Under the best of conditions, tens of millions of people have trouble getting a decent night’s sleep. These days, though, it’s harder than ever. News about the coronavirus is nonstop. People have lost their jobs and their savings. And there is the constant threat of catching a potentially lethal infection. Lots of people have turned to anti-anxiety agents, antidepressants or sleeping pills. Doctors are prescribing alprazolam for nerves and zolpidem for insomnia. What are the risks?
Prescriptions Up for Treating Anxiety, Depression and Insomnia:
In April, one of the largest pharmacy benefit managers (PBMs) issued its “America’s State of Mind Report.” Express Scripts serves over 20 million Americans with employer-funded health insurance.
“Our research shows that the number of prescriptions filled per week for antidepressant, anti-anxiety and anti-insomnia medications increased 21% between February 16 and March 15, peaking the week ending March 15, when COVID-19 was declared a pandemic.”
People are dipping into their medicine chests for old bottles of alprazolam, clonazepam, diazepam or lorazepam. These are benzodiazepines or benzos for short. Many folks are also contacting their physicians or seeking online prescribers to get refills or brand new scripts. New prescriptions for these anti-anxiety agents jumped up 34% between mid February and mid March.
According to Express Scripts, this is a radical departure from the last five years. Over that time frame there was a decline in anti-anxiety drug use of around 12%. Sleeping pill use was down by about as much.
Zolpidem for Insomnia:
Many people have been losing sleep for months, and some have asked their doctors to prescribe something to help them get some extra ZZZs. Express Scripts reported a big bump in prescriptions for sleep aids. Between February and March new scripts for sleeping pills jumped about 15%.
Zolpidem, also sold under brand names Ambien, Ambien CR, Edluar and Zolpimist, was the first in its category of “Z-drugs.” The FDA approved Ambien in 1992, and at first doctors thought this drug was super-safe. Over the decades since then, though, patients and clinicians have discovered some drawbacks.
When doctors prescribe zolpidem for insomnia, they are advised to limit its use to no more than two weeks. Nonetheless, many individuals take this medication for months or years. It can be hard to stop once you become reliant on zolpidem for insomnia.
The most obvious problem is morning “hangover.” Some people may not realize that they are impaired. They grab a cup of coffee and get behind the wheel. We have heard from many readers that driving can be hazardous in this situation.
A father wrote to us a few years ago about traumatizing his daughter on the way to school. He had taken zolpidem the night before. The next morning, while driving to his daughter’s school he kept running into the curve. He described himself as a “dangerous driving zombie.”
He said that he “didn’t truly wake up until I was sitting in my car in the garage after returning home.” He had a flat tire from hitting the curve so many times. His daughter would not let him drive her to school after that incident.
Another reader reported this incident after taking zolpidem:
“I was arrested for DWI when I was sleep driving while taking Ambien. I never misused it, but I lost my driver’s license as well as my career. When I quit Ambien suddenly, the rebound insomnia led to a horrible car accident. I fell asleep at the wheel and now I have 24/7 chronic pain.”
Suzy also had an accident while taking zolpidem for insomnia:
“I had a bad experience with Ambien. I totaled my car only two houses from my home. One evening, about 10-15 minutes after I had taken the drug, my husband mentioned that he had forgotten to pick up one of his prescriptions. I told him I would go pick it up. The pharmacy is only about 5 minutes from our home. I felt fine to drive.
“I crashed into a mailbox and tree. I never felt sleepy while driving. I have wondered if a study has been done regarding the number of traffic accidents/violations that have occurred after taking zolpidem.”
This story suggests that zolpidem for insomnia can sometimes have tragic consequences:
“My sweet sister took zolpidem prescribed by her family physician. She was a person who trusted her doctor’s advice.
“She apparently walked in her sleep and got into her car after midnight on at least five separate occasions. She was stopped by police in five separate towns, each time but the last. She was driving too slow, cooperative, not drunk, but acting dazed each time.
“The last time, she drove to the top of a bridge and went over the side at two o’clock in the morning. Her body was found that night in the water. Our family was notified and devastated over her apparent tragic ‘suicide’.
“That night she had told a neighbor how excited she was for the next day because her young adult son was coming home for a visit. Our only clue to what was happening were a few late-night phone calls that were a bit unusual.”
Bizarre Behavior Under the Influence of Zolpidem for Insomnia:
Some people report unusual behavior that they cannot recall.
Another reader commented:
“My psychiatrist prescribed zolpidem as an aid to eliminate depression-induced insomnia. Within a few short months, I experienced a night-eating episode.
“One morning I woke up out on my back porch (I had gone to sleep in my second-floor bedroom) and my mouth was filled with blue-black bits which I first thought to be cockroaches. I had no idea how I had gotten out on the porch.
“When I went in the house to look in the mirror to see what was in my mouth, I saw the blue tortilla corn chips strewn about. I blamed my cat, Winston, who loved them, until I saw them in my own mouth in the mirror.
“I was horrified, having not one shred of a memory of even awakening in the night. I later found the bag stashed in the refrigerator. (I usually keep the tortilla chips in the pantry.)
“I discussed this at my next appointment. My doctor immediately took me off the drug and told me that I was the fourth person in two months who had had a scary nocturnal episode like mine. She would no longer be prescribing it as a result. To experience the complete loss of control over your behavior and also your memory of the event is frightening indeed.”
Stopping Alprazolam or Zolpidem Too Fast:
No one should ever stop zolpidem or alprazolam suddenly without medical supervision. A gradual taper in dose may assist in reducing withdrawal symptoms, such as rebound insomnia or anxiety.
To learn more about managing insomnia without medication, you may wish to consult our eGuide to Getting a Good Night’s Sleep. This online resource is available in the Health eGuide section of the website. You will also find a free guide to Psychological Side Effects. It was written some time ago but describes the potential complications of benzodiazepine withdrawal and provides some insights on gradual tapering.
Please share your own experience with benzos like alprazolam or clonazepam in the comment section below. Are you dependent upon zolpidem to get a good night’s sleep? What about other sleeping pills? Have you ever experienced any complications from such drugs or have the benefits far exceeded the risks?
How are you coping with the psychological stresses of the coronavirus? We would very much like to hear from you and learn about your coping strategies.