Zolpidem for insomnia

[itsrebel]

I was this afternoon prescribed Zolpidem Tartrate 10 mg (Aurbindo) for insomnia by a GP. Does anyone have any experience with this specific tablet? I don't really like to take pills, but it has gotten to a point where, unless I pass out from alcohol, I can't sleep.

What bothers me about this presription is that the doctor didn't really think too much or ask any serious questions. It was at a large hospital in Bangkok and I had gone to get a medical certificate for work permit renewal. I mentioned to her that I am having trouble sleeping. All she asked if i had anxeity and I said no. Then she prescribed this and said it is not addictive (I read on this forum that it is addictive). And that was that.

Would really appreciate any comments/reviews about the tablet. I bought it but want to know everything I can before I take it. I am looking up reviews online, and thought that I will ask here as well.

Thanks in advance.

Cheers!

[CaptHaddock]

Google "ambien." Same thing.

[Sheryl]

Good that you ask as it does have a lot of side effects and potential risks, especially if used regularly (which it should not be).

The most common side effect is being dizzy, groggy and/or mentally "spaced out" the next day (obviously you will be at night too but hopefully you sleep through that part), along with impaired physical coordination. People vary in how long the effects last.

In some cases people sleep walk or do things at night after taking it that they do not remember.

Some people also suffer depression or anxiety from using this drug. Muscle aches/headache are also not uncommon.

Personally I took this drug exactly once. About 30 - 45 minutes after taking it, I began to hallucinate (luckily I understood what was happening). After about an hour it stopped though I continued to feel odd for a few hours. At no time was I remotely sleepy. But some people do fall asleep with it.

If used, it should definitely be only on rare occasion, not regularly, do not ever combine with alcohol and do not ever drive after taking it. And don't plan on any complicated mental work of important physical tasks for 8-10 hours after taking. First time you take it, make it the night before a day where you don't have to work or do anything important just in case it leaves you wiped out as it does that to some people (but not all).

The drug interacts badly with a number of other drugs so if you are on any other medication need to check first.

Full list of side effects (parentheses indicate frequency):

Dizziness (5-12%)

Headache (7-19%)

Drowsiness (6-15%)

Allergy (4%)

Hallucinations (4%)

Myalgia (4%)

Sinusitis (4%)

Memory disorder (3%)

Visual disturbance (3%)

Pharyngitis (3%)

Lightheadedness (2%)

Palpitation (2%)

Rash (2%)

Constipation (2%)

Depression (2%)

Drowsiness (2%)

Asthenia (1%)

Diarrhea (1%)

Dry mouth (1%)

Flu-like symptoms (1%)

And these are the "cautions" that the US FDA requires the manufacturer to proivde:

"Cautions

Data show that zolpidem blood levels may remain high enough the morning after nighttime usage to impair activities that require alertness, including driving; this next-morning impairment is highest for the extended-release dosage form and is more prevalent in women because they eliminate more slowly than men

Use caution in patients with history of drug dependence (increases risk of abuse)

Food increases time to attain peak plasma level and decreases peak plasma concentration

Need to evaluate for comorbid diagnoses; reevaluate if insomnia persists after 7-10 days of use

Severe anaphylactic/anaphylactoid reactions: Angioedema and anaphylaxis have been reported; do not rechallenge if such reactions occur

Abnormal thinking, behavioral changes, complex behaviors: May include “sleep driving” and hallucinations; coadministration of alcohol and other CNS depressants appears to increase the risk of such behaviors

Do not use with alcohol

CNS depressant effects: Use can impair respiratory drive, alertness, and motor coordination; if used in combination with other CNS depressants, dose reductions of 50% may be needed due to additive effects

Depression: Worsening of depression or suicidal thinking may occur; prescribe the least amount feasible to avoid intentional overdose

Withdrawal effects: Symptoms may occur with rapid dose reduction or discontinuation

Elderly/debilitated patients: Use lower dose due to impaired motor, cognitive performance and increased sensitivity

Use with caution and monitor closely in patients with hepatic impairment, mild to moderate COPD, impaired drug metabolism or hemodynamic responses, or mild to moderate sleep apnea

-- http://reference.medscape.com/drug/ambien-cr-zolpidem-342931#5

[jmccarty]

Don't mix any sleeping medication with alcohol or you are likely to do and say things that night that you will not remember or even believe when you come around the next day.

