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Ambien Zolpidem withdrawal. Ambien Zolpidem withdrawal step by step procedures.

Ambien Zolpidem Withdrawal

Ambien withdrawal can be a thing of the past. Most likely you are having Ambien withdrawal before finding this website. Getting you stable again is the first thing to do.

Go back up to the last dosage of Ambien you were doing ok at, where you felt stable, and remain at that Ambien dosage until you get the supplements in you will need.

At this point it's likely more than insomnia you are experiencing. The daytime hours are probably pretty rough as well. A brain on fire is how many describe Ambien withdrawal.

You will need to get 3 supplements: JNK Formula Complete, Neuro Day and Neuro Night. Just follow the How to Take instructions on each bottle, with a little exception. The Neuro Night is formulated to help with sleep and you do not want to take the Neuro Night while still taking the Ambien.

The night you no longer take Ambien, begin taking 2 capsules of Neuro Night 15-minutes before bedtime.

With you taking the JNK Formula and and Neuro Day you should be stress and anxiety free during the daytime and more relaxed when bedtime comes.

To order the supplements Click here


INDICATIONS AND USAGE Ambien CR (zolpidem tartrate extended-release tablets) is indicated for the treatment of insomnia characterized by difficulties with sleep onset and/or sleep maintenance (as measured by wake time after sleep onset).The clinical trials performed in support of efficacy were up to 3 weeks (using polysomnography measurement up to 2 weeks in both adult and elderly patients) and 24 weeks (using patient-reported assessment in adult patients only) in duration

DOSAGE AND ADMINISTRATION The dose of Ambien CR should be individualized. Dosage in adults The recommended dose of Ambien CR for adults is 12.5 mg once daily immediately before bedtime. The total Ambien CR dose should not exceed 12.5 mg per day. 

Special populations Elderly or debilitated patients may be especially sensitive to the effects of zolpidem tartrate. Patients with hepatic insufficiency do not clear the drug as rapidly as normal. The recommended dose of Ambien CR in both of these patient populations is 6.25 mg once daily immediately before bedtime Use with CNS depressants

Dosage adjustments may be necessary when Ambien CR is combined with other CNS depressant drugs because of the potentially additive effects Administration Ambien CR extended-release tablets should be swallowed whole, and not be divided, crushed, or chewed. The effect of Ambien CR may be slowed by ingestion with or immediately after a meal.

DOSAGE FORMS AND STRENGTHS Ambien CR is available as extended-release tablets containing 6.25 mg or 12.5 mg of zolpidem tartrate for oral administration. Tablets are not scored. Ambien CR 6.25 mg tablets are pink, round, bi-convex, and debossed with A~ on one side. Ambien CR 12.5 mg tablets are blue, round, bi-convex, and debossed with A~ on one side.

CONTRAINDICATIONS Ambien CR is contraindicated in patients with known hypersensitivity to zolpidem tartrate or to any of the inactive ingredients in the formulation. Observed reactions include anaphylaxis and angioedema

WARNINGS AND PRECAUTIONS Need to evaluate for co-morbid diagnoses because sleep disturbances may be the presenting manifestation of a physical and/or psychiatric disorder, symptomatic treatment of insomnia should be initiated only after a careful evaluation of the patient. The failure of insomnia to remit after 7 to 10 days of treatment may indicate the presence of a primary psychiatric and/or medical illness that should be evaluated. Worsening of insomnia or the emergence of new thinking or behavior abnormalities may be the consequence of an unrecognized psychiatric or physical disorder. Such findings have emerged during the course of treatment with sedative/hypnotic drugs, including zolpidem. Severe anaphylactic and anaphylactoid reactions

Rare cases of angioedema involving the tongue, glottis or larynx have been reported in patients after taking the first or subsequent doses of sedative-hypnotics, including zolpidem. Some patients have had additional symptoms such as dyspnea, throat closing or nausea and vomiting that suggest anaphylaxis. Some patients have required medical therapy in the emergency department. If angioedema involves the throat, glottis or larynx, airway obstruction may occur and be fatal. Patients who develop angioedema after treatment with zolpidem should not be rechallenged with the drug.

Abnormal thinking and behavioral changes. A variety of abnormal thinking and behavior changes have been reported to occur in association with the use of sedative/hypnotics. Some of these changes may be characterized by decreased inhibition (e.g. aggressiveness and extroversion that seemed out of character), similar to effects produced by alcohol and other CNS depressants. Visual and auditory hallucinations have been reported as well as behavioral changes such as bizarre behavior, agitation and depersonalization. In controlled trials, <1% of adults with insomnia who received zolpidem reported hallucinations. In a clinical trial, 7.4% of pediatric patients with insomnia associated with attention-deficit/hyperactivity disorder (ADHD), who received zolpidem reported hallucinations [Complex behaviors such as "sleep-driving" (i.e., driving while not fully awake after ingestion of a sedative-hypnotic, with amnesia for the event) have been reported with sedative-hypnotics, including zolpidem. These events can occur in sedative-hypnotic-naive as well as in sedative-hypnotic-experienced persons. Although behaviors such as "sleep-driving" may occur with Ambien CR alone at therapeutic doses, the use of alcohol and other CNS depressants with Ambien CR appears to increase the risk of such behaviors, as does the use of Ambien CR at doses exceeding the maximum recommended dose. Due to the risk to the patient and the community, discontinuation of Ambien CR should be strongly considered for patients who report a "sleep-driving" episode. Other complex behaviors (e.g., preparing and eating food, making phone calls, or having sex) have been reported in patients who are not fully awake after taking a sedative-hypnotic. As with "sleep-driving", patients usually do not remember these events. Amnesia, anxiety and other neuro-psychiatric symptoms may occur unpredictably.

In primarily depressed patients, worsening of depression, including suicidal thoughts and actions (including completed suicides), have been reported in association with the use of sedative/hypnotics. It can rarely be determined with certainty whether a particular instance of the abnormal behaviors listed above is drug induced, spontaneous in origin, or a result of an underlying psychiatric or physical disorder. Nonetheless, the emergence of any new behavioral sign or symptom of concern requires careful and immediate evaluation.

Withdrawal effects Following the rapid dose decrease or abrupt discontinuation of sedative/hypnotics, there have been reports of signs and symptoms similar to those associated with withdrawal from other CNS-depressant drugs [CNS depressant effects Ambien CR, like other sedative/hypnotic drugs, has CNS-depressant effects.  

Due to the rapid onset of action, Ambien CR should only be taken immediately prior to going to bed. Patients should be cautioned against engaging in hazardous occupations requiring complete mental alertness or motor coordination such as operating machinery or driving a motor vehicle after ingesting the drug, including potential impairment of the performance of such activities that may occur the day following ingestion of Ambien CR. Ambien CR showed additive effects when combined with alcohol and should not be taken with alcohol. Patients should also be cautioned about possible combined effects with other CNS-depressant drugs. Dosage adjustments may be necessary when Ambien CR is administered with such agents because of the potentially additive effects. 

Special populations Use in the elderly and/or debilitated patients: Impaired motor and/or cognitive performance after repeated exposure or unusual sensitivity to sedative/hypnotic drugs is a concern in the treatment of elderly and/or debilitated patients. Therefore, the recommended Ambien CR dosage is 6.25 mg in such patients to decrease the possibility of side effects. These patients should be closely monitored. Use in patients with concomitant illness: Clinical experience with Ambien CR (zolpidem tartrate) in patients with concomitant systemic illness is limited. Caution is advisable in using Ambien CR in patients with diseases or conditions that could affect metabolism or hemodynamic responses.

Although studies did not reveal respiratory depressant effects at hypnotic doses of zolpidem in normal or in patients with mild to moderate chronic obstructive pulmonary disease (COPD), a reduction in the Total Arousal Index together with a reduction in lowest oxygen saturation and increase in the times of oxygen desaturation below 80% and 90% was observed in patients with mild-to-moderate sleep apnea when treated with an immediate-release formulation of zolpidem tartrate (10 mg) when compared to placebo. Since sedative/hypnotics have the capacity to depress respiratory drive, precautions should be taken if Ambien CR is prescribed to patients with compromised respiratory function. Post-marketing reports of respiratory insufficiency, most of which involved patients with pre-existing respiratory impairment, have been received. Ambien CR should be used with caution in patients with sleep apnea syndrome or myasthenia gravis. 

