Ambien: An overview
Ambien is the brand name for the active pharmacological substance zolpidem. Ambien is a prescription medication used to treat short-term insomnia in adults. Ambien belongs to a group of drugs known as hypnotics, which work by slowing brain activity and facilitating falling asleep [1]. Ambien does this by binding to inhibitory GABA receptors, thereby reducing activity [2].
Ambien is sold in two forms: immediate-release and extended-release capsules taken orally. The immediate-release tablets primarily help you fall asleep, while the extended-release tablets help you stay asleep by maintaining sleepiness and sleep-like brain activity. This occurs by extending the release of the drug into the body throughout the night [3].
Ambien should be taken at most once daily upon bedtime using a 5mg or 10mg capsule. Ambien has also been marketed as an oral spray [4]. You mustn't take Ambien as a long-term medication, as it can be addictive [2].
Side effects of taking Ambien
GABA receptors are important for multiple functions in the nervous system. Additionally, Ambien includes supplementary substances that enable zolpidem to reach its target, which may enhance side effects. Common side effects include: [4]
- Drowsiness
- Dizziness
- Altered appetite
- Dry mouth
More serious side effects of Ambien include:
- Sleep walking or increased activity during sleep
- Increased anxiety
- Memory loss (called amnesia)
- Symptoms of depression or low mood
- Swelling of the respiratory system
- CNS depression - this is a cluster of symptoms that can present as reduced breathing ability, heart rate and potentially even loss of consciousness or coma [2]
You must disclose any comorbid diagnoses, such as depression or anxiety, when consulting your prescribing medical provider, as these may increase the risk of side effects or exaccerbate your pre-existing condition.
Can I Drink Alcohol While Taking Ambien?
Drinking alcohol while taking Ambien is discouraged, as both alcohol and Ambien act on GABA receptors in the brain [5]. Although alcohol also increases sleepiness, which may be desired in individuals with insomnia, alcohol severely disrupts sleep architecture, leading to less recovery and rest during sleep [6]. Therefore, alcohol reduces the effectiveness of Ambien in the treatment of insomnia.
Drinking alcohol while taking Ambien also raises the risk of engaging in unusual sleep behaviours, such as sleepwalking or sleep driving [4].
The cumulative sedative effect of drinking alcohol and taking Ambien can also be a problem [7].
This is because drinking alcohol while taking Ambien increases the risk of a severe interaction effect called CNS depression. This can result in confusion, loss of consciousness, low heart rate, seizures, or abnormal breathing [7].
If you have any questions about drinking during your Ambien treatment, you should talk with your healthcare provider or pharmacist.
What should I do if I drank alcohol while taking Ambien?
If you have drunk alcohol after taking Ambien, it is essential to follow your usual bedtime routine and avoid carrying out demanding activities. Monitor your symptoms and contact your healthcare professional immediately if you experience reduced breathing capacity, dizziness, nausea or abnormal swelling [7].
Interactions of Ambien
Ambien may interact with various other substances, affecting its efficacy, breakdown or exacerbating side effects.
- Selective serotonin reuptake inhibitors (SSRIs) (e.g. fluoxetine) - SSRIs can increase the length of time Ambien remains in your body, potentially leading to morning sleepiness [7].
- Benzodiazepines (e.g. diazepam, klonopin, Xanax) - Benzodiazepines act on a related class of GABA receptors. Their combination with Ambien can have a cumulative effect on sedation, potentially leading to loss of consciousness.
- Herbal supplements - Melatonin, valerian, and St. John's wort can interact with Ambien, potentially causing excessive drowsiness and increasing the risk of severe side effects. St. John's Wort, a CYP3A4 inducer, can reduce Ambien's effectivity and duration by increasing the Ambien breakdown rate [7].
- Cannabis - Cannabis may affect the liver enzyme responsible for breaking down Ambien, potentially raising the risk of side effects from the drug [7]. Intriguingly, Ambien has been successfully used to enhance sleep during cannabis withdrawal, demonstrating the complementary nature of the two drugs when taken in succession [8].
To summarise, avoid drinking alcohol while taking Ambien and consult with a healthcare professional if you experience any unusual side effects.