[JDGRUEN]

OP ... Here is my experience with using meds to get sleep.

For many years I have used Diphenhydramine - Benadryl the antihistamine. It will allow most people to get to sleep - 25 milligrams will do it ... some people take 50 mg. Drawbacks are 'antihistamine hangover' - grogginess upon waking up - plus dry mouth and maybe dry eyes... Use google to check if you are concerned about side effects. Using Benadryl is okay - not perfect but better than going without sleep. It does not work well for some people.

I just found what I consider a better med. A local pharmacist who didn't have diphenhydramine recommend using Atarax - hydroxine dihydrochloride. I bought some - fairly cheap ... 25 mg tabs. It is made by GlaxoSmithKline. It is labeled as (using the old fashion term) a 'tranquilizer with antihistamine action'. They are very small white caplets ... I find the drug to be better than diphenhydramine... with little to no antihistamine hangover... my nightly experience is pleasant - easy to fall asleep and stay asleep - it seems to induce pleasant dreams...

OP --- you may also want to try Melatonin - a substance found in the human brain which regulates the circadian rhythm - sleep/wake cycle in humans. Melatonin should be able to be found in Thailand. It comes in 3 mg tabs and higher dosage. Melatonin works well - BUT you have to take it the right way. One 3 mg tab (normally) 30 minutes before bedtime. However if you want to get up at 6:00 to 7:00 a.m. bedtime has to be about 10:30 or 11:00 p.m. Do not take Melatonin in the day time and do not take it at 1:00 a.m. unless you plan to sleep until 12:00 noon or so. Melatonin taken at the wrong time of day will make you very lethargic and groggy - but it wears off. Taken correctly as I suggest and it works well - you will wake up feeling refreshed.

Melatonin taken over a week will reset your biological clock in your brain. Most people as they get older have a lowering of Melatonin levels in the brain tissues - hence the problem of insomnia for many people. How many days - weeks you take Melatonin is purely a personal experience. You may be able to stop using it and then notice after a couple of weeks you need to start again. A pleasant side effect of taking Melatonin - for some people is that it induces very sexual dreams ... not a bad deal for a cheap over the counter natural medication.

OP - While I have an extensive health-medical education and considerable first career experience in health-medicine, I am sure there will be some sharpshooters on TVF who will go SHRILL screeching at me for my recommendations ... but some people just never get over themselves.

In this regard OP, you are an adult and can use Google and Bing to research and read about any recommendation from anyone -- become self educated, knowledgeable and more than capable of making your own decision... And I also recommend - pay little attention to naysayers - they are often only regurgitating crap that they read from God knows what source.

[submaniac]

I am on it. Zolpidem is the generic for ambien. From my experience, the real drug works better than the generic (seriously, the problem has been said by others which can be found with a google search). And yes, it is addictive. Take it too much and the problem you get is you can't sleep without it.

[itsrebel]

Thanks guys. I think I will skip this one. Will probably look at other options mentioned here or I found online elsewhere. I really don't want to get addicted to another substance.

What is really worrying is that the doctor prescribed this without even mentioning any of the possible side effects and actually said that this was non-addictive. There is enough and more anecdotal evidence on the net that says otherwise.

Anyway, thanks much.

Cheers!

[scoutman360]

OP --- you may also want to try Melatonin - a substance found in the human brain which regulates the circadian rhythm - sleep/wake cycle in humans. Melatonin should be able to be found in Thailand. It comes in 3 mg tabs and higher dosage. Melatonin works well - BUT you have to take it the right way. One 3 mg tab (normally) 30 minutes before bedtime. However if you want to get up at 6:00 to 7:00 a.m. bedtime has to be about 10:30 or 11:00 p.m. Do not take Melatonin in the day time and do not take it at 1:00 a.m. unless you plan to sleep until 12:00 noon or so. Melatonin taken at the wrong time of day will make you very lethargic and groggy - but it wears off. Taken correctly as I suggest and it works well - you will wake up feeling refreshed.

