SUMAYYA
09 September 2022
Medically reviewed by
Kajal Jain
M. Pharm
side-effects-of-zolpidem
Table of Contents

In 1992, the US FDA approved Zolpidem (Ambien) for the short-term management of insomnia. It works by slowing your brain activity and thereby inducing sleep.

As a nonbenzodiazepine, it has a better Safety profile than benzodiazepines and is now often utilized in therapeutic settings to treat insomnia.

Zolpidem is known in America by the brand name Ambien. It lowers nighttime awakenings, enhances sleep, and shortens the time it takes to fall asleep. 

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How Does Zolpidem Work?

Zolpidem interacts preferentially with a subset of GABA-A benzodiazepine receptor complexes and increases GABA inhibitory effects leading to sedation.

It is a fast-acting sedative-hypnotic medication. It has negligible muscle-relaxing, anxiolytic, and anticonvulsant effects.

How Do Side Effects of Zolpidem Happen?

Ambien, upon release, was a safe, short-term sleep aid without the drawbacks of narcotic sedatives. Side effects of Ambien have nonetheless become known now that it has been on the market for more than 20 years.

The Drug Enforcement Agency has designated Ambien as a controlled substance due to the possibility of misuse and dependence. Long-term use is not permitted.

Knowledge of these side effects makes consumers well-informed choices about hypnotic medications, which may deter the recreational use of the substance by non-medical users.

Ambien reduces brain activity, which makes it simpler for the user to fall asleep. At the same time, Ambien can also have side effects on the sensory, respiratory, digestive, and cardiovascular systems.

Zolpidem and Its Side effects

The body metabolizes Ambien quickly, and its bloodstream concentration is undetectable in less than a day.
Higher doses, however, might last in the body for up to three days. Side effects disappear after these intervals.   

  • Rapid or irregular heartbeat 
  • Nausea and vomiting
  • Abdominal pain
  • Diarrhea
  • Appetite loss
  • Double vision
  • Respiratory depression
  • Muscle cramps
  • Skin rashes

Abnormal body movements
Side effects that require immediate medical attention

These include:

  • Complex sleep behaviors (sleepwalking, sleep-driving, etc.)       
  • Next-day mental impairment
  • Confusion
  • Hallucinations
  • Depression
  • Suicidality
  • Severe allergic reactions

Even though Ambien does not produce as much drowsiness as other sleep aids, more recent research has shown that at higher doses, the medicine has a lasting effect on the body that lasts until the morning.

An FDA black-box warning for complex sleep behaviors, which include sleepwalking, sleep-driving, sleep cooking, and similar activity while awake, is present on the Ambien label.

The FDA claims that some users had high levels of Ambien in their blood, which made it impossible for them to perform activities that require mental alertness and coordination. So, avoid operating on heavy machinery and vehicles.

The FDA advises prescribers to restrict the dosage of the medication, particularly for women, to lower the chance of this side effect.

When Ambien affects memory, patients do not lose their memories. The ability of the brain to make new memories is lost instead, leading to a disorder called anterograde amnesia. 

Additionally, Ambien causes dementia, a general decline in mental capacity among the elderly.
The side effects of Zolpidem can include confusion, disorientation, and hallucinations, which are all signs of delirium and are seen rarely in the elderly. 

Some of the drug's dangerous side effects will depress the CNS system and show severe breathing problems, like respiratory distress and even death.
You can take up to 10mg daily, but taking it for longer than four weeks will develop an addiction to the drug.
Zolpidem is used only for short-term management of insomnia; it is not meant for more extended usage due to the habit-forming of the drugs.

Does Abusing And Misuse Of Zolpidem Have Side Effects?

The potential for developing a chemical dependence on the drug is one of the most dangerous side effects of using Ambien.

People who use Ambien for longer than a few weeks, those who take more than the advised dosage, and recreational users who abuse the drug for non-medical purposes are at risk of developing an addiction.

Ambien is frequently ingested dangerously by recreational users, who may powder it and mix it with alcohol or snort it. Thereby it increases the risk of overdose and excessive sedation.

Some signs of zolpidem abuse include:

  • Fatigue.
  • Headache.
  • Dizziness.
  • Struggle to maintain balance.
  • Nausea.
  • Gastrointestinal issues.
  • Changes in appetite.
  • Body shakes.
  • Redness of the eyes. 

