Ambien Non-benzodiazepine Hypnotic

• Active ingredient: Zolpidem tartrate
• Drug class: Non-benzodiazepine hypnotic, Sleep agent, Iimidazopyridine
• Pregnancy category: B
• Dosages: mg tablets
• FDA approved: December 16, 1992
• Company name: Sanofi-Aventis
• Habit forming? Yes
• Avalable as generic? No

Ambien (Zolpidem tartrate) is a prescription short-acting nonbenzodiazepine hypnotic. Ambien is one of the most commonly prescribed drugs for insomnia. Ambien is used for the short-term treatment of insomnia. It has been studied for nightly use up to six months.

2002 study suggested that the drug might be used on an as-needed basis, with up to 5 tablets taken a week. After 3 weeks, two-thirds of the patients taking Ambien this way were able to reduce their tablet intake by more than 25% without losing improvements in sleep.

It works quickly (usually within 15 minutes) and has a short half-life (2-3 hours). This means that Ambien is great for helping you get to sleep but could be less helpful if you tend to wake up a lot in the middle of the night. It appears to preserve deep sleep (stages 3 and 4) with infrequent changes in REM sleep.

Ambien hypnotic effects are similar to those of the benzodiazepine class of drugs, but it is actually classified as an imidazopyridine. Flumazenil, which is used for benzodiazepine overdose, can also reverse zolpidem's sedative/hypnotic effects.

Ambien off-label uses:

• restless leg syndrome
• by stimulant users to "come down" after the use of stimulants such as methamphetamine, cocaine, MDMA (ecstasy), or amphetamine
• suggested to have positive effects for sufferers of persistent vegetative state

Advantages:

• works quickly - usually within 15-30 minutes
• appears to preserve deep sleep (stages 3 and 4) with infrequent changes in REM sleep
• minimal effect on sleep stages
• helps to stay asleep
• highly effective for the treatment of insomnia on a short-term basis
• minimal potential of 'hangover' effects
• less likely than benzodiazepines to cause addiction, withdrawal symptoms, or a buildup of tolerance
• unlike nonselective benzodiazepines, does not decrease REM or sleep

Disadvantages:

• is a Schedule IV controlled substance
• has the potential for addiction
• discontinuation after long-term use can lead to withdrawal symptoms
• may cause daytime drowsiness
• rebound insomnia may be present for a short period after discontinuing nightly use

How does Ambien works?

Ambien works in combination with the natural brain neurotransmitter GABA (gamma-aminobutyric acid). GABA is one of the 18 major brain chemicals that control communication among neighboring brain cells. Once this chemical is discharged from a brain cell, it is hypothesized that GABA dampens the electrical activity of neighboring brain cells. Laboratory studies have shown that Ambien works with GABA to further reduce the possibility of certain brain cells becoming electrically active. Unlike older sleep drugs, Ambien targets a specific area of the brain cell.

Residual next-day drowsiness

Because Ambien has a short half-life (about 2.8 hours in persons with normal hepatic and renal function) and no active metabolites, the possibility of residual next-day prolonged or excessive sedation is not significant. There are minimal reports of 'hangover' effects with Ambien.

Withdrawal symptoms

Withdrawal from Ambien can cause slight but not significant rebound effects. Problems associated with abrupt discontinuation are more likely to occur following chronic therapy.

Rebound insomnia

Rebound insomnia may be present for a short period after discontinuing nightly use of Ambien. However, studies have found that this effect is not significantly greater than that of a placebo when Ambien was administered at the recommended dose of 10 mg. Rebound insomnia usually goes away on its own after 1 or 2 nights.

Abuse and dependence potential

Ambien abuse can occur when used longer than recommended, at high doses (more than the usual 10 mg), and in people who have been dependent on other drugs or alcohol in the past. Ambien effects can increase and intensify if mixed with other substances like alcohol.

Ambien may be habit-forming and should be used only by the person it was prescribed for.

Incidence of reported dependence for the non-benzodiazepine hypnotics Ambien is remarkably lower than that of benzodiazepines. However, as Ambien is psychotropic drugs, patients with a history of abuse or dependence and those with psychiatric diseases seem to be at increased risk of abuse of these agents.

• It's best to take Ambien or Ambien CR on an empty stomach for faster absorption and sleep-onset.
• Ambien has no significant residual sedation in morning.
• Produces less memory and cognitive impairment than classic benzodiazepines.
• Ambien is less likely to cause addiction, withdrawal symptoms, or a buildup of tolerance than benzodiazepines.