I also recommend melatonin, but a 3 mg dose would knock me out for 2 days. Every body is different, so find what works for you. I found 1 mg back home that works perfect without the hangover. Unfortunately I've never found melatonin in Thailand. Please post if anyone knows the location. Prepare yourself for some crazy dreams. I am waiting for the sexy one.

[Water Buffalo]

This may sound odd at first. Have you considered hypnotherapy? I began suffering from sleep problems (laying awake for hours worrying and stressing out) until a friend recommended a Youtube cannel called "free hypnosis sessions". It has many different ones for different mental problems. I have found them helpful. Some i feel the benfit more and more as i listen to them regularly, but the insomnia session i only had to listen to once. I fell asleep during it and have started having the best sleeps evernight that i have had in 2 years.

At the very least it will help you relax 30 mins.

[ammagic]

Sadly there are no good drugs for insomnia in Thailand. Thank the Thai FDA. IMO the best one is ezopiclone - recently approved by the US FDA for long term use. Long available in Europe. Various brand names. But it will never come here. Sometimes a low dose of Ativan helps. Sweet dreams!

[JSixpack]

Thanks guys. I think I will skip this one. Will probably look at other options mentioned here or I found online elsewhere. I really don't want to get addicted to another substance.

What is really worrying is that the doctor prescribed this without even mentioning any of the possible side effects and actually said that this was non-addictive. There is enough and more anecdotal evidence on the net that says otherwise.

Anyway, thanks much.

Cheers!

Nah, go ahead and give it try. Otherwise, you'll never know. Don't like it afterwards, then stop. Any med comes w/ a long list "possible" side effects.

[jmccarty]

Nothing is wrong with valium (Diazepam) if used in low doses and not every night or mixed with alcohol. If my sleep pattern gets interrupted and I start waking up too early, like 03:00 and unable to sleep again, 10mg the next 2 nights with no alcohol sorts me out and gets me back on track for a long time. But that works for me. If you are trying to stop drinking after many years of heavy drinking, see a doctor that deals with addiction. Combinations of drugs including valium around the end of the day when you would normally start drinking and of course a change of venue, will sort it out for most. Start reading books, watching movies, exercising, any hobby will help. And in a month or two, you should be sleeping without the need for drugs or booze. But, you can't really hang out at the bar much unless you can just stick to nam-soda or tonics on the rocks.

[jacky54]

OP ... Here is my experience with using meds to get sleep.

For many years I have used Diphenhydramine - Benadryl the antihistamine. It will allow most people to get to sleep - 25 milligrams will do it ... some people take 50 mg. Drawbacks are 'antihistamine hangover' - grogginess upon waking up - plus dry mouth and maybe dry eyes... Use google to check if you are concerned about side effects. Using Benadryl is okay - not perfect but better than going without sleep. It does not work well for some people.

I just found what I consider a better med. A local pharmacist who didn't have diphenhydramine recommend using Atarax - hydroxine dihydrochloride. I bought some - fairly cheap ... 25 mg tabs. It is made by GlaxoSmithKline. It is labeled as (using the old fashion term) a 'tranquilizer with antihistamine action'. They are very small white caplets ... I find the drug to be better than diphenhydramine... with little to no antihistamine hangover... my nightly experience is pleasant - easy to fall asleep and stay asleep - it seems to induce pleasant dreams...

Totally agree atarax is cheap and legal and it works, at least for me. However my wife tried this, and everything else mentioned on here and nothing worked for her. People who suffer should try going to bed and getting up at the same time every day and no matter how tired no daytime sleeping. Try for two weeks and see.

[damo]

Have a look for restavit, They work well, I don't have a huge sleeping problem though but for work I need to sleep at certain times to short change. That being said, they are only an over the counter drug here in Australia and have never really presented me with and great issues other than being quite a lot more passive than usual the day after using Restavit.

