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Ambien Use: Can It Lead to Depression? (What Research Says)

Ambien is the brand name for a sedative-hypnotic medication called zolpidem. The drug was developed as a safer approach to short-term insomnia treatment. The brand name was approved by the U.S. Food and Drug Administration (FDA) in 1992, and the generic form of this insomnia treatment was approved in 2007. Now, there are several formulas of insomnia medications that contain zolpidem, but Ambien is among the most widely known ones.

Side Effects of Ambien

Side effects associated with Ambien use include: 

  • Feeling drowsy or tired
  • Daytime sleepiness or fatigue
  • Dizziness
  • Feeling “drugged”
  • Nausea
  • Diarrhea
  • Headaches
  • Difficulty concentrating

Because daytime sleepiness and feeling sluggish are common side effects from this medication, it is recommended that you do not drive, operate heavy machinery, or perform physically intensive actions that may put you at risk if you are less able to concentrate and react quickly. The medication is prescribed for short-term use, so you’ll only need to give up these activities for a week or less.

Serious side effects associated with Ambien include:

  • Abnormal thoughts and behaviors, including aggressiveness, loss of inhibitions, confusion, agitation, hallucinations, or changes in mood, including depression
  • Memory loss
  • Increased anxiety
  • Extensive sleepiness during the day, impairing normal functioning
  • Parasomnias, especially walking, eating, talking, or even driving or having sex while asleep

Because of how Ambien works in the brain, it is important to let your doctor know if you have depression. This medication can change important neurotransmitters and cause a relapse in depression symptoms. While Ambien targets specific receptors in the brain more than other central nervous system (CNS) depressants, the medication is still itself a CNS depressant, which can lead to depression-like symptoms.

People who struggle with insomnia may develop depression. At the same time, insomnia is also a symptom of depression. While Ambien may make some depression symptoms worse, it is not often the direct cause of this condition; however, people who abuse Ambien are more likely to develop other mental struggles like anxiety, and depression may be correlated with this.

People who are anxious about struggling with insomnia may abuse Ambien for longer than prescribed or at higher doses because they worry they will not get enough rest. Paradoxically, abusing Ambien in this way increases the likelihood of sleep disorders long term, along with related conditions like depression. People may simply abuse Ambien to get high, which can imbalance their brain chemistry enough to make underlying mental conditions like depression worse.

What Is Depression?

While different physiological or life events can trigger several forms of depression, and last different lengths of time, they share a set of symptoms

  • Feeling sad or anxious with no specific cause for a long time
  • Feeling empty or experiencing anhedonia (lack of pleasure)
  • Irritability or restlessness
  • Feeling guilty, worthless, or helpless
  • Quitting hobbies or activities that were once fun
  • Lower physical energy, ranging from moving more slowly to being unable to get out of bed
  • Sleep disturbances, including sleeping less, waking up frequently, or sleeping much more
  • Moving and speaking more slowly
  • Having difficulty sitting still
  • Trouble getting up in the morning and being persistently late to events
  • Dramatic changes in eating that lead to weight shifts, either gaining or losing weight
  • Physical pain, including headaches, backaches, neck pain, chest pain, or digestive issues with no specific cause
  • Thinking about death or suicide

About 7 percent of people living in the United States experience some form of depression annually. The first instance of a depressive episode usually occurs between the ages of 18 and 29, but it can often occur earlier; for many people, depression also occurs around puberty. Abusing drugs or alcohol, including prescription sedatives like Ambien, can increase the risk of developing depression, especially at a young age if substance abuse starts in adolescence.

depression

Types of depression range from major depression, in which symptoms interrupt life and last for two weeks or more; dysthymia or persistent depression, which lasts for two years or more but during which the individual is predominantly still functional in daily life; hormone-related depressions like perinatal depression after childbirth and premenstrual dysphoric disorder (PMDD), which is triggered by severe hormonal shifts in the menstrual cycle; and seasonal affective disorder (SAD), a form of depression related to seasonal changes that may be triggered by light.

One consistent symptom associated with mood disorders like depression is insomnia. The inability to sleep well can increase anxiety, frustration, and fatigue, which, in turn, continue to imbalance brain chemistry and increase the experience of depressive symptoms. People who struggle with depression and receive treatment may speak to their therapist or counselor about how to manage depression without medication or by safely taking antidepressants.

Unfortunately, too many people go to their doctor for a prescription for Ambien or related insomnia treatments and do not get a thorough mental and physical exam to understand if there are potential underlying symptoms that cause insomnia. Although one request for Ambien does not automatically mean someone suffers from depression that triggered their insomnia, if the person frequently has bouts of insomnia and receives frequent prescriptions, it should indicate that they have an underlying condition that exacerbates the sleep issue.

The Connection Between Insomnia and Depression

Some estimates suggest that about 30 percent of Americans will at some point experience clinical depression. About 40 percent of adults in the United States also complain about sleep disturbances most nights, including waking up several times, trouble falling asleep, or not feeling rested upon waking.