Data in end-stage renal failure patients repeatedly treated with an immediate-release formulation of zolpidem tartrate (10 mg) did not demonstrate drug accumulation or alterations in pharmacokinetic parameters. No dosage adjustment in renally impaired patients is required; however, these patients should be closely monitored A study in subjects with hepatic impairment did reveal prolonged elimination in this group; therefore, treatment should be initiated with Ambien CR 6.25 mg in patients with hepatic compromise, and they should be closely monitored Use in patients with depression: As with other sedative/hypnotic drugs, Ambien CR should be administered with caution to patients exhibiting signs or symptoms of depression. Suicidal tendencies may be present in such patients and protective measures may be required. Intentional overdosage is more common in this group of patients; therefore, the least amount of drug that is feasible should be prescribed for the patient at any one time. 

Use in pediatric patients: Safety and effectiveness of zolpidem has not been established in pediatric patients. In an 8-week study in pediatric patients (aged 6–17 years) with insomnia associated with ADHD given an immediate-release oral solution of zolpidem tartrate, zolpidem did not decrease sleep latency compared to placebo. Hallucinations were reported in 7.4% of the pediatric patients who received zolpidem; none of the pediatric patients who received placebo reported hallucinations

ADVERSE REACTIONS The following serious adverse reactions are discussed in greater detail in other sections of the labeling:¥Serious anaphylactic and anaphylactoid reactions ¥Abnormal thinking, behavior changes, and complex behaviors Withdrawal effects CNS-depressant effects  

Clinical trials experience Associated with discontinuation of treatment: In 3-week clinical trials in adults and elderly patients (> 65 years), 3.5% (7/201) patients receiving Ambien CR 6.25 or 12.5 mg discontinued treatment due to an adverse reaction as compared to 0.9% (2/216) of patients on placebo. The reaction most commonly associated with discontinuation in patients treated with Ambien CR was somnolence (1%).In a 6-month study in adult patients (18–64 years of age), 8.5% (57/669) of patients receiving Ambien CR 12.5 mg as compared to 4.6% on placebo (16/349) discontinued treatment due to an adverse reaction. Reactions most commonly associated with discontinuation of Ambien CR included anxiety (anxiety, restlessness or agitation) reported in 1.5% (10/669) of patients as compared to 0.3% (1/349) of patients on placebo, and depression (depression, major depression or depressed mood) reported in 1.5% (10/669) of patients as compared to 0.3% (1/349) of patients on placebo. 

Data from a clinical study in which selective serotonin reuptake inhibitor- (SSRI-) treated patients were given zolpidem revealed that four of the seven discontinuations during double-blind treatment with zolpidem (n=95) were associated with impaired concentration, continuing or aggravated depression, and manic reaction; one patient treated with placebo (n =97) was discontinued after an attempted suicide. 

Most commonly observed adverse reactions in controlled trials: During treatment with Ambien CR in adults and elderly at daily doses of 12.5 mg and 6.25 mg, respectively, each for three weeks, the most commonly observed adverse reactions associated with the use of Ambien CR were headache, next-day somnolence, and dizziness. 

In the 6-month trial evaluating Ambien CR 12.5 mg, the adverse reaction profile was consistent with that reported in short-term trials, except for a higher incidence of anxiety (6.3% for Ambien CR versus 2.6% for placebo).Adverse reactions observed at an incidence of ≥1% in controlled trials: The following tables enumerate treatment-emergent adverse reaction frequencies that were observed at an incidence equal to 1% or greater among patients with insomnia who received Ambien CR in placebo-controlled trials. Events reported by investigators were classified utilizing the MedDRA dictionary for the purpose of establishing event frequencies.

The prescriber should be aware that these figures cannot be used to predict the incidence of side effects in the course of usual medical practice, in which patient characteristics and other factors differ from those that prevailed in these clinical trials. Similarly, the cited frequencies cannot be compared with figures obtained from other clinical investigators involving related drug products and uses, since each group of drug trials is conducted under a different set of conditions. However, the cited figures provide the physician with a basis for estimating the relative contribution of drug and nondrug factors to the incidence of side effects in the population studied. 

The following tables were derived from results of two placebo-controlled efficacy trials involving Ambien CR. These trials involved patients with primary insomnia who were treated for 3 weeks with Ambien CR at doses of 12.5 mg (Table 1) or 6.25 mg (Table 2), respectively. The tables include only adverse reactions occurring at an incidence of at least 1% for Ambien CR patients and with an incidence greater than that seen in the placebo patients.Table 1. Incidences of Treatment-Emergent Adverse Reactions in a 3-Week Placebo-Controlled Clinical Trial in Adults (percentage of patients reporting)Body System/Adverse Reaction *Ambien CR12.5 mgPlacebo(N = 102)(N = 110)Infections and infestationsInfluenza30Gastroenteritis10Labyrinthitis10Metabolism and nutrition disorders 

Appetite disorder10Psychiatric disorders Hallucinations 40Disorientation32Anxiety20Depression20Psychomotor retardation20Binge eating10Depersonalization10Disinhibition10Euphoric mood10Mood swings10Stress symptoms10Nervous system disordersHeadache1916Somnolence152Dizziness125Memory disorders 30Balance disorder20Disturbance in attention20Hypoesthesia21Ataxia10Paresthesia10Eye disorders Visual disturbance30Eye redness20Vision blurred21Altered visual depth perception10Asthenopia10Ear and labyrinth disordersVertigo20Tinnitus10Respiratory, thoracic and mediastinal disorders Throat irritation10Gastrointestinal disordersNausea74Constipation20Abdominal discomfort10Abdominal tenderness10Frequent bowel movements10Gastroesophageal refluxdisease10Vomiting10Skin and subcutaneous tissue disordersRash10Skin wrinkling10Urticaria10Musculoskeletal and connective tissue disorders Back pain43Myalgia40Neck pain10Reproductive system and breast disordersMenorrhagia10General disorders and administration site conditionsFatigue32Asthenia10Chest discomfort10InvestigationsBlood pressure increased10Body temperature increased10Injury, poisoning and procedural complicationsContusion10Social circumstances Exposure to poisonous plant10*Reactions reported by at least 1% of patients treated with Ambien CR and at greater frequency than in the placebo group.Hallucinations included hallucinations NOS as well as visual and hypnogogic hallucinations. Memory disorders include: memory impairment, amnesia, anterograde amnesia. Table 2. Incidences of Treatment-Emergent Adverse Reactions in a 3-Week Placebo-Controlled Clinical Trial in Elderly (percentage of patients reporting)Body System/Adverse Reaction *Ambien CRPlacebo6.25 mg(N=99)(N=106)Infections and infestationsNasopharyngitis64Lower respiratory tract infection10Otitis externa10Upper respiratory tract infection10Psychiatric disordersAnxiety32Psychomotor retardation20Apathy10Depressed mood10Nervous system disordersHeadache1411Dizziness83Somnolence65Burning sensation10Dizziness postural10Memory disorders 10Muscle contractions involuntary10Paresthesia10Tremor10Cardiac disordersPalpitations20Respiratory, thoracic and mediastinal disorders Dry throat10Gastrointestinal disordersFlatulence10Vomiting10Skin and subcutaneous tissue disordersRash10Urticaria10Musculoskeletal and connective tissue disordersArthralgia20Muscle cramp21Neck pain20Renal and urinary disordersDysuria10Reproductive system and breast disorders Vulvo vaginal dryness10General disorders and administration site conditions Influenza like illness10Pyrexia10Injury, poisoning and procedural complications Neck injury10*Reactions reported by at least 1% of patients treated with Ambien CR and at greater frequency than in the placebo group. Memory disorders include: memory impairment, amnesia, anterograde amnesia. Dose relationship for adverse reactions: There is evidence from dose comparison trials suggesting a dose relationship for many of the adverse reactions associated with zolpidem use, particularly for certain CNS and gastrointestinal adverse events. 

