The main component of Ambien drug is zolpidem tartrate, which is a benzodiazepine-like hypnotic drug belonging to the imidazopyridine group. When studying the substance, it was revealed that it can have a sedative effect when consumed in doses lower than the doses necessary for the development of muscle relaxant, anxiolytic, and anticonvulsant effects. The formation of these effects is associated with the specific agonistic effect of zolpidem tartrate on central ω-receptors, which belong to macromolecular GABA-receptor complexes that cause the opening of neuronal anion channels for chlorine. In addition, zolpidem tartrate has a selective interaction with central type I benzodiazepine receptors.

Indications

Ambien is intended for the treatment of insomnia in short courses.

Before prescribing a sleeping pill, it is recommended to establish the cause of the sleep disorder. If insomnia persists for 7 or 14 days while using the drug, this indirectly indicates that the patient has a primary psychiatric or physical illness.

Contraindications

Ambien is contraindicated in cases of hypersensitivity to zolpidem tartrate, as well as in the presence of myasthenia gravis, respiratory failure, asthenic bulbar palsy, sleep apnea syndrome, and severe liver dysfunction. The use of the drug is contraindicated for persons under 18 years of age.

Long-term use of Ambien may cause the development of drug dependence or a decrease in the hypnotic effect of the drug.

With the development of drug dependence, abrupt discontinuation of the drug can cause withdrawal syndrome, which is characterized by the development of muscle pain, increased anxiety, feelings of tension, restlessness, irritability, and confusion. In especially severe cases, symptoms of depersonalization, hyperacusis, derealization, tingling and numbness of the extremities, increased sensitivity to light, epileptic seizures, and hallucinations appear.

Use during pregnancy and breastfeeding

Due to the lack of clinical experience with the use of Ambien during pregnancy or breastfeeding, it is not prescribed to these patients.

Directions for use and doses

Ambien is intended for oral use. The drug should be used only in minimally effective doses. It is not recommended to take the medication in doses exceeding the maximum permissible.

• Adult patients take Ambien 10 mg daily. Due to the rapid onset of the effect of taking the drug, it is taken before going to bed. Elderly and debilitated patients, as well as those suffering from renal failure, are recommended to take the drug 5 mg.
• The maximum daily dose of a sleeping pill is 10 mg.

The drug can be taken in the form of short continuous courses. The duration of therapy is 4 weeks; if necessary, the duration of treatment can be increased, but only after assessing the patient’s condition.

Overdose

Taking high doses of Ambien can cause the development of bradycardia, ataxia, blurred vision, dizziness, drowsiness, respiratory failure, nausea, uncontrollable vomiting, convulsions, inappropriate behavior, loss of consciousness, and reversible coma.

To normalize the patient’s condition, the patient is given gastric lavage, or vomiting is induced, and sorbent agents and the necessary symptomatic treatment are prescribed.

Side effects

Taking the drug may be accompanied by the development of angioedema, hallucinations, increased agitation, confusion, nightmares, increased irritability, dysphoria, aggressiveness, psychosis, delirium, unreasonable anger, somnambulism, drug dependence, decreased libido, depression, drowsiness, headache, increased insomnia, the appearance of dizziness, anterograde amnesia, impaired consciousness, allergic reactions, and dyspeptic disorders.

Tolerance and dependence

It has been established that long-term use of Ambien can cause addiction and dependence. It is recommended to use the medicine only for short periods of time, using the lowest effective dose. Animal studies have shown that rodents have less tolerance to zolpidem than to benzodiazepines, but in primates, tolerance to zolpidem is comparable to benzodiazepines. In some people, addiction may develop within a few weeks. Stopping the drug after long-term use may cause seizures or other effects, especially if it was used for a long time and at high doses.

Treatment for physical dependence on Ambien typically involves a gradual dose reduction over a month to minimize withdrawal symptoms, which may resemble benzodiazepine withdrawal.

Alcohol enhances the effect of the drug, acting in the same way as with benzodiazepines. For this reason, alcoholism leads to an increased risk of physical dependence on zolpidem. In addition, there is a possibility of developing psychological dependence on Ambien.