Miya Pearson
Ambien (Zolpidem) and Ativan (Lorazepam) are both drugs used to treat insomnia. While they work in similar ways, there are key differences between the two. This article will explore the benefits and drawbacks of each drug, and discuss which may be the better option for treating sleep disorders. With both drugs carrying risks of side effects and addiction, it is important to understand the implications of taking either.
| Characteristics | Values |
|---|---|
| Brand Name | Ativan: Lorazepam, Ambien: Zolpidem |
| Drug Class | Ativan: Benzodiazepine, Ambien: Sedative-Hypnotic |
| Mechanism of Action | Both act on GABA receptors in the body |
| Sleep Induction | Ambien: Immediate and Extended-release forms available for sleep induction and sleep maintenance |
| Treatment Duration | Ambien: Recommended for short-term use (up to 2 weeks) |
| Addiction Potential | Ativan: Higher potential for addiction and abuse, Ambien: Lower potential for addiction, but still addictive |
| Withdrawal | Ativan: More severe withdrawal symptoms, Ambien: Mild withdrawal symptoms |
| Side Effects | Ativan: Muscle relaxation, anxiolytic, anticonvulsant, Ambien: Euphoria at high doses, increased risk of falls, fractures, delirium, amnesia |
| Age Restriction | Ambien: Not recommended for children under 18 years |
| Precautions | Consult a doctor regarding medical history, especially kidney/liver disease, mental health issues, substance use disorder, sleepwalking, breathing problems |
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What You'll Learn
Ambien's side effects
Ambien, the brand name for zolpidem, is a sedative-hypnotic medication commonly prescribed for the short-term treatment of insomnia. While it is effective, Ambien does have its risks and side effects. The FDA has cautioned that treatment with Ambien should be "as short as possible", with a higher risk of dependence with longer-term usage (more than 10 nights).
The side effects of Ambien range from mild symptoms such as daytime drowsiness, dizziness, and nausea, to more severe symptoms that should be discussed with a doctor, including complex sleep behaviours, abnormal behavioural changes, and next-day impairment.
Complex Sleep Behaviours
Those taking Ambien may experience complex sleep behaviours such as sleepwalking, sleep-driving, sleep-cooking, and engaging in other activities like making phone calls, online shopping, or eating while not fully awake. These behaviours can carry a risk of serious and potentially fatal injury to oneself or others.
Behavioural Changes
Abnormal behavioural changes can include depression, anxiety, nervousness, confusion, hallucinations, irritability, hostility, and thoughts of suicide or self-harm. Research indicates that the use of Ambien may worsen depression or suicidal thoughts and behaviours in primarily depressed individuals.
Next-Day Impairment
The FDA has lowered the recommended dose of zolpidem products due to next-day impairment, especially for controlled-release zolpidem (Ambien CR). Zolpidem levels can remain high enough the next day to impair activities that require complete alertness, such as driving. The risk of next-day impairment is higher for women and older adults, as zolpidem is eliminated more slowly in women and older people have a higher risk of side effects like memory impairment and confused thinking.
Other possible side effects include allergic reactions, changes in vision, CNS depression, and withdrawal symptoms. Combining Ambien with opioids or other CNS depressants, including alcohol and benzodiazepines, can result in dangerous symptoms of oversedation.
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Ativan's side effects
Ativan (lorazepam) is a short-acting tranquilizer that is typically prescribed to treat anxiety disorders, insomnia, and alcohol use disorders. While it can be effective when taken as directed under medical supervision, there are several potential side effects associated with its use.
Ativan can cause both mild and serious side effects. Mild side effects may include drowsiness, dizziness, impaired coordination, blurred vision, constipation, changes in appetite or weight, and physical weakness. It can also cause disorientation, confusion, and trouble concentrating or remembering things. In some cases, people taking Ativan have reported increased depressive feelings and suicidal thoughts.