These two conditions feed into each other because of how sleep works on the brain. 

  • Deep sleep helps to produce growth hormones. This stage of sleep is also critical for memory formation and decision-making. Consistent loss of deep sleep for several nights impairs these functions, increasing frustration, mental fogginess, and difficulty making neurotransmitters.
  • Waking up several times, or experiencing fragmented sleep, can be as detrimental as not sleeping enough.
  • Depression changes how rapid eye movement (REM) sleep is experienced, making it more fragmented, which can affect memory, hormone production, learning, and sleep quality.

If someone has not experienced a depressive episode before or has not been appropriately diagnosed to receive mental health treatment, insomnia can plague them and seem like the primary issue. However, this can lead to drug-seeking behaviors and reliance on medications like Ambien. These medications may seem like a solution to the problem, but they do not actually improve sleep or treat the underlying causes of sleeplessness. 

Without additional help, people struggling with depression can make their depression worse, and people who struggle with insomnia may develop a depressive episode from chronic lack of sleep.

Ambien Makes Depression Worse

According to FDA data about Ambien, people who experience depression are more likely to experience worsened depression, increased suicidal ideation, and completed suicide when they take Ambien. This is because Ambien is a sedative that slows brain function even further, and the medication tends to lower inhibitions. 

People who complete suicide and who take Ambien, either by prescription or illicitly, are more likely to use this drug to attempt suicide. Additionally, in a clinical study, combining Ambien and selective serotonin reuptake inhibitor (SSRI) antidepressants increased the risk of continuing or aggravating depression, a manic reaction, and other severe mental conditions.

Studies on zolpidem have found that depression is a psychiatric reaction commonly reported in people who take Ambien and related medications. Many people who took Ambien and struggled with depression as a side effect or an underlying cause of sleep disorders also reported psychotic symptoms. 

  • Vivid nightmares
  • Visual and auditory hallucinations
  • Sensory distortions
  • Amnesia
  • Delirium
  • Compulsive behaviors
  • Uncontrolled eating
  • Parasomnias, particularly sleep-eating and sleepwalking

Experiencing parasomnias, nightmares, sensory distortions, memory troubles, and other issues can all increase anxiety and depression symptoms.

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Insomnia and depression both respond well to cognitive behavioral therapy as a form of long-term treatment. Many people who struggle with depression also benefit from taking SSRIs or other antidepressants, which can improve sleep quality as brain chemistry adjusts. Relieving symptoms of a mood disorder may also alleviate compulsions to take drugs.

People who abuse Ambien also benefit from cognitive behavioral therapy during rehabilitation. It can help them to change their approach to medications and stay away from intoxicating substances.

SOURCES

(March 17, 2014). What is Ambien (Zolpidem)? Everyday Health. Retrieved January 2019 from https://www.everydayhealth.com/drugs/zolpidem

Parasomnias. Sleep Education.org. Retrieved January 2019 from http://sleepeducation.org/sleep-disorders-by-category/parasomnias

(May 30, 2018). What is Ambien and What are Its Known Side Effects? ABC News. Retrieved January 2019 from https://abcnews.go.com/Health/ambien-side-effects/story?id=55530690

(May 17, 2018). Ambien: Is Dependence a Concern? Mayo Clinic. Retrieved January 2019 from https://www.mayoclinic.org/diseases-conditions/insomnia/expert-answers/ambien/faq-20058103

(February 2018). Depression: Overview. National Institute of Mental Health (NIMH). Retrieved January 2019 from https://www.nimh.nih.gov/health/topics/depression/index.shtml#part_145397

(December 6, 2018). Depression. Substance Abuse and Mental Health Services Administration (SAMHSA). Retrieved January 2019 from https://www.samhsa.gov/treatment/mental-disorders/depression

(1992). Highlights of Prescribing Information: Ambien. U.S. Food and Drug Administration (FDA). Retrieved January 2019 from https://www.accessdata.fda.gov/drugsatfda_docs/label/2008/019908s027lbl.pdf

(2010). Adverse Reactions to Zolpidem: Case Reports and a Review of the Literature. The Primary Care Companion to the Journal of Clinical Psychiatry. Retrieved January 2019 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3067983/

(April 7, 2011). Is Depression Making Me Sleepless, or is Insomnia Making Me Depressed? Psychology Today. Retrieved January 2019 from https://www.psychologytoday.com/us/blog/the-power-rest/201104/is-depression-making-me-sleepless-or-is-insomnia-making-me-depressed-0

(November 25, 2013). Therapy Provides “Critical Breakthrough” for Depressed Insomniacs. Healthline. Retrieved January 2019 from https://www.healthline.com/health-news/mental-cognitive-behavioral-therapy-helps-insomnia-depression-112513#1

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