DRUG INTERACTIONSCNS-active drugs since the systematic evaluations of zolpidem in combination with other CNS-active drugs have been limited, careful consideration should be given to the pharmacology of any CNS-active drug to be used with zolpidem. Any drug with CNS-depressant effects could potentially enhance the CNS-depressant effects of zolpidem. An immediate-release formulation of zolpidem tartrate was evaluated in healthy subjects in single-dose interaction studies for several CNS drugs. Imipramine in combination with zolpidem produced no pharmacokinetic interaction other than a 20% decrease in peak levels of imipramine, but there was an additive effect of decreased alertness. Similarly, chlorpromazine in combination with zolpidem produced no pharmacokinetic interaction, but there was an additive effect of decreased alertness and psychomotor performance. A study involving haloperidol and zolpidem revealed no effect of haloperidol on the pharmacokinetics or pharmacodynamics of zolpidem. The lack of a drug interaction following single-dose administration does not predict a lack following chronic administration. 

An additive effect on psychomotor performance between alcohol and zolpidem was demonstrated A single-dose interaction study with zolpidem 10 mg and fluoxetine 20 mg at steady-state levels in male volunteers did not demonstrate any clinically significant pharmacokinetic or pharmacodynamic interactions. When multiple doses of zolpidem and fluoxetine at steady-state concentrations were evaluated in healthy females, the only significant change was a 17% increase in the zolpidem half-life. There was no evidence of an additive effect in psychomotor performance. 

Following five consecutive nightly doses of zolpidem 10 mg in the presence of sertraline 50 mg (17 consecutive daily doses, at 7:00 am, in healthy female volunteers), zolpidem Cmax was significantly higher (43%) and Tmax was significantly decreased (53%). Pharmacokinetics of sertraline and N-desmethylsertraline were unaffected by zolpidem.

Drugs that affect drug metabolism via cytochrome P450Some compounds known to inhibit CYP3A may increase exposure to zolpidem. The effect of inhibitors of other P450 enzymes has not been carefully evaluated. 

A randomized, double-blind, crossover interaction study in ten healthy volunteers between itraconazole (200 mg once daily for 4 days) and a single dose of zolpidem (10 mg) given 5 hours after the last dose of itraconazole resulted in a 34% increase in AUC0–∞ of zolpidem. There were no significant pharmacodynamic effects of zolpidem on subjective drowsiness, postural sway, or psychomotor performance. A randomized, placebo-controlled, crossover interaction study in eight healthy female subjects between five consecutive daily doses of rifampin (600 mg) and a single dose of an immediate-release formulation of zolpidem tartrate (20 mg) given 17 hours after the last dose of rifampin showed significant reductions of the AUC (–73%), Cmax (–58%), and T1/2 (–36%) of zolpidem together with significant reductions in the pharmacodynamic effects of zolpidem. 

A randomized double-blind crossover interaction study in twelve healthy subjects showed that co-administration of a single 5 mg dose of immediate-release zolpidem tartrate with ketoconazole, a potent CYP3A4 inhibitor, given as 200 mg twice daily for 2 days increased Cmax of zolpidem by a factor of 1.3 and increased the total AUC of zolpidem by a factor of 1.7 compared to zolpidem alone and prolonged the elimination half-life by approximately 30% along with an increase in the pharmacodynamic effects of zolpidem. Caution should be used when ketoconazole is given with zolpidem and consideration should be given to using a lower dose of zolpidem when ketoconazole and zolpidem are given together. Patients should be advised that use of Ambien CR with ketoconazole may enhance the sedative effects. 

Other drugs with no interaction with zolpidem A study involving cimetidine/zolpidem and ranitidine/zolpidem combinations revealed no effect of either drug on the pharmacokinetics or pharmacodynamics of zolpidem. Zolpidem had no effect on digoxin pharmacokinetics and did not affect prothrombin time when given with warfarin in normal subjects. 

Drug-laboratory test interactions Zolpidem is not known to interfere with commonly employed clinical laboratory tests. In addition, clinical data indicate that zolpidem does not cross-react with benzodiazepines, opiates, barbiturates, cocaine, cannabinoids, or amphetamines in two standard urine drug screens. 

USE IN SPECIFIC POPULATIONS Pregnancy Category There are no adequate and well-controlled studies of Ambien CR in pregnant women. Ambien CR should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Administration of zolpidem to pregnant rats and rabbits resulted in adverse effects on offspring development at doses greater than the Ambien CR maximum recommended human dose (MRHD) of 12.5 mg/day (approximately 10 mg/day zolpidem base); however, teratogenicity was not observed.

When zolpidem was administered at oral doses of 4, 20, and 100 mg base/kg (approximately 4, 20 and 100 times the MRHD on a mg/m2 basis) to pregnant rats during the period of organogenesis, dose-related decreases in fetal skull ossification occurred at all but the lowest dose, which is approximately 4 times the MRHD on a mg/m2 basis. In rabbits treated during organogenesis with zolpidem at oral doses of 1, 4, and 16 mg base/kg (approximately 2, 8 and 30 times the MRHD on a mg/m2 basis), increased embryo-fetal death and incomplete fetal skeletal ossification occurred at the highest dose. The no-effect dose for embryo-fetal toxicity in rabbits is approximately 8 times the MRHD on a mg/m2 basis. Administration of zolpidem to rats at oral doses of 4, 20, and 100 mg base/kg (approximately 4, 20 and 100 times the MRHD on a mg/m2 basis) during the latter part of pregnancy and throughout lactation produced decreased offspring growth and survival at all but the lowest dose, which is approximately 4 times the MRHD on a mg/m2 basis.

Neonatal complications studies in children to assess the effects of prenatal exposure to zolpidem have not been conducted; however, cases of severe neonatal respiratory depression have been reported when zolpidem was used at the end of pregnancy, especially when taken with other CNS depressants. 

Children born to mothers taking sedative-hypnotic drugs may be at some risk for withdrawal symptoms during the postnatal period. Neonatal flaccidity has been reported in infants born to mothers who received sedative-hypnotic drugs during pregnancy.

Labor and delivery Ambien CR has no established use in labor and delivery nursing mothers Zolpidem is excreted in human milk. Studies in lactating mothers indicate that the half-life of zolpidem is similar to that in non-lactating women (2.6 ± 0.3 hr). The effect of zolpidem on the nursing infant is not known. Caution should be exercised when Ambien CR is administered to a nursing woman. 

Pediatric use Safety and effectiveness of zolpidem have not been established in pediatric patients. In an 8-week controlled study, 201 pediatric patients (aged 6–17 years) with insomnia associated with attention-deficit/hyperactivity disorder (90% of the patients were using psychoanaleptics), were treated with an oral solution of zolpidem (n=136), or placebo (n = 65). Zolpidem did not significantly decrease latency to persistent sleep, compared to placebo, as measured by polysomnography after 4 weeks of treatment. Psychiatric and nervous system disorders comprised the most frequent (> 5%) treatment emergent adverse reactions observed with zolpidem versus placebo and included dizziness (23.5% vs. 1.5%), headache (12.5% vs. 9.2%), and hallucinations (7.4% vs. 0%). Ten patients on zolpidem (7.4%) discontinued treatment due to an adverse reaction.

FDA has not required pediatric studies of Ambien CR in the pediatric population based on these efficacy and safety findings. Geriatric useA total of 99 elderly (≥ 65 years of age) received daily doses of 6.25 mg Ambien CR in a 3-week placebo-controlled study. The adverse reaction profile of Ambien CR 6.25 mg in this population was similar to that of Ambien CR 12.5 mg in younger adults (≤ 64 years of age). Dizziness was reported in 8% of Ambien CR-treated patients compared with 3% of those treated with placebo. The dose of Ambien CR in elderly patients is 6.25 mg to minimize adverse effects related to impaired motor and/or cognitive performance and unusual sensitivity to sedative/hypnotic drugs  

DRUG ABUSE AND DEPENDENCE Controlled substance Zolpidem tartrate is classified as a Schedule IV controlled substance by federal regulation. Abuse and addiction are separate and distinct from physical dependence and tolerance. Abuse is characterized by misuse of the drug for non-medical purposes, often in combination with other psychoactive substances. Tolerance is a state of adaptation in which exposure to a drug induces changes that result in a diminution of one or more of the drug effects over time. Tolerance may occur to both desired and undesired effects of drugs and may develop at different rates for different effects. 