More serious side effects may include low blood pressure, which can lead to fainting or falls, convulsions or seizures, paradoxical reactions such as aggression or hostility, and an increased risk of overdose, dependence, and addiction. Ativan is a habit-forming drug, and long-term use can lead to physical and psychological dependence, with potentially dangerous withdrawal symptoms such as rebound anxiety, insomnia, irritability, agitation, increased heart rate, and muscle pain.
Ativan is not recommended for children under 18 or older adults over 65, as these individuals may be more susceptible to certain side effects. It should also be used cautiously or avoided in individuals with a history of depression or substance use disorders. Even when taken as directed, Ativan can impair coordination and cognitive function, making activities that require hand-eye coordination and quick reflexes, such as driving, dangerous.
It is important for individuals taking Ativan to be aware of these potential side effects and to work closely with their doctor to monitor their symptoms and adjust their dosage as needed.
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Ambien's misuse potential
Ambien is a prescription sedative used to treat insomnia. While it can be effective when used within recommended doses, Ambien has a potential for misuse and abuse. Misuse of prescription sedatives, including Ambien, can involve taking the medication in a manner or amount other than prescribed, taking someone else's prescription, or using it to experience a high. The National Survey on Drug Use and Health found that approximately 5 million people over the age of 12 misused prescription sedatives like Ambien in 2022, with the highest percentage of misuse among adults between 18 and 24 years old.
The effects of Ambien may be pleasurable for some individuals, increasing the risk of misuse and subsequent addiction. Side effects of Ambien may vary depending on the dose, individual biological differences, and the use of other substances. When combined with alcohol, opioids, or other central nervous system (CNS) depressants, the side effects of Ambien may be amplified, leading to an increased risk of death by overdose.
Physical dependence on Ambien is uncommon when taken at prescribed doses, but it can occur with higher doses and more frequent use. Abruptly stopping Ambien after developing a dependence can result in dangerous withdrawal symptoms. Therefore, medical supervision and gradual tapering of doses are recommended during the detoxification process.
Chronic abuse of Ambien can lead to severe consequences, including extreme cravings, dependence, and adverse health effects. To prevent and manage Ambien misuse, new prescription policies and combination therapies have been suggested as potential solutions. It is crucial to seek professional help for Ambien misuse or suspected addiction. Treatment centers offer medical detox and continuing care under the guidance of medical professionals to ensure safer and more effective long-term recovery.
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Ativan's misuse potential
Ativan (lorazepam) is a central nervous system (CNS) depressant that falls in the benzodiazepine class of medications. It is primarily prescribed for the short-term relief of anxiety. As with any medication, there are side effects associated with taking Ativan, even when it is taken as prescribed. Like other benzodiazepines, there is a potential for misuse, the development of physical dependence, and, in some cases, addiction.
Ativan is one of the most potent benzodiazepines available and carries a substantial addiction risk. Taking Ativan for longer than the prescribed period of time and/or more than the recommended dose increases the likelihood of developing a dependence. However, some people have become dependent on Ativan even after following a prescription. A person physically dependent on Ativan needs it to function normally and will experience physical and emotional discomfort if they suddenly stop taking it. These symptoms are the first signs of Ativan withdrawal, which can be severe and life-threatening. Studies indicate that 20% to 30% of untreated patients with benzodiazepine withdrawal syndrome experience seizures.
Ativan misuse commonly occurs in conjunction with other substance use, also known as polysubstance use. Research indicates that misuse of benzodiazepines, like lorazepam, is most often associated with the misuse of opioids, stimulants, and alcohol. Individuals who engage in polysubstance use may take lorazepam to enhance the euphoric effects of opioids or alcohol or to temper the high from stimulants like cocaine. Mixing substances, whether intentional or not, can lead to unpredictable, dangerous, and even lethal effects. The most severe side effects associated with Ativan use occur when the drug is mixed with other central nervous system depressants.
Signs of Ativan abuse can range from headaches and tremors to more dangerous side effects like seizures and respiratory depression. Cravings are a hallmark of psychological dependence, and a person may experience cravings while still taking Ativan or after a period of not using. Continuing to use Ativan despite problems with responsibilities or social relationships is another sign of a potential addiction. It is important for individuals who believe they may be suffering from an Ativan addiction to be assessed by an addiction professional. Treatment plans are tailored to individual needs and may include medically managed detox, inpatient rehab, and different interventions.
