in two formulations:

  • Immediate-release: is used to initiate sleep
  • Extended-release: used to maintain sleep

Ambien was initially developed to provide an alternative to other sleeping pills with a lower potential for addiction or abuse. However, research suggests that Ambien can produce dependency, tolerance, and withdrawal, which are signs of a potentially addictive drug.  

Some people also use Ambien to reduce headaches or decrease Anxiety and stress. Due to its relaxant characteristics, Ambien and its generic equivalent, Zolpidem, are sometimes taken to ease people suffering from a migraine or a solid headache for sleep, thereby reducing the symptoms of the headache. However, it does not necessarily eliminate the cause of the headache and is not meant to treat it. Aside from that, it is not recommended for children below 18 years. 

How Does Ambien Work?

Ambien exhibits its therapeutic action like other sedatives/hypnotic drugs. It binds to the gamma-aminobutyric acid (GABA) receptors in the brain to increase the effectiveness of the neurotransmitter. The prime responsibility of the inhibitory neurotransmitter, GABA, is to regulate the excitability of the nervous system and help you calm and relax during bedtime. 

As a sedative/hypnotic drug, Ambien can cause an intoxicated feeling and possibly short-term euphoria. Zolpidem has a short half-life. Unlike other sleeping pills, this means it wears off in a few hours.

What Are Benzodiazepines?

Benzodiazepines are included in the category of drugs called CNS depressants that cause drowsiness. These medications help treat insomnia as well as anxiety and panic disorders. The Food and Drug Administration (FDA) has approved them to treat:

  • Insomnia
  • Social Anxiety Disorder
  • Generalized Anxiety Disorder
  • Panic Disorder
  • Seizure Disorders, such as Epilepsy

The type of benzodiazepine will determine the potential uses. Doctors may also prescribe these drugs off-label for various conditions, including:

  • Other Sleep Disorders
  • Bipolar Disorder
  • Tic Disorders
  • Managing Alcohol Withdrawal

Benzodiazepines or benzos are highly habit-forming drugs, even if taken in a manner as prescribed. The risk for misuse and abuse is high. Prolonged usage of these drugs leads to increased tolerance, which means you will need higher doses of the drug to achieve the intended effects. Generally, individuals with a history of alcohol or drug abuse are more likely to develop an addiction to such drugs.

How Do Benzodiazepines Work?

Benzodiazepines work by enhancing the effect of GABA (gamma-aminobutyric acid) neurotransmitter. GABA is a neurotransmitter that communicates inhibitory messages between brain cells and sends calming messages to the body.

When an individual feels anxious, overstimulation occurs in the brain. When people take benzodiazepines, the brain will send messages to counter this overstimulation. Thus, taking benzodiazepines can reduce anxiety symptoms.

Is Ambien A Benzodiazepine?

Ambien is a non-benzodiazepine drug belonging to a class of sedatives/hypnotics. It is commonly used to treat short-term insomnia by activating the neurotransmitter receptors for GABA, which slows down the brain, resulting in sedative action.

It is prescribed only as a second-line treatment for insomnia after non-pharmacological options have been exhausted. These options include sleep hygiene therapy and cognitive behavioral therapy.

Ambien can be harmful if you take more than the prescribed dose every day. Ambien causes long-term side effects, including frequent headaches, chronic fatigue, and digestive problems.
Ambien can have less severe side effects as compared to Benzodiazepines. However, both medications have a risk of withdrawal symptoms.
Ambien can worsen depression or cause anxiety. The action medication is intended to sedate a person who needs sleep. Thus, it relies on changing the brain's chemistry, which can have several adverse effects. This includes worsening anxiety.

Can You Abuse Benzodiazepine?