Addiction is a primary, chronic, neurobiological disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. It is characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving. Drug addiction is a treatable disease, using a multidisciplinary approach, but relapse is common.

Studies of abuse potential in former drug abusers found that the effects of single doses of zolpidem tartrate 40 mg were similar, but not identical, to diazepam 20 mg, while zolpidem tartrate 10 mg effects were difficult to distinguish from placebo.

Because persons with a history of addiction to, or abuse of, drugs or alcohol are at increased risk for misuse, abuse and addiction of zolpidem, they should be monitored carefully when receiving zolpidem or any other hypnotic.  

Dependence Physical dependence is a state of adaptation that is manifested by a specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of an antagonist. Sedative/hypnotics have produced withdrawal signs and symptoms following abrupt discontinuation. These reported symptoms range from mild dysphoria and insomnia to a withdrawal syndrome that may include abdominal and muscle cramps, vomiting, sweating, tremors, and convulsions. The following adverse events, which are considered to meet the DSM-III-R criteria for uncomplicated sedative/hypnotic withdrawal, were reported during U.S. clinical trials following placebo substitution occurring within 48 hours following last zolpidem treatment: fatigue, nausea, flushing, lightheadedness, uncontrolled crying, emesis, stomach cramps, panic attack, nervousness, and abdominal discomfort. These reported adverse events occurred at an incidence of 1% or less. However, available data cannot provide a reliable estimate of the incidence, if any, of dependence during treatment at recommended doses. Post-marketing reports of abuse, dependence and withdrawal have been received.

OVERDOSAGE Signs and symptoms in postmarketing experience of overdose with zolpidem tartrate alone, or in combination with CNS-depressant agents, impairment of consciousness ranging from somnolence to coma, cardiovascular and/or respiratory compromise and fatal outcomes have been reported. 

Recommended treatment General symptomatic and supportive measures should be used along with immediate gastric lavage where appropriate. Intravenous fluids should be administered as needed. Zolpidem's sedative hypnotic effect was shown to be reduced by flumazenil and therefore may be useful; however, flumazenil administration may contribute to the appearance of neurological symptoms (convulsions). As in all cases of drug overdose, respiration, pulse, blood pressure, and other appropriate signs should be monitored and general supportive measures employed. Hypotension and CNS depression should be monitored and treated by appropriate medical intervention. Sedating drugs should be withheld following zolpidem overdosage, even if excitation occurs. The value of dialysis in the treatment of overdosage has not been determined, although hemodialysis studies in patients with renal failure receiving therapeutic doses have demonstrated that zolpidem is not dialyzable. As with the management of all overdosage, the possibility of multiple drug ingestion should be considered. The physician may wish to consider contacting a poison control center for up-to-date information on the management of hypnotic drug product overdosage. 

DESCRIPTION Ambien CR contains zolpidem tartrate, a non-benzodiazepine hypnotic of the imidazopyridine class. Ambien CR (zolpidem tartrate extended-release tablets) is available in 6.25 mg and 12.5 mg strength tablets for oral administration.Chemically, zolpidem is N,N,6-trimethyl-2-p-tolylimidazo[1,2-a] pyridine-3-acetamide L-(+)-tartrate (2:1). It has the following structure:Zolpidem tartrate is a white to off-white crystalline powder that is sparingly soluble in water, alcohol, and propylene glycol. It has a molecular weight of 764.88.Ambien CR consists of a coated two-layer tablet: one layer that releases its drug content immediately and another layer that allows a slower release of additional drug content. The 6.25 mg Ambien CR tablet contains the following inactive ingredients: colloidal silicon dioxide, hypromellose, lactose monohydrate, magnesium stearate, microcrystalline cellulose, polyethylene glycol, potassium bitartrate, red ferric oxide, sodium starch glycolate, and titanium dioxide. The 12.5 mg Ambien CR tablet contains the following inactive ingredients: colloidal silicon dioxide, FD&C Blue #2, hypromellose, lactose monohydrate, magnesium stearate, microcrystalline cellulose, polyethylene glycol, potassium bitartrate, sodium starch glycolate, titanium dioxide, and yellow ferric oxide.

CLINICAL PHARMACOLOGY Mechanism of action Zolpidem, the active moiety of zolpidem tartrate, is a hypnotic agent with a chemical structure unrelated to benzodiazepines, barbiturates, or other drugs with known hypnotic properties. It interacts with a GABA-BZ receptor complex and shares some of the pharmacological properties of the benzodiazepines. In contrast to the benzodiazepines, which non-selectively bind to and activate all BZ receptor subtypes, zolpidem in vitro binds the BZ1 receptor preferentially with a high affinity ratio of the α1/α5 subunits. This selective binding of zolpidem on the BZ1 receptor is not absolute, but it may explain the relative absence of myorelaxant and anticonvulsant effects in animal studies as well as the preservation of deep sleep (stages 3 and 4) in human studies of zolpidem tartrate at hypnotic doses.

Pharmacokinetics Ambien CR exhibits biphasic absorption characteristics, which results in rapid initial absorption from the gastrointestinal tract similar to zolpidem tartrate immediate-release, then provides extended plasma concentrations beyond three hours after administration. A study in 24 healthy male subjects was conducted to compare mean zolpidem plasma concentration-time profiles obtained after single oral administration of Ambien CR 12.5 mg and of an immediate-release formulation of zolpidem tartrate (10 mg). The terminal elimination half-life observed with Ambien CR (12.5 mg) was similar to that obtained with immediate-release zolpidem tartrate (10 mg). The mean plasma concentration-time profiles are shown in Figure 1.Figure 1: Mean plasma concentration-time profiles for Ambien CR (12.5 mg) and immediate-release zolpidem tartrate (10 mg)In adult and elderly patients treated with Ambien CR, there was no evidence of accumulation after repeated once-daily dosing for up to two weeks.

Absorption: Following administration of Ambien CR, administered as a single 12.5 mg dose in healthy male adult subjects, the mean peak concentration (Cmax) of zolpidem was 134 ng/mL (range: 68.9 to 197 ng/ml) occurring at a median time (Tmax) of 1.5 hours. The mean AUC of zolpidem was 740 ng∙hr/mL (range: 295 to 1359 ng∙hr/mL).A food-effect study in 45 healthy subjects compared the pharmacokinetics of Ambien CR 12.5 mg when administered while fasting or within 30 minutes after a meal. Results demonstrated that with food, mean AUC and Cmax were decreased by 23% and 30%, respectively, while median Tmax was increased from 2 hours to 4 hours. The half-life was not changed. These results suggest that, for faster sleep onset, Ambien CR should not be administered with or immediately after a meal. Distribution:

Total protein binding was found to be 92.5 ± 0.1% and remained constant, independent of concentration between 40 and 790 ng/mL.Metabolism:Zolpidem is converted to inactive metabolites that are eliminated primarily by renal excretion.  

Elimination: When Ambien CR was administered as a single 12.5 mg dose in healthy male adult subjects, the mean zolpidem elimination half-life was 2.8 hours (range: 1.62 to 4.05 hr). 

Special Populations Elderly: In 24 elderly (≥ 65 years) healthy subjects administered a single 6.25 mg dose of Ambien CR, the mean peak concentration (Cmax) of zolpidem was 70.6 (range: 35.0 to 161) ng/mL occurring at a median time (Tmax) of 2.0 hours. The mean AUC of zolpidem was 413 ng∙hr/mL (range: 124 to 1190 ng∙hr/mL) and the mean elimination half-life was 2.9 hours (range: 1.59 to 5.50 hours). 