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How Ambien and Ativan differ
Ambien, also known as Zolpidem, is a drug primarily used for the short-term treatment of sleep problems, specifically insomnia in adults. It is a sedative-hypnotic drug that slows down brain activity, allowing users to fall asleep faster and get a better night's rest. The drug is typically recommended for use after other treatments, such as cognitive-behavioural therapy for insomnia and sleep hygiene practices, have been explored. Ambien is available in both immediate-release and extended-release formulations. The immediate-release form helps users fall asleep quickly, while the extended-release version has two layers: the first layer aids in falling asleep, and the second layer dissolves slowly to help users stay asleep. While Ambien can be effective for treating insomnia, it is a controlled substance that carries a risk of misuse, abuse, and addiction. It may cause side effects such as extreme sleepiness, confusion, clumsiness, and an increased risk of falls and fractures. The effects of Ambien can last into the next day, impacting activities that require alertness, such as driving.
On the other hand, Ativan (Lorazepam) is a benzodiazepine medication. Like Ambien, it affects GABA receptors in the body, producing a calming effect. However, benzodiazepines have a broader range of effects, including muscle relaxation, anxiety relief, and anticonvulsant properties. Benzodiazepines have a higher potential for misuse, dependence, and abuse compared to Ambien, and they can be more challenging to discontinue. They also carry a higher risk of tolerance and typically have more severe withdrawal symptoms.
When comparing the safety of Ambien and benzodiazepines, it is challenging to declare a clear winner. Both drugs have their own set of advantages and disadvantages, and individual responses may vary. While Ambien may be less likely to lead to tolerance, dependence, and severe withdrawal symptoms, it is still an addictive substance with serious side effects, particularly in older adults. Benzodiazepines, on the other hand, have a higher rate of misuse and abuse and can be more challenging to discontinue.
In terms of effectiveness, both Ambien and Ativan can be effective for treating insomnia. However, Ambien is specifically indicated for this purpose and is often recommended as a short-term treatment option. Ativan, being a benzodiazepine, has multiple indications, including anxiety relief and anticonvulsant effects, in addition to its use as a sedative.
In conclusion, Ambien (Zolpidem) and Ativan (Lorazepam) are both effective in treating insomnia but differ in their mechanisms of action and side effects. Ambien is a selective sedative-hypnotic drug primarily used for short-term insomnia treatment, while Ativan is a benzodiazepine with additional anxiolytic and anticonvulsant properties. Ambien may have a lower potential for misuse and dependence but is still addictive and carries serious side effects. Benzodiazepines like Ativan have a higher risk of tolerance, dependence, and abuse and typically result in more severe withdrawal symptoms. The choice between the two drugs depends on various factors, including the patient's medical history, the severity of insomnia, and the presence of other indications for benzodiazepine use.
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Frequently asked questions
Zolpidem, sold under the brand name Ambien, is a medicine used for the short-term treatment of sleep problems, specifically insomnia in adults. It is a sedative-hypnotic drug that slows down brain activity, allowing the user to fall asleep quickly.
Ativan (lorazepam) is a benzodiazepine medication. Like Ambien, it is used to treat insomnia and other sleep problems. Benzodiazepines act as hypnotics, muscle relaxants, anxiolytics, and anticonvulsants.
Yes, Ambien has been associated with an increased risk of falls, delirium, fractures, and rare but serious side effects such as amnesia. These side effects are particularly concerning for older individuals. It is important to note that Ambien is a controlled substance that can lead to dependence and abuse.
Benzodiazepines like Ativan have a higher likelihood of tolerance, dependence, and abuse. They also tend to have more severe withdrawal effects compared to Ambien. However, it is important to note that both drugs have their own sets of positives and negatives, and the safety of long-term use depends on various factors.
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