Benzodiazepine abuse is a significant cause of concern. Most people take these drugs for recreational purposes without the supervision of a licensed medical professional, which can be potentially dangerous and harmful. Individuals can avoid potentially life-threatening problems by:

  • Using these drugs only after a prescription from a doctor
  • Following the doctor's instructions precisely
  • Consulting your doctor before changing the dosage
  • Telling the doctor about any medications or other substances, including supplements, they are taking
  • Avoiding using the drugs for longer than the doctor prescribes
  • Keeping all medications out of the reach of children
  • Refraining from using another person's prescription drugs
  • Refraining from using alongside opioids or alcohol
  • Considering asking the physician about alternative options

Ambien vs. Benzodiazepines

Ambien is used to treat short-term insomnia only. On the other hand, benzodiazepines treat sleep disorders, Anxiety, seizures, muscle spasms, panic disorders, nervousness, seizures, and alcohol withdrawal. Common benzodiazepines include Diazepam, Alprazolam, Clonazepam, and Lorazepam. Withdrawal symptoms may occur if you stop taking benzodiazepines or Ambien abruptly. However, withdrawal symptoms may vary for both.

Side effects of benzodiazepines that differ from Ambien include:

  • Reduces sex drive
  • Lightheadedness
  • Nausea and vomiting
  • Memory impairment
  • Dry mouth
  • Changes in appetite
  • Constipation
  • Weight gain
  • Fatigue

While side effects of Ambien that vary from benzodiazepines include:

  • Euphoria
  • Headache
  • Insomnia
  • Weakness and dizziness
  • Diarrhea
  • Hallucinations
  • Depression
  • Rash
  • Visual changes

Ambien also induces parasomnia that includes all strange things while people are technically asleep, with no memory of doing so, such as binge-eating, sleepwalking, hallucinations, or cleaning the house.

Similarities With Benzodiazepines

Despite different properties, Ambien and benzodiazepine have similar characteristics.

These include:

  1. According to the Drug Enforcement Administration (DEA), Ambien and benzodiazepines are considered Schedule IV controlled drugs. 
  2. They are effective in treating insomnia by helping initiate and maintain sleep.
  3. Both Ambien and benzodiazepines enhance the effect of a specific neurotransmitter, GABA. 
  4. Both can potentially form an addiction. Although, it may take longer for Ambien to establish a habit.
  5. While both classes of drugs have the potential for withdrawal symptoms, those of Ambien tend to be less severe than that of the benzodiazepines.
  6. Benzodiazepines and Ambien have some overlapping side effects, including:
    • Dry mouth
    • Drowsiness
    • Impaired balance
    • Confusion

What Are The Possible Side Effects?

The side effects of Ambien and benzodiazepines may range from mild to more severe symptoms that should be discussed with your healthcare professional. The side effects of both drugs are as follows:

Benzodiazepine Side Effects:

Common Side Effects

Less Common Side Effects

Sedation

Weakness

Memory impairment

Dizziness

Increase or decrease in appetite

Headache

Improper body balance

Drowsiness

Nausea & Vomiting

Drugged feeling

Constipation

Insomnia

Dry mouth

Rare Side effects

Reduced libido

Blood Disorders

Lightheadedness

Yellowing of Skin (Jaundice)

Fatigue

Gynecomastia

Ambien (Zolpidem) Side Effects: 

Common Side Effects

Less Common Side Effects

Drowsiness

Back Pain

Headache

Double Vision

Muscle Aches

Indigestion/Heartburn

Stuffy/Runny Nose

Hoarseness

Nausea & Vomiting

Irritability

Diarrhea

Rare Side effects

Lightheadedness

Blurred Vision

Fatigue

Breast Pain

Lack of Appetite

Changes in Taste

Severe Side Effects

  • Changes in behavior, mood, or thinking
  • Slower than usual concentration
  • Respiratory problems
  • Sleep-related behavioral abnormalities
  • Withdrawal (abrupt discontinuation) side effects:
    • Chills or shivering
    • Tremors
    • Restlessness
    • Constant muscle pain
    • Sweating
    • Depression

Contact your doctor immediately if you have any of these severe side effects. Adjustments in your prescription may be necessary for further treatment.

Can You Get Addicted To Benzodiazepines Or Ambien?