Hepatic Impairment: Ambien CR was not studied in patients with hepatic impairment. The pharmacokinetics of an immediate-release formulation of zolpidem tartrate in eight patients with chronic hepatic insufficiency were compared to results in healthy subjects. Following a single 20-mg oral zolpidem tartrate dose, mean Cmax and AUC were found to be two times (250 vs. 499 ng/mL) and five times (788 vs. 4,203 ng∙hr/mL) higher, respectively, in hepatically compromised patients. Tmax did not change. The mean half-life in cirrhotic patients of 9.9 hr (range: 4.1 to 25.8 hr) was greater than that observed in normal subjects of 2.2 hr (range: 1.6 to 2.4 hr). Dosing should be modified accordingly in patients with hepatic insufficiency

Renal Impairment: Ambien CR was not studied in patients with renal impairment. The pharmacokinetics of an immediate-release formulation of zolpidem tartrate were studied in 11 patients with end-stage renal failure (mean ClCr = 6.5 ± 1.5 mL/min) undergoing hemodialysis three times a week, who were dosed with zolpidem tartrate 10 mg orally each day for 14 or 21 days. No statistically significant differences were observed for Cmax, Tmax, half-life, and AUC between the first and last day of drug administration when baseline concentration adjustments were made. On day 1, Cmax was 172 ± 29 ng/mL (range: 46 to 344 ng/mL). After repeated dosing for 14 or 21 days, Cmax was 203 ± 32 ng/mL (range: 28 to 316 ng/mL). On day 1, Tmax was 1.7 ± 0.3 hr (range: 0.5 to 3.0 hr); after repeated dosing Tmax was 0.8 ± 0.2 hr (range: 0.5 to 2.0 hr). This variation is accounted for by noting that last-day serum sampling began 10 hours after the previous dose, rather than after 24 hours. This resulted in residual drug concentration and a shorter period to reach maximal serum concentration. On day 1, T1/2 was 2.4 ± 0.4 hr (range: 0.4 to 5.1 hr). After repeated dosing, T1/2 was 2.5 ± 0.4 hr (range: 0.7 to 4.2 hr). AUC was 796 ± 159 ng∙hr/mL after the first dose and 818 ± 170 ng∙hr/mL after repeated dosing. Zolpidem was not hemodialyzable. No accumulation of unchanged drug appeared after 14 or 21 days. Zolpidem pharmacokinetics were not significantly different in renally-impaired patients. No dosage adjustment is necessary in patients with compromised renal function. However, as a general precaution, these patients should be closely monitored. 

NONCLINICAL TOXICOLOGY Carcinogenesis, mutagenesis, impairment of fertility Carcinogenesis: Zolpidem was administered to mice and rats for 2 years at dietary dosages of 4, 18, and 80 mg base/kg. In mice, these doses are approximately 2, 9, and 40 times the maximum recommended human dose (MRHD) of 12.5 mg/day (10 mg zolpidem base) on mg/m2 basis. In rats, these doses are approximately 4, 18, and 80 times the MRHD on a mg/m2 basis. No evidence of carcinogenic potential was observed in mice. In rats, renal tumors (lipoma, liposarcoma) were seen at the mid- and high doses.

Mutagenesis: Zolpidem was negative in in vitro (bacterial reverse mutation, mouse lymphoma, and chromosomal aberration) and in vivo (mouse micronucleus) genetic toxicology assays.

Impairment of fertility: Oral administration of zolpidem (doses of 4, 20, and 100 mg base/kg or approximately 4, 20, and 100 times the MRHD on a mg/m2 basis) to rats prior to and during mating, and continuing in females through postpartum day 25, resulted in irregular estrus cycles and prolonged precoital intervals. The no-effect dose for these findings is approximately 20 times the MRHD on a mg/m2 basis. There was no impairment of fertility at any dose tested 

Ambien withdrawal. Ambien withdrawal side effects, Ambien withdrawal warnings, Ambien withdrawal precautions, Ambien withdrawal adverse effects, overdose, withdrawal symptoms and Ambien natural alternatives. Before you begin the spiral down with Ambien, try giving your body what it really wants.


Ambien withdrawal - Dry Mouth - The usual amount to moisture in the mouth is noticeably less.

Ambien withdrawal - Sweating Increased - A large quantity of perspiration that is medically caused.

Cardiovascular (Involving the heart and the blood vessels)

Ambien withdrawal - Palpitation - Unusual and not normal heartbeat, that is sometimes irregular, but rapid and forceful thumping or fluttering. It can be brought on by shock, excitement, exertion, or medical stimulants. A person is normally unaware of his/her heartbeat.

Ambien withdrawal - Hypertension - is high blood pressure, which is a symptom of disease in the blood vessels leading away from the heart. Hypertension is known as the “silent killer”. The symptoms are usually not obvious, however it can lead to damage to the heart, brain, kidneys and eye, and even to stroke and kidney failure. Treatment includes dietary and lifestyle changes.

Ambien withdrawal - Bradycardia - The heart rate is slowed from 72 beats per minute, which is normal, to below 60 beats per minute in an adult. 

Ambien withdrawal - Tachycardia - The heart rate is speeded up to above 100 beats per minute in an adult. Normal adult heart rate is 72 beats per minute.

Ambien withdrawal - ECG Abnormal - A test called an electrocardiogram (ECG) that records the activity of the heart. It measures heartbeats as will as the position and size of the heart’s four chambers. It also measures if there is damage to the heart and the effects of drugs or mechanical devices like a pacemaker on the heart. When the test is abnormal this means that one or more of the following are present: heart disease, defects, beating too fast or too slow, disease of the blood vessels leading from the heart or of the heart valves, and/or a past or about to occur heart attack.

Ambien withdrawal - Flushing - The skin all over the body turns red.

Ambien withdrawal - Varicose Vein - Unusually swollen veins near the surface of the skin that sometimes appear twisted and knotted, but always enlarged. They are called hemorrhoids when they appear around the rectum. The cause is attributed to hereditary weakness in the veins aggravated by obesity, pregnancy, pressure from standing, aging, etc. Severe cases may develop swelling in the legs, ankles and feet, eczema and/or ulcers in the affected areas.

Gastrointestinal (Involving the stomach and the intestines)

Ambien withdrawal - Abdominal Cramp/Pain - Sudden, severe, uncontrollable and painful shortening and thickening of the muscles in the belly. The belly includes the stomach as well as the intestines, liver, kidneys, pancreas, spleen, gall bladder, and urinary bladder. 

Ambien withdrawal - Belching - Noisy release of gas from the stomach through the mouth; a burp. 

Ambien withdrawal - Bloating - Swelling of the belly caused by excessive intestinal gas.

Ambien withdrawal - Constipation - Difficulty in having a bowel movement where the material in the bowels is hard due to a lack of exercise, fluid intake, and roughage in the diet, or due to certain drugs.

Ambien withdrawal - Diarrhea - Unusually frequent and excessive, runny bowel movements that may result in severe dehydration and shock.

Ambien withdrawal - Dyspepsia - Indigestion. This is the discomfort you experience after eating. It can be heartburn, gas, nausea, a bellyache or bloating. 

Ambien withdrawal - Flatulence - More gas than normal in the digestive organs. 

Ambien withdrawal - Gagging - Involuntary choking and/or involuntary throwing up. 

Ambien withdrawal - Gastritis - A severe irritation of the mucus lining of the stomach either short in duration or lasting for a long period of time.

Ambien withdrawal - Gastroenteritis - A condition where the membranes of the stomach and intestines are irritated.

Ambien withdrawal - Gastroesophageal Reflux - A continuous state where stomach juices flow back into the throat causing acid indigestion and heartburn and possibly injury to the throat.

Ambien withdrawal - Heartburn - A burning pain in the area of the breastbone caused by stomach juices flowing back up into the throat. 

Ambien withdrawal - Hemorrhoids - Small rounded purplish swollen veins that either bleed, itch or are painful and appear around the anus.

Ambien withdrawal - Increased Stool frequency - Diarrhea.  