Occasionally, users may sleepwalk or engage in other activities, such as eating, driving, or having sex, during their sleep. The person may experience a period of amnesia afterward, forgetting what they said or did while asleep. Users show psychological fallout from their Abuse of Ambien. Symptoms include:

  • Aggressive or strange behavior.
  • Hallucinations.
  • Anxiety.
  • Confusion.
  • Mood changes.
  • Depression.
  • Suicidal thoughts.

Abusing Ambien increases the risk of overdose. Signs include extreme sleepiness, slowed breathing and heartbeat, loss of consciousness, and coma. 

Interaction That Increases Its Side Effects     

  • Concomitant administration of Zolpidem with other CNS depressants increases CNS depression, drowsiness, and psychomotor impairment.
  • Using Zolpidem and opioids together increases the risk of drowsiness, respiratory depression, and coma and may even be fatal.
  • Zolpidem may interact with sedatives and lead to altered thinking, behavioral issues, drowsiness, and more sedation.
  • Combining alcohol and oral Zolpidem affects psychomotor function. Avoid concomitant use of Zolpidem with sertraline due to increased exposure to Zolpidem.
  • Avoid concomitant use of Imipramine and Zolpidem as it may decrease alertness. Multiple doses of Zolpidem and fluoxetine increase the zolpidem half-life (17%).

Do Any Foods Interact With Zolpidem?

When you take Zolpidem with food, it may delay the onset of sleep. Do not take Zolpidem with or immediately after a meal.

Alcohol raises the possibility of CNS depression and sleepiness the next day. The risk of dependence, psychomotor impairment (slowing of thinking process and diminished physical movements), sleepwalking, and sleep driving is further increased by alcohol consumption.

Limit intake of caffeine-containing products within a few hours of going to bed if you are taking Zolpidem, as it may exacerbate Anxiety or insomnia.

The use of Cannabis can change the effect of the drug. Consult your doctor before taking  Ambien.

Precautions While Taking Zolpidem 

  • Inform your doctor or pharmacist before taking Zolpidem if:
  • You have a history of alcohol or drug abuse.
  • Your lungs or liver problems.
  • You have had depression or another mental illness in the past.
  • Tell your doctor if you have taken Zolpidem or other similar medicines for more than four weeks.
  • Do not take a higher dose than prescribed.
  • Do not operate heavy machinery or perform activities that require mental alertness.
  • Take Ambien at bedtime.
  • Make sure you stay 7-8 hours in bed after taking Ambien.
  • Avoid alcohol intake when you are on Ambien.
  • Inform your doctor or pharmacist of any additional medications you are now taking.

Tell your doctor if you are pregnant or breastfeeding. Zolpidem during the second or third trimester of pregnancy may result in decreased fetal movement and decreased fetal heart rate variability.

If you are breastfeeding, avoid taking Zolpidem. The drug can enter the mother's milk. 

Bottom Line From Practical Anxiety Solutions

Take Ambien as directed by your doctor. Review your medication history and discuss what to expect while taking them with your doctor.

Patients should notify their doctor if they experience any side effects while on the medication. Stop Ambien only after consulting with your doctor. 

  • Holm KJ, Goa KL. Zolpidem: an update of its pharmacology, therapeutic efficacy and tolerability in the treatment of insomnia. Drugs. 2000 Apr;59(4):865-89. doi: 10.2165/00003495-200059040-00014. PMID: 10804040. https://doi.org/10.2165/00003495-200059040-00014 Obtain On 31/10/2022
  • Courtet P, Pignay V, Castelnau D, Boulenger JP. Abus et dépendance au zolpidem: à propos de sept cas [Abuse of and dependence on zolpidem: a report of seven cases]. Encephale. 1999 Nov-Dec;25(6):652-7. French. PMID: 10668611.  Obtain On 31/10/2022
  • Toner, Laura C., et al. "Central nervous system side effects associated with zolpidem treatment." Clinical neuropharmacology 23.1 (2000): 54-58. https://journals.lww.com/clinicalneuropharm/toc/2000/01000 Obtain On 31/10/2022
  • Yang, Weibin, Mary Dollear, and Sri Ranjini Muthukrishnan. "One rare side effect of zolpidem—sleepwalking: a case report." Archives of physical medicine and rehabilitation 86.6 (2005): 1265-1266. https://doi.org/10.1016/j.apmr.2004.11.022  Obtain On 31/10/2022
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