Both drugs are classified as Schedule IV drugs by the Drug Enforcement Administration (DEA). This means they have a limited potential and risk for abuse and dependence than other, more powerful, controlled drugs.

Ambien

Ambien becomes addictive at higher than prescribed doses or for longer than two weeks. Aside from that, it can also cause withdrawal symptoms when it is discontinued abruptly.

Ambien also causes abnormal behavior with confusion, or paradoxical insomnia, which may include sleep-driving. If these dangerous side effects occur, Ambien should be discontinued.

Benzodiazepines

Benzodiazepines are highly effective medications. As mentioned earlier, these are habit-forming. Individuals are more likely to become addicted to these drugs, even if taken as prescribed. People with a history of alcohol or drug abuse have a high risk for addiction to these medications. 

People get addicted if they take benzodiazepines over a longer period. This means an individual needs higher doses of the drug to treat health conditions because you have become tolerant of the weaker formulations. 

Signs and symptoms of benzodiazepine addiction include:

  • Diarrhea
  • Problems sleeping
  • Nausea and vomiting
  • Goosebumps
  • Bone and muscle pain
  • Uncontrollable leg movements

Benzodiazepine addiction is challenging to overcome since these drugs alter the brain's chemistry. Doctors and other licensed medical practitioners that treat addiction are likely to formulate a tapering schedule to wean off the medication gradually. This scheduling system effectively reduces the severity of withdrawal symptoms during treatment and prevents addiction. 

Drug Interactions

Ambien

In total, there are currently 377 drugs that are likely to have an interaction with Ambien. Out of the 377, 24 are significant, 350 are moderate, and 3 are minor interactions. These interactions with Ambien are a matter of concern since some of them can lead to an unintended increase in blood levels of each specific medication, raising the risks of more severe side effects.

Ambien is processed in the liver, wherein the liver enzymes breaks it down for elimination from the body. If other medications (e.g. antibiotics) inhibit these enzymes, the levels of Ambien in the blood may rise. Ambien may also interact with other drugs. These drugs or substances include:

  • A combination of Ambien and Alcohol should be avoided because of their synergistic depressant effect. 
  • Ambien also interacts with other sedatives because of the additive effects.
  • Ketoconazole and Itraconazole might increase Ambien's blood concentration by decreasing the enzyme activity that breaks it down in the liver. 
  • Rifampin reduces the concentration of Ambien by increasing the activity of the enzymes that cause its breakdown. 

Benzodiazepines

A combination of alcohol and benzodiazepine is hazardous. People taking alcohol while on this drug will feel the effects of alcohol faster. It is unsafe to take alcohol or other drugs with similar effects on the central nervous system (CNS) simultaneously.

These drugs interact with oral benzodiazepines, causing different brain and respiratory depression, which can even be fatal. Examples of drugs that increase sedative side effects of respiratory depression from benzodiazepines include:
Pain medicines called opioids that also cause respiratory depression, including:

  • Fentanyl
  • Morphine
  • Acetaminophen
  • Hydrocodone
  • Oxycodone 

Sedatives drugs include:

  • Ambien (Zolpidem)
  • Zaleplon
  • Eszopiclone
  • Phenobarbital

Always ask your doctor or pharmacist to run a drug interaction screen before taking benzodiazepines or Ambien with other medications or supplements.

Bottom Line From Practical Anxiety Solutions

Ambien is used to treat insomnia. Benzodiazepines are also used to treat other conditions aside from insomnia. These medications are included in the drug class of CNS depressants that cause drowsiness. On the other hand, Ambien belongs to the sedative-hypnotic class that has some characteristics similar to benzodiazepines.

Both work by activating the GABA neurotransmitter receptor. Long-term use of these medications is associated with tolerance or dependence. Individuals can potentially develop an addiction to using either drug. Despite being recommended for short-term only, Ambien and benzodiazepines are prescribed in high volumes in different countries. 

Individuals should always discuss with their doctor any other drugs they are taking and any particular concern related to their prescription for Ambien or benzodiazepine for better treatment.

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