Ambien withdrawal - Indigestion - Unable to properly consume and absorb food in the digestive tract causing constipation, nausea, stomach ache, gas, swollen belly, pain and general discomfort or sickness. 

Ambien withdrawal - Nausea - Stomach irritation with a queasy sensation similar to motion sickness and a feeling that one is going to vomit. 

Ambien withdrawal - Polyposis Gastric - Tumors that grow on stems in the lining of the stomach, which usually become cancerous. 

Ambien withdrawal - Swallowing Difficulty - A feeling that food is stuck in the throat or upper chest area and won’t go down, making it difficult to swallow. 

Ambien withdrawal - Toothache - Pain in a tooth above and below the gum line.

Ambien withdrawal - Vomiting - Involuntarily throwing up the contents of the stomach and usually getting a nauseated, sick feeling just prior to doing so. 


Ambien withdrawal - Allergy - The extreme sensitivity of body tissues triggered by substances in the air, drugs, or foods causing a reaction like sneezing, itching, asthma, hay fever, skin rashes, nausea and/or vomiting.

Ambien withdrawal - Anaphylaxis - A violent, sudden, and severe drop in blood pressure caused by a re-exposure to a foreign protein or a second dosage of a drug that may be fatal unless emergency treatment is given right away.

Ambien withdrawal - Asthenia - A physically weak condition. 

Ambien withdrawal - Chest Pains - Severe discomfort in the chest caused by not enough oxygen going to the heart because of narrowing of the blood vessels or spasms.

Ambien withdrawal - Chills - Appearing pale while cold and shivering; sometimes with a fever.

Ambien withdrawal - Edema of Extremities - Abnormal swelling of the body’s tissue caused by the collection of fluid. 

Ambien withdrawal - Fall - To suddenly lose your normal standing upright position as if you were shot.

Ambien withdrawal - Fatigue - Loss of normal strength so as to not be able to do the usual physical and mental activities.  

Ambien withdrawal - Fever - Abnormally high body temperature, the normal being 98 degrees Fahrenheit or 37 degrees Centigrade in humans, which is a symptom of disease or disorder in the body. The body is affected by feeling hot, chilled, sweaty, weak and exhausted. If the fever goes too high, death can result.

Ambien withdrawal - Hot Flashes - Brief, abnormal enlargement of the blood vessels that causes a sudden heat sensation over the entire body. Women in menopause will sometimes experience this. 

Ambien withdrawal - Influenza-like Symptoms - Demonstrating irritation of the respiratory tract (organs of breathing) such as a cold, sudden fever, aches and pains, as well as feeling weak and seeking bed rest, which is similar to having the flu. 

Ambien withdrawal - Leg Pain - A hurtful sensation in the legs that is caused by excessive stimulation of the nerve endings in the legs and results in extreme discomfort.

Ambien withdrawal - Malaise - The somewhat unclear feeling of discomfort you get when you start to feel sick. 

Ambien withdrawal - Pain in Limb - Sudden, sharp and uncontrolled leg discomfort.

Ambien withdrawal - Syncope - A short period of light headedness or unconsciousness (black-out) also know as fainting caused by lack of oxygen to the brain because of an interruption in blood flowing to the brain. 

Ambien withdrawal - Tightness of Chest - Mild or sharp discomfort, tightness or pressure in the chest area (anywhere between the throat and belly). The causes can be mild or seriously life-threatening because they include the heart, lungs and surrounding muscles. 

Hemic and Lymphatic Disorders (Involving the blood and the clear fluids in the tissues that contain white blood cells) 

Ambien withdrawal - Bruise - Damage to the skin resulting in a purple-green-yellow skin coloration that’s caused by breaking the blood vessels in the area without breaking the surface of the skin. 

Ambien withdrawal - Anemia - A condition where the blood is no longer carrying enough oxygen, so the person looks pale and easily gets dizzy, weak and tired. More severely, a person can end up with an abnormal heart, as well as breathing and digestive difficulties. The causes of anemia are not enough protein in the red blood cells, or missing and chemically destroyed red blood cells, as well as diseased or destroyed bone marrow. 

Ambien withdrawal - Nosebleed - Blood lost from the part of the face that has the organs of smell and is where the body takes in oxygen. 

Ambien withdrawal - Hematoma - Broken blood vessels that cause a swelling in an area on the body.

Ambien withdrawal - Lymphadenopathy Cervical - The lymph nodes in the neck, which are part of the body’s immune system get swollen and enlarge by reacting to the presence of a drug. The swelling is the result of the white blood cells multiplying in order to fight the invasion of the drug.

Metabolic and Nutritional Disorders (Energy and health)

Ambien withdrawal - Arthralgia - Sudden sharp nerve pain in one or more joints.

Ambien withdrawal - Arthropathy - Having joint disease or abnormal joints.

Ambien withdrawal - Arthritis - Painfully inflamed and swollen joints. The reddened and swollen condition is brought on by a serious injury or shock to the body either from physical or emotional causes.

Ambien withdrawal - Back Discomfort - Severe physical distress in the area from the neck to the pelvis along the backbone. 

Ambien withdrawal - Bilirubin Increased - Bilirubin is a waste product of the breakdown of old blood cells. Bilirubin is sent to the liver to be made water-soluble so it can be eliminated from the body through emptying the bladder. A drug can interfere with or damage this normal liver function creating liver disease. 

Ambien withdrawal - Decreased Weight - Uncontrolled and measured loss of heaviness or weight.

Ambien withdrawal - Gout - A severe arthritis condition that is caused by the dumping of a waste product called uric acid in the tissues and joints. It can become worse and cause the body to develop a deformity after going through stages of pain, inflammation, severe tenderness, and stiffness. 

Ambien withdrawal - Hepatic Enzymes Increased - An increase in the amount of paired liver proteins that regulate liver processes causing a condition where the liver functions abnormally.

Ambien withdrawal - Hypercholesterolemia - Too much cholesterol in the blood cells.

Ambien withdrawal - Hyperglycemia - An unhealthy amount of sugar in the blood. 

Ambien withdrawal - Increased Weight - A concentration and storage of fat in the body accumulating over a period of time caused by unhealthy eating patterns, that can predispose the body to many disorders and diseases. 

Ambien withdrawal - Jaw Pain - The pain due to irritation and swelling of the nerves associated with the mouth area where it opens and closes just in front of the ear. Some of the symptoms are pain when chewing, headaches, losing your balance, stuffy ears or ringing in the ears, and teeth grinding.

Ambien withdrawal - Jaw Stiffness - The result of squeezing and grinding the teeth while asleep that can cause your teeth to deteriorate as well as the muscles and joints of the jaw.

Ambien withdrawal - Joint Stiffness - A loss of free motion and easy flexibility where any two bones come together.

Ambien withdrawal - Muscle Cramp - When muscles contract uncontrollably without warning and do not relax. The muscles of any of the body’s organs can cramp.

Ambien withdrawal - Muscle Stiffness - Tightening of muscles making it difficult to bend.

Ambien withdrawal - Muscle Weakness - Loss of physical strength. 

Ambien withdrawal - Myalgia - A general widespread pain and tenderness of the muscles.

Ambien withdrawal - Thirst - A strong, unnatural craving for moisture/water in the mouth and throat.

Nervous System (Sensory channels)

Ambien withdrawal - Carpal Tunnel Syndrome - A pinched nerve in the wrist that causes pain, tingling, and numbing. 

Ambien withdrawal - Coordination Abnormal - A lack of normal, harmonious interaction of the parts of the body when it is in motion 

Ambien withdrawal - Dizziness - Losing one’s balance while feeling unsteady and lightheaded which may lead to fainting.

Ambien withdrawal - Disequilibrium - Lack of mental and emotional balance. 

Ambien withdrawal - Faintness - A temporary condition where one is likely to go unconscious and fall.

Ambien withdrawal - Headache - A sharp or dull persistent pain in the head

Ambien withdrawal - Hyperreflexia - A not normal and involuntary increased response in the tissues connecting the bones to the muscles.

Ambien withdrawal - Light-headed Feeling – Uncontrolled and usually brief loss of consciousness caused by lack of oxygen to the brain.