[JDGRUEN]

OP ... Here is my experience with using meds to get sleep.

For many years I have used Diphenhydramine - Benadryl the antihistamine. It will allow most people to get to sleep - 25 milligrams will do it ... some people take 50 mg. Drawbacks are 'antihistamine hangover' - grogginess upon waking up - plus dry mouth and maybe dry eyes... Use google to check if you are concerned about side effects. Using Benadryl is okay - not perfect but better than going without sleep. It does not work well for some people.

I just found what I consider a better med. A local pharmacist who didn't have diphenhydramine recommend using Atarax - hydroxine dihydrochloride. I bought some - fairly cheap ... 25 mg tabs. It is made by GlaxoSmithKline. It is labeled as (using the old fashion term) a 'tranquilizer with antihistamine action'. They are very small white caplets ... I find the drug to be better than diphenhydramine... with little to no antihistamine hangover... my nightly experience is pleasant - easy to fall asleep and stay asleep - it seems to induce pleasant dreams...

Totally agree atarax is cheap and legal and it works, at least for me. However my wife tried this, and everything else mentioned on here and nothing worked for her. People who suffer should try going to bed and getting up at the same time every day and no matter how tired no daytime sleeping. Try for two weeks and see.

I have been back to Thailand for six months now after several decades away - and I am very surprised at the levels of consumption of coffee and caffeinated drinks ... No one who drinks coffee all day long or caffeine drinks can expect to get normal sleep... For those that drink coffee all day ... it is not surprising you cannot sleep.

And yes to the know it alls there are drugs - safe ones available in Thailand - Atarax is only one of them. Valium - diazepam related drugs -- are available over the counter -- I personally do not recommend them as they can induce depression.

[Neeranam]

Trazedone can be useful and non addictive

Stay away from Ambien unless you want to be 70 years old and have no memory of your life.

[Sheryl]

.....there are drugs - safe ones available in Thailand - Atarax is only one of them. Valium - diazepam related drugs -- are available over the counter -- I personally do not recommend them as they can induce depression.

Valium and other benzos are illegal to obtain in Thailand other than at a hospital pharmacy with prescription.

Penalties can be significant.

[arjunadawn]

Experience taking ambien- a little works well- at first. After a time I still fall asleep but wake earlier. I then take the whole 10mg. After two weeks like this I require 12.5-15mg. Regardless of the amount I wake after a few hours. Ambien is great, but intermittently. It often made my hungry. Apparently while under influence of Ambien I convinced my thai girlfriend of the following prior to her returning before me to Thailand. "Baby, since your mom has no son, before we marry I'll enter the Temple for her." I then forgot about this, of course, until she told me months later how pleased mom was with... "WHAT?" I did say it.

Experience prescribing Ambien- 2003, a gathering of former special forces and delta for a 2 week train up for contract. I noted on the bosses desk a bottle of temazapam, an older class of sleep meds. "Why don't you try this," I offered, and gave him a few ambien to try. I warned him not to drink, asked if allergies, and ensured he had enough sleep time ahead. "Good night!"

The following morning during my initial gathering with some of the worlds best "operators" joe the boss said, "Doc, that crap you gave me last night was garbage. It didn't work!" Everyone laughed of course. You never want to be told your a dumbass around such company. So, perhaps ambien doesn't work equally for all? No! It does!

Monday morning: in front of class- "Doc, I'm sorry. Apparently that drug did work. Sunday morning fedex delivered a Chuck Norris Workout Gym RUSH to my home and dropped on front doorstep. I ordered it at 2am Thursday night. I also spent $1,000 on international calls to buddies around the world!"

Be careful taking ambien.

Edited July 18, 2014 by arjunadawn

[arjunadawn]

Trazedone can be useful and non addictive

Stay away from Ambien unless you want to be 70 years old and have no memory of your life.

Be weary of trazedone. In the us Veterans med system they're currently trying to reduce veterans use of ambien as their, questionably, a national epidemic. However, many of the multiple murder mass killing in the US recently are suspected to have this drug in common. Be informed!