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Ambien Withdrawal Symptoms And How To Stop Zolpidem

zolpidem withdrawal symptoms

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Dependence on zolpidem can produce a number of Ambien withdrawal symptoms, which may require a medically supervised detox and rehab programs for treatment. The symptoms vary in severity and duration, manifesting differently in the patients.

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How Does Ambien Withdrawal Occur?

If one either stops taking the drug cold turkey or make an attempt to reduce Ambien dose drastically, the body will react negatively, producing symptoms of Ambien withdrawal. This is especially true if done without medical supervision. Symptoms may also occur after missing doses or switching to zolpidem alternatives. Considering an alternative often relates to the high cost of Ambien.

The process of zolpidem withdrawal can be explained by gradual developing tolerance and dependence on the drug over some period of time. As a result, when a patient discontinues taking the drug, the adverse symptoms manifest as withdrawal.

How Long Does Ambien Withdrawal Last?

Generally, an individual will experience Ambien withdrawal for 2 weeks, with the worst of the effects occurring between days 3 and 5. Symptoms that will remain after 2 weeks are called post-acute withdrawal symptoms (PAWS). They may last for months depending on several factors.

Ambien Withdrawal Symptoms & Their Timeline

Missing a dose of zolpidem, lowering the dose, or switching to a new drug to prevent unwanted side effects often results in zolpidem withdrawal. Patients who take Ambien extended-release are likely to experience more severe and longer symptoms. This is because this form of the drug remains in the system longer, hence dependence is common.

The zolpidem withdrawal symptoms include: 

  • extreme mood swings
  • tremors
  • sweating
  • hot flushes
  • nausea
  • vomiting
  • abdominal and muscle cramps
  • panic attacks
  • irritability
  • depression
  • severe anxiety
  • lightheadedness
  • fatigue
  • delirium
  • rebound insomnia
  • seizures

The drug type, length of time and amount used, presence of other substances, and individual differences will also affect the severity and length of the process. A typical timeline for Ambien withdrawal is as follows.

First 2 Days

Zolpidem half-life is short. Individuals who have developed a dependence on this drug may start experiencing zolpidem withdrawal symptoms in as early as 4 to 8 hours after the last dose. During the first 2 days, people are most likely to experience rebound insomnia, mood swings, mild confusion, and difficulty concentrating.

Days 3 To 5

Symptoms of withdrawal from Ambien will peak between 3 and 5 days after the last dose. Individuals often complain of stomach pain, anxiety, confusion, depression, mood swings, flushing, and flu-like symptoms. It is also difficult to sleep. Users may feel nauseated and shaky. Others experience panic attacks. Rebound insomnia remains to be a problem during this phase.

Weeks 1 To 2

For most users, zolpidem withdrawal symptoms will subside within the first 2 weeks. However, in some cases, psychological side effects, including anxiety, depression, and insomnia may continue for months. Others may also experience ongoing cravings. Tremors, hallucinations, and seizures may occur rarely among individuals who stop zolpidem cold turkey.

Treatment Options

Ambien withdrawal treatment requires careful planning to ensure safety and prevent serious side effects. Medical supervision and monitoring are important in all cases; hence, Ambien detox at home is not recommended.

Ambien detox nearly always involves a tapering strategy. Also, the basis of Ambien withdrawal treatment is built around three principles: medical assistance, psychological monitoring, and social support. These three fundamentals create the environment for a successful recovery.

Most symptoms of zolpidem withdrawal are not severe and can be managed without medications. However, when these symptoms adversely interfere with a patient’s daily life, The treating physician can prescribe some medical remedies to ease the effects. In the cases when rebound insomnia is severe, physicians may recommend short-term use of sedative medications. Patients who are suffering from severe anxiety and suicidal thoughts are likely to be given mood-stabilizing drugs. Anti-nausea and anti-seizure drugs may also be used to manage other symptoms. Also, physicians switch patients to long-acting benzodiazepines during the process to ease the symptoms caused by stopping the use of zolpidem.

How To Wean Off Ambien Safely?

People should not stop Ambien without medical supervision. Those who are emotionally unstable are at risk for self-harm or even suicidal attempts. Also, withdrawal from Ambien can be potentially fatal because of the seizure risk.

Weaning off Ambien can be done safely through careful medical assessment of a patient’s health and continuous monitoring. A complete assessment should be done to determine the presence of co-occurring diseases and substances.

Abruptly stopping Ambien after long term use poses the highest risk of developing the most severe symptoms. A tapering approach should always be used. The individual should be given zolpidem in periodically reduced doses to slowly wean the drug off and prevent negative reactions.

The Ambien withdrawal schedule can be specified for every individual’s needs and condition. Most professionals order patients to slowly reduce the amount of zolpidem taken on a weekly basis. This process continues until one has successfully stopped taking the drug completely.

Getting Help From Ambien Misuse

People completing zolpidem withdrawal should enroll in a comprehensive treatment program to deal with the issues that drive their substance misuse. Rehabilitation centers offer cognitive and behavioral therapies, psychoeducation, family support, social group discussions, along with medical interventions. Combining the tapering with addiction treatment programs will help prevent relapse in the future.

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View Sources
  1. Cubała WJ, Landowski J. Seizure following sudden zolpidem withdrawal. Progress in Neuro-Psychopharmacology & Biological Psychiatry. 2007; 31(2): 539-540. doi:10.1016/j.pnpbp.2006.07.009. https://pubmed.ncbi.nlm.nih.gov/16950552/.
  2. Ambien® (zolpidem tartrate) tablets: HIGHLIGHTS OF PRESCRIBING INFORMATION. sanofi-aventis U.S. LLC. 2008. https://www.accessdata.fda.gov/drugsatfda_docs/label/2008/019908s027lbl.pdf.
Sharon Levy

About Author

Sharon Levy, MD, MPH

After successful graduation from Boston University, MA, Sharon gained a Master’s degree in Public Health. Since then, Sharon devoted herself entirely to the medical niche. Sharon Levy is also a certified addiction recovery coach.

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