Ambien withdrawal - Migraine - Reoccurring severe head pain usually with nausea, vomiting, dizziness, flashes or spots before the eyes, and ringing in the ears 

Ambien withdrawal - Muscle Contractions Involuntary - Spontaneous and uncontrollable tightening reaction of the muscles caused by electrical impulses from the nervous system.

Ambien withdrawal - Muscular Tone Increased - Uncontrolled and exaggeration muscle tension. Muscles are normally partially tensed and this is what gives us muscle tone.  

Ambien withdrawal - Paresthesia - Burning, prickly, itchy, or tingling skin with no obvious or understood physical cause. 

Ambien withdrawal - Restless Legs - A need to move the legs without any apparent reason. Sometimes there is pain, twitching, jerking, cramping, burning, or a creepy-crawly sensation associated with the movements. It worsens when a person is inactive and can interrupt one’s sleep so one feels the need to move to gain some relief.

Ambien withdrawal - Shaking - Uncontrolled quivering and trembling as if one is cold and chilled. 

Ambien withdrawal - Sluggishness - Lack of alertness and energy, as well as being slow to respond or perform in life. 

Ambien withdrawal - Tics - A contraction of a muscle causing a repeated movement not under the control of the person usually on the face or limbs. 

Ambien withdrawal - Tremor - A nervous and involuntary vibrating or quivering of the body.

Ambien withdrawal - Twitching - Sharp, jerky and spastic motion sometimes with a sharp sudden pain. 

Ambien withdrawal - Vertigo - A sensation of dizziness with disorientation and confusion.

Psychiatric Disorders (Mental and emotional) 

Ambien withdrawal - Aggravated Nervousness - A progressively worsening, irritated and troubled state of mind.

Ambien withdrawal - Agitation - Suddenly violent and forceful, emotionally disturbed state of mind. 

Ambien withdrawal - Amnesia - Long term or short term, partial or full memory loss created by emotional or physical shock, severe illness, or a blow to the head where the person was caused pain and became unconsciousness.

Ambien withdrawal - Anxiety Attack - Sudden and intense feelings of fear, terror, and dread physically creating shortness of breath, sweating, trembling and heart palpitations.

Ambien withdrawal - Apathy - Complete lack of concern or interest for things that ordinarily would be regarded as important or would normally cause concern.

Ambien withdrawal - Appetite Decreased - Having a lack of appetite despite the ordinary caloric demands of living with a resulting unintentional loss of weight.

Ambien withdrawal - Appetite Increased - An unusual hunger causing one to overeat.

Ambien withdrawal - Auditory Hallucination - Hearing things without the voices or noises being present.

Ambien withdrawal - Bruxism - Grinding and clenching of teeth while sleeping. 

Ambien withdrawal - Carbohydrate Craving - A drive and craving to eat foods rich in sugar and starches (sweets, snacks and junk foods) that intensifies as the diet becomes more and more unbalanced due to the unbalancing of the proper nutritional requirements of the body. 

Ambien withdrawal - Concentration Impaired - Unable to easily focus your attention for long periods of time. 

Ambien withdrawal - Confusion - Not able to think clearly and understand in order to make a logical decision.

Ambien withdrawal - Crying Abnormal - Unusual and not normal fits of weeping for short or long periods of time for no apparent reason. 

Ambien withdrawal - Depersonalization - A condition where one has lost a normal sense of personal identity. 

Ambien withdrawal - Depression - A hopeless feeling of failure, loss and sadness that can deteriorate into thoughts of death.

Ambien withdrawal - Disorientation - A loss of sense of direction, place, time or surroundings as well as mental confusion on personal identity. 

Ambien withdrawal - Dreaming Abnormal - Dreaming that leaves a very clear, detailed picture and impression when awake that can last for a long period of time and sometimes be unpleasant.

Ambien withdrawal - Emotional Lability - Suddenly breaking out in laughter or crying or doing both without being able to control the outburst of emotion. These episodes are unstable as they are caused by things that normally would not have this effect on an individual. 

Ambien withdrawal - Excitability - Uncontrollably responding to stimuli.

Ambien withdrawal - Feeling Unreal - The awareness that one has an undesirable emotion like fear but can’t seem to shake off the irrational feeling. For example, feeling like one is going crazy but rationally knowing that it is not true. The quality of this side effect resembles being in a bad dream and not being able to wake up.

Ambien withdrawal - Forgetfulness - Unable to remember what one ordinarily would remember. 

Ambien withdrawal - Insomnia - Sleeplessness caused by physical stress, mental stress or stimulants such as coffee or medications; it is a condition of being abnormally awake when one would ordinarily be able to fall and remain asleep.

Ambien withdrawal - Irritability - Abnormally annoyed in response to a stimulus.

Ambien withdrawal - Jitteriness - Nervous fidgeting without an apparent cause.

Ambien withdrawal - Lethargy - Mental and physical sluggishness and apathy that can deteriorate into an unconscious state resembling deep sleep. A numbed state of mind. 

Ambien withdrawal - Libido Decreased - An abnormal loss of sexual energy or desire.

Ambien withdrawal - Panic Reaction - A sudden, overpowering, chaotic and confused mental state of terror resulting in being doubt ridden often accompanied with hyperventilation, and extreme anxiety.

Ambien withdrawal - Restlessness Aggravated - A constantly worsening troubled state of mind characterized by the person being increasingly nervous, unable to relax, and easily angered. 

Ambien withdrawal - Somnolence - Feeling sleepy all the time or having a condition of semi-consciousness. 

Ambien withdrawal - Suicide Attempt - An unsuccessful deliberate attack on one’s own life with the intention of ending it.

Ambien withdrawal - Suicidal Tendency - Most likely will attempt to kill oneself.

Ambien withdrawal - Tremulousness Nervous - Very jumpy, shaky, and uneasy while feeling fearful and timid. The condition is characterized by thoughts of dreading the future, involuntary quivering, trembling, and feeling distressed and suddenly upset.

Ambien withdrawal - Yawning - involuntary opening of the mouth with deep inhalation of air.

Reproductive Disorder Female

Ambien withdrawal - Breast Neoplasm - A tumor or cancer, of either of the two milk-secreting organs on the chest of a woman.

Ambien withdrawal - Menorrhagia - Abnormally heavy menstrual period or a menstrual flow that has continued for an unusually long period of time.

Ambien withdrawal - Menstrual Cramps - Painful, involuntary uterus contractions that women experience around the time of their menstrual period, sometimes causing pain in the lower back and thighs.

Ambien withdrawal - Menstrual Disorder - A disturbance or derangement in the normal function of a woman’s menstrual period. 

Ambien withdrawal - Pelvic Inflammation - The reaction of the body to infectious, allergic, or chemical irritation, which in turn causes tissue irritation, injury, or bacterial infection characterized by pain, redness, swelling, and sometimes loss of function. The reaction usually begins in the uterus and spreads to the fallopian tubes, ovaries, and other areas in the hipbone region of the body.

Ambien withdrawal - Premenstrual Syndrome - Various physical and mental symptoms commonly experienced by women of childbearing age usually 2 to 7 days before the start of their monthly period. There are over 150 symptoms including eating binges, behavioral changes, moodiness, irritability, fatigue, fluid retention, breast tenderness, headaches, bloating, anxiety, and depression. The symptoms cease shortly after the period begins, and disappear with menopause. 

Ambien withdrawal - Spotting Between Menses - Abnormal bleeding between periods. Unusual spotting between menstrual cycles.

Respiratory System (Organs involved in breathing)

Ambien withdrawal - Asthma - A disease of the breathing system initiated by and allergic reaction or a chemical with repeated attacks of coughing, sticky mucus, wheezing, shortness of breath, and a tight feeling in the chest. The disease can reach a state where it stops a person from exhaling, leading to unconsciousness and death.

Ambien withdrawal - Breath Shortness - Unnatural breathing using a lot off effort resulting in not enough air taken in by the body.

Ambien withdrawal - Bronchitis - Inflammation of the two main breathing tubes leading from the windpipe to the lungs. The disease is marked with coughing, a low-grade fever, chest pains, and hoarseness, caused by an allergic reaction. 

