A good night's sleep is important to mental, physical and emotional health. If you occasionally need help falling asleep, there are a variety of prescription and non-prescription remedies available. Melatonin, a hormone produced and secreted in the brain, is a natural treatment for insomnia available as a dietary supplement. Ambien, the brand name for zolipidem, is a prescription insomnia drug which works like benzodiazepines, but is not related chemically. Since these two substances work by different mechanisms, they may have positive, additive benefits when taken together. If you have been prescribed Ambien and are considering taking melatonin as well, talk with your physician first.
Ambien Drug Interactions
Ambien works by interacting at the same receptors as the neurotransmitter gamma-aminobutyric acid, or GABA. Benzodiazepines such as diazepam, clorazepate, oxazepam, lorazepam, alprazolam and clonazepam also act at GABA receptors. The prescribing information produced by Ambien's manufacturor, Sanofi-Aventis U.S. LLC, makes no mention of a possible melatonin-Ambien drug interaction. They do, however, warn about Ambien's possible interactions with drugs that depress the central nervous system such as alcohol, haloperidol, fluoxetine, imipramine or chlorpromazine.
Melatonin Drug Interactions
The National Institutes of Health website MedlinePlus lists melatonin's possible interactions with birth control pills, caffeine, fluvoxamine, anti-diabetes drugs, immuno-suppressants, anticoagulant and anti-platelet drugs, the blood pressure medication nifedipine, verapamil and flumazenil. Taking melatonin with herbs such as Valerian, catnip, hops, kava; over-the-counter sleep aids, some antihistamines and prescriptions drugs that have sedative effects many increase the amount of sluggishness, drowsiness and dullness you experience.
Rozerem and Melatonin
As a rule, dietary supplements have not received the vetting the U.S. Food and Drug Administration requires of prescription or over-the-counter drugs. The prescription drug ramelteon resembles melatonin chemically and mimics its effect on the sleep cycle. Since ramelteon and melatonin act on same parts of the brain and have identical medical indications, they may share drug interactions as well. The official prescribing information ramelteon's manufacturer, Takeda Pharmaceuticals America, provided the FDA in November 2010, however, makes no mention of any drug interaction with zolpidem.
Study Results
A 2005 study published in the journal "Sleep" examined the benefits of using melatonin to reduce the dose of Ambien needed to produce daytime sleep and also reduce Ambien's impairment of memory and mental performance. Subjects were given 5 mg of melatonin alone or in combination with up to 20 mg of Ambien. Reported side effects were few and non-life threatening. One subject out of 80 reported dizziness with 5 mg each of Ambien and melatonin. Nine out of 80 saw dizziness with 20 mg Ambien and 5 mg melatonin. Three subjects out of 80 reported dizziness and seven out of 80 reported reduced coordination on Ambien 20 mg alone.
References
- Washington State University Spokane; Daytime Sleep and Performance Following a Zolpidem and Melatonin Cocktail; Nancy Jo Wesensten, et al.: 2005
- Sanofi-Aventis: Ambien CR Prescribing Information
- Consumer Reports Health.org: Sedatives: Summary of Recommendations
- PubMed Health; Zolpidem
- "Hospital Pharmacy": Ramelteon; Dennis J. Cada, et al.; January 2006
- FDA: Rozerem Tablets
Member Comments