What is Ambien (Zolpidem) Withdrawal?
Medical professionals consider “z-drugs” like Ambien less habit-forming than other sedatives such as benzodiazepines. Some people may take this as a sign that Ambien isn’t addictive. This may lead to misuse, abuse, and potentially an addiction.
Even individuals who take Ambien as prescribed can build a tolerance to the drug in as little as two weeks.
Tolerance is the body’s diminished response to Ambien due to it adapting to the use of the same drug over a period of time, resulting in the need to take larger dosages in order to achieve the same desired effect. Dependence occurs when the body has become so used to the presence of Ambien that is is no longer able to function “normally” without it. If the user either stops taking Ambien or reduces their dose, their body may react negatively, and withdrawal symptoms may appear. This is especially true if the user attempts to go “cold turkey,” or stop taking Ambien entirely without medical supervision. This is can be highly dangerous, as Ambien withdrawal symptoms can be very severe, and some of their complications can even be fatal. A medically-assisted detox can help prevent the dangerous complications of withdrawal and make the user more comfortable.
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Withdrawing from Ambien is difficult partly because of the changes that are taking place in the brain; withdrawal symptoms are a result of the brain trying to reestablish normal activity. Withdrawal from Ambien has the opposite effect of taking the drug, and abruptly stopping doses of Ambien leads to more severe symptoms.
Seizures have been observed after the discontinuation of [Ambien] in individuals using extremely high doses of this agent, as have other signs of withdrawal including tremor, agitation and anxiety.
Other Ambien withdrawal symptoms include:
- Agitation and irritability
- High blood pressure
- Stomach cramps
- Nausea and vomiting
- Uncontrollable crying
- Panic attacks
Ambien’s main purpose is the short-term treatment of sleeping disorders, especially insomnia. When a person becomes dependent on Ambien and stops taking it, they may be unable to sleep. This is known as “rebound insomnia,” a withdrawal symptom in which the inability to sleep returns, often worse than before. When users stop taking Ambien entirely and suddenly, the risk of rebound insomnia is increased. This is also the time when there is greater risk of complications, such as seizures or even delirium.
Rebound insomnia occurs because Ambien suppresses the central nervous system and reduces the firing of certain nerves in the brain. When the use of Ambien is suddenly stopped, the diminishing effects of Ambien suddenly dissipate, leaving the brain in overdrive trying to overcome this sudden change. This results in the inability to sleep, along with increased anxiety and other withdrawal symptoms. Rather than quitting cold-turkey, it is recommended to talk with a physician so that the dosages can be tapered down (meaning reduced gradually over time) in a detox setting to prevent the risk of complicated side effects.
Some former Ambien addicts have said their rebound insomnia lasted several weeks after they decided to quit. But ultimately, most addicted people end up sleeping better after the withdrawal period is over.
The duration of withdrawal from Ambien varies from user to user. Symptoms may last as little as a few days or as much as several weeks.
Those who take larger doses over a longer period of time generally have the most intense symptoms. Heavy Ambien users are also likely to struggle with withdrawal symptoms for a longer time period than moderate users.
A typical dose of Ambien is 5 mg daily. But many people addicted to Ambien take far larger doses, often 10-20 mg per day, and in some cases hundreds. One case study described a woman who struggled with severe withdrawal from taking 160 mg of Ambien per day.
People taking Ambien CR (controlled release) should be aware that their withdrawal symptoms may last longer. The goal of Ambien CR is to keep users asleep, whereas regular Ambien is meant to help users fall asleep. Ambien CR keeps users asleep by remaining in the body for a longer period of time, meaning it takes longer to leave the body.
Due to how similar the chemical make up of Ambien is to benzodiazepines such as Xanax and Valium, the withdrawal symptoms from Ambien and benzos are very similar. Generally, an individual will be symptom-free after 2 weeks, with the worst of the withdrawal symptoms occurring between days 3 and 5. Symptoms that remain after 2 weeks or so are no longer considered acute withdrawal symptoms and are called oost-acute withdrawal symptoms (PAWS). PAWS may last 18-24 months depending on various factors; however, the symptoms tend to reduce in severity as time goes by. Some of the most common PAWS include anxiety, poor concentration, insomnia, poor appetite, mood-swings, irritability, and agitation.
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Ambien Withdrawal Timeline
|First 48 hrs||Ambien has a half life of about 2 hours, which is shorter than most sedatives. Half-life is how long it takes for the drug to leave the body. Ambien withdrawal symptoms generally begin to appear within 48 hours of the last dose. For most individuals, symptoms on days 1-2 will be mild but increasing.|
|Days 3-5||Usually about 48 hours after the last dose of Ambien, withdrawal symptoms fully manifest. Days 3-5 are when symptoms are the most severe for most individuals. Users are likely to experience confusion, memory loss, and mood swings. It is also difficult to sleep during this time. Users might feel shaky and nauseated. Some people also have panic attacks. Rebound insomnia may still be a struggle.|
|Weeks 1-2||After withdrawal symptoms peak, former Ambien users begin to feel normal again. Symptoms slowly fade during the second week and former addicts should start being able to sleep normally without Ambien.|
Detoxing from Ambien nearly always involves a tapering down approach. By gradually reducing a user’s doses over time, the recovering user’s body can slowly readjust to life without Ambien. A tapered detox keeps the body from becoming overactive, which can lead to panic attacks, convulsions and dangerously high blood pressure.
Some people are able to taper off Ambien in as little as two weeks while it takes months for others. In either case, the goal of Ambien detox is to minimize discomfort and prevent harmful withdrawal symptoms.
Some physicians switch Ambien users to long-acting benzodiazepines like Valium. Because the withdrawal symptoms of Ambien are nearly identical to benzo withdrawal, Valium can ease the symptoms caused by quitting Ambien. In the case of a person severely addicted to Ambien, physicians reported that they “used [a Valium] tapering regimen to treat the zolpidem withdrawal symptoms successfully without recurrence of seizure.”
It’s important to note that Valium is also a powerfully addictive substance and is only suggested by a physician as a medication to taper off Ambien. It is not used as a replacement medication.
Treatment for Ambien Addiction
Many inpatient and outpatient rehabs offer a medically-managed detox as part of their programs. However, treating an addiction to Ambien is often more complex than making it through the withdrawal period. Combining the tapering-off process with therapies like cognitive behavioral therapy improves the chances of a successful recovery.
Both medically-assisted detox and therapy are essential in helping former users permanently quit Ambien. If you or someone you love is struggling with an Ambien addiction and fear you might relapse, there is help available. Contact a treatment provider to learn about your options today.