Ambien withdrawal - Coughing - A cough is the response to an irritation, such as mucus, that causes the muscles controlling the breathing process to expel air from the lungs suddenly and noisily to keep the air passages free from the irritating material. 

Ambien withdrawal - Laryngitis - Inflammation of the voice box characterized by hoarseness, sore throat, and coughing. It can be cause by straining the voice or exposure to infectious, allergic or chemical irritation.

Ambien withdrawal - Nasal Congestion - The presence of an abnormal amount of fluid in the nose.

Ambien withdrawal - Pneumonia Tracheitis - Bacterial infection of the air passageways and lungs that causes redness, swelling and pain in the windpipe. Other symptoms are high fever, chills, pain in the chest, difficulty in breathing, and coughing with mucus discharge 

Ambien withdrawal - Rhinitis - Chemical irritation causing pain, redness and swelling in the mucus membranes of the nose.

Ambien withdrawal - Sinus Congestion - The mucus-lined areas of the bones in the face that are thought to help warm and moisten air to the nose. These areas become clogged with excess fluid or infected.

Ambien withdrawal - Sinus Headache - The abnormal amount of fluid in the hollows of the face bone area especially around the nose. This excess fluid creates pressure, causing pain in the head.

Ambien withdrawal - Sinusitis - The body reacting to chemical irritation causing redness, swelling and pain in the area of the hollows in the facial bones especially around the nose.

SkeletalAmbien withdrawal - Neck/Shoulder Pain - Hurtful sensations of the nerve endings caused by damage to the tissues in the neck and shoulder signaling danger of disease.

Skin and Appendages Disorders (Skin, legs and arms)

Ambien withdrawal - Acne - Eruptions of the oils glands of the skin, especially on the face, marked by pimples, blackheads, whiteheads, bumps, and more severely, by cysts and scarring.

Ambien withdrawal - Alopecia - The loss of hair or baldness.

Ambien withdrawal - Eczema - A severe or continuing skin disease marked by redness, crusting and scaling with watery blisters and itching. It is often difficult to treat and will sometimes go away only to reappear again. 

Ambien withdrawal - Dermatitis - Generally irritated skin that can be caused by any of a number of irritating things such as parasites, fungus, bacteria, or foreign substances causing an allergic reaction. It is a general inflammation of the skin. 

Ambien withdrawal - Dry Lips - The lack of normal moisture in the fleshy folds that surround the mouth.

Ambien withdrawal - Dry Skin - The lack of normal moisture/oils in the surface layer of the body. The skin is the body’s largest organ. 

Ambien withdrawal - Folliculitis - Inflammation of a follicle (small body sac) especially a hair follicle. A hair follicle contains the root of a hair.

Ambien withdrawal - Furunculosis - Skin boils that show up repeatedly.

Ambien withdrawal - Lipoma - A tumor of mostly fat cells that is not health endangering.

Ambien withdrawal - Pruritus - Extreme itching of often-undamaged skin. 

Ambien withdrawal - Rash - A skin eruption or discoloration that may or may not be itching, tingling, burning, or painful. It may be caused by an allergy, an skin irritation, a skin disease. 

Ambien withdrawal - Skin Nodule - A bulge, knob, swelling or outgrowth in the skin that is a mass of tissue or cells. 

Special Senses

Ambien withdrawal - Conjunctivitis - Infection of the membrane that covers the eyeball and lines the eyelid, caused by a virus, allergic reaction, or an irritating chemical. It is characterized by redness, a discharge of fluid and itching.

Ambien withdrawal - Dry Eyes - Not enough moisture in the eyes. 

Ambien withdrawal - Earache - Pain in the ear.

Ambien withdrawal - Eye Infection - The invasion of the eye tissue by a bacteria, virus, fungus, etc, causing damage to the tissue, with toxicity. Infection spreading in the body progresses into disease. 

Ambien withdrawal - Eye Irritation - An inflammation of the eye.

Ambien withdrawal - Metallic Taste - A range of taste impairment from distorted taste to a complete loss of taste. 

Ambien withdrawal - Pupils Dilated - Abnormal expansion of the blace circular opening in the center of the eye.

Ambien withdrawal - Taste alteration - Abnormal flavor detection in food. 

Ambien withdrawal - Tinnitus - A buzzing, ringing, or whistling sound in one or both ears occurring from the internal use of certain drugs.

Ambien withdrawal - Vision Abnormal - Normal images are seen differently by the viewer.  

Ambien withdrawal - Vision Blurred - Eyesight is dim or indistinct and hazy in outline or appearance.

Ambien withdrawal - Visual Disturbance - Eyesight is interfered with or interrupted. Some disturbances are light sensitivity and the inability to easily distinguish colors.

Urinary System Disorder

Ambien withdrawal - Blood in Urine - Blood is present when one empties liquid waste product of the kidneys through the bladder by urinating in the toilet turning the water pink to bright red. Or you could see pots of blood in the water after urinating.

Ambien withdrawal - Dysuria - Difficult or painful urination.

Ambien withdrawal - Kidney Stone - Small hard masses of salt deposits that the kidney forms.

Ambien withdrawal - Urinary Frequency - Having to urinate more often than usual or between unusually short time periods.

Ambien withdrawal - Urinary Tract Infection - An invasion of bacteria, viruses, fungi, etc., of the system in the body that starts with the kidneys and eliminates urine from the body. If the invasion goes unchecked it can injure tissue and progress into disease. 

Ambien withdrawal - Urinary Urgency - A sudden compelling urge to urinate, accompanied by discomfort in the bladder.

Urogenital (Urinary tract and genital structures or functions)

Ambien withdrawal - Anorgasmia - Failure to experience an orgasm.

Ambien withdrawal - Ejaculation Disorder - Dysfunction of the discharge of semen during orgasm.

Ambien withdrawal - Menstrual Disorder - Dysfunction of the discharge during the monthly menstrual cycle.

Ambien withdrawal - Acute Renal Failure - The kidneys stop functioning properly to excrete wastes.

Ambien withdrawal - Angioedema - Intensely itching and swelling welts on the skin called hives caused by an allergic reaction to internal or external agents. The reaction is common to a food or a drug. Chronic cases can last for a long period of time.

Ambien withdrawal - Toxic Epidermal Necrolysis - An abnormal condition where a large portion of skin becomes intensely red and peels off like a second-degree burn. Often the symptoms include blistering.

Ambien withdrawal - Gastrointestinal Hemorrhage - Stomach and intestinal excessive internal bleeding.

Ambien withdrawal - Grand Mal Seizures (or Convulsions) - A recurring sudden violent and involuntary attack of muscle spasms with a loss of consciousness.

Ambien withdrawal - Neuroleptic Malignant Syndrome - A life threatening, rare reaction to an anti-psychotic drug marked by fever, muscular rigidity, changed mental status, and dysfunction of the autonomic nervous system. 

Ambien withdrawal - Pancreatitis - Chemical irritation with redness, swelling, and pain in the pancreas where digestive enzymes and hormones are secreted. 

Ambien withdrawal - QT Prolongation - A very fast heart rhythm disturbance that is too fast for the heart to beat effectively so the blood to the brain falls causing a sudden loss of consciousness and may cause sudden cardiac death. 

Ambien withdrawal - Rhabdomyolysis - The breakdown of muscle fibers that releases the fibers into the circulatory system. Some of the fibers are poisonous to the kidney and frequently result in kidney damage.

Ambien withdrawal - Serotonin Syndrome - A disorder brought on by excessive levels of serotonin caused by drugs and can be fatal as death from this side effect can come very rapidly. 

Ambien withdrawal - Thrombocytopenia - An abnormal decrease in the number of blood platelets in the circulatory system. A decrease in platelets would cause a decrease in the ability of the blood to clot when necessary.

Ambien withdrawal - Torsades de Pointes - Unusual rapid heart rhythm starting in the lower heart chambers. If the short bursts of rapid heart rhythm continue for a prolonged period it can degenerate into a more rapid rhythm and can be fatal