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.
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.
- Pub Med: Neuropsychiatric Disease and Treatment: Zolpidem modified-release in insomnia; Kirkwood et al.; 2007.
- Pub Med: Psychopharmacology: Lorazepam dose-dependently decreases risk-taking related activation in limbic areas; Arce et al.; November 2006.
- Sanofi-Aventis: Ambien Side Effects.
- Pub Med: BMC Psychiatry: Greater incidence of depression with hypnotic use than with placebo; D.F. Kripke; August 2007.
- Pub Med: Current Treatment Options in Neurology: Treatment of sleep dysfunction and psychiatric disorders; P.M. Becker and M. Sattar; September 2009.