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Ambien & Anxiety

by
author image Fabian Fernandez, Ph.D.
Based in Miami, Fabian Fernandez has been writing science- and health-related articles since 2004. His work has appeared in several prestigious academic magazines including "Nature" and ”Proceedings of the National Academy of Sciences." Fernandez received a National Science Foundation (NSF) Graduate Fellowship in 2003, and a Research Service Award from the NIH in 2007. He holds a Ph.D. in neurosciences from Stanford University.
Ambien & Anxiety
Ambien's effects on anxiety are nuanced. Photo Credit métis 72 image by Nathalie P from <a href='http://www.fotolia.com'>Fotolia.com</a>

Doctors typically prescribe Ambien, also known as zolpidem tartrate, for the short-term treatment of insomnia. Because of its pharmacological actions in the brain, Ambien rarely--if ever--gets used as an anxiety-reducing medication. However, the drug might exert nuanced effects on anxiety and depression.

Ambien & Anxiety: Conventional Thinking

Benzodiazepines like Xanax increase the effects of GABA, which is a signal normally used by cells to reduce excitability in brain circuits. Therapeutically, these drugs decrease the incidence of seizures in people with epilepsy and decrease subjective feelings of anxiety in those suffering from generalized anxiety or post-traumatic stress disorder. Like Xanax, Ambien binds benzodiazepine receptors in the brain and drives GABA chemical signaling. However, while Xanax tends to bind all benzodiazepine receptors, Ambien binds only certain subpopulations. According to Cynthia Kirkwood and other pharmacy researchers at Virginia Commonwealth University, this specificity allows Ambien to selectively act as a sedative drug without also acting as a seizure- or anxiety-reducing medication.

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Ambien And Anxiety: Impulsivity

In a paper published in "Psychopharmacology," Dr. Estibaliz Arce and her colleagues at the University of California San Diego suggest that the anxiety-reducing properties of typical benzodiazepines might stem from their ability to reduce the excitability of an almond-shaped structure in the brain called the amygdala. Activity in the amygdala positively correlates with the expression of fear-related behavior. As such, when amygdala excitability drops, people will show more risk-taking and impulsivity. Sanofi-Aventis, the pharmaceutical manufacturer of Ambien, cautions Ambien users that they might experience abnormal increases in impulsivity or become "more outgoing" during treatment. Together, this information points to the possibility that Ambien might have some limited anxiety-reducing effects.

Ambien & Anxiety: Paradoxical Effects Related to Depression

Depression often co-occurs with anxiety. According to Dr. Daniel Kripke at the Scripps Clinic Sleep Center, people who regularly use Ambien and other hypnotic drugs might actually be at greater risk for developing depression than those who do not. Of note, the relationship between sleep and depression is a complicated one, and the degree to which insomnia itself contributes to anxiety and depression is currently under study.

Ambien Side Effects

People taking Ambien might experience anxiety as a result of the drug's side effects, not because of its direct actions. Ambien's unpleasant side effects can include next-day drowsiness, nausea, impaired driving and poor concentration at work.

Anxiety Linked to Ambien Withdrawal

Sudden discontinuation of Ambien can cause serious withdrawal symptoms involving heightened anxiety and restlessness--effects antithetical to benzodiazepine drugs. People taking Ambien should consult their doctors about how to taper their Ambien prescription over time to avoid drug withdrawal.

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