Tapering Ambien (Zolpidem) and Benzodiazepine Withdrawal with Medications for Insomnia

Published 2022-12-30
Dr. Pagnani of Rittenhouse Psychiatric Associates discusses tapering of benzodiazepines and other sedative medications, when a patient has taken them for long periods of time, and at escalating doses. Often patients are put on medications for sleep (with good cause), but providers and patients should always be considering whether the medication is doing more harm than good, or whether the medication can be decreased or tapered off. In his example, a patient's dose of Ambien had escalated to the point where they were physiologically addicted to the medication being in their system throughout the day (leading to withdrawal anxiety during the day, and leading to their night time doses). Physiologically, this is very similar to alcohol withdrawal, in an individual who drinks daily, throughout the day.

Dr. Pagnani is the founder and medical director of Rittenhouse Psychiatric Associates, an Instructor at The Johns Hopkins Hospital for the Department of Psychiatry, he supervises psychiatric residents at Jefferson Hospital, he serves on the Young Professional Board of Uplift, the Center for Grieving Children and he maintains a private practice of Psychiatry in Philadelphia where he sees patients for one-time psychiatric evaluations and second opinions. He is a licensed physician and surgeon in NJ, PA, NY, MD, DE, FL and CA and can provide consultations to individuals via HIPAA compliant Telehealth visits living in these locations.

Rittenhouse Psychiatric Associates is a private practice of psychiatry consisting of about 25 psychiatrists, psychiatric nurse practitioners and psychotherapists with physical locations in Philadelphia and Paoli, PA and serving all of PA, NJ, NY and FL virtually via HIPAA compliant tele-psychiatry. Individuals seeking not only evaluations but long-term psychiatric care, can contact Rittenhouse Psychiatric Associates directly.

These videos aim to increase awareness and discussion of mental health topics and to encourage struggling individuals to schedule an appointment directly with a mental health provider. Mental health needs to be normalized, and simply speaking about mental health topics openly, is an important first step.

Dr. Pagnani and Rittenhouse Psychiatric Associates are NOT advocating for or against the use of any mentioned psychiatric medications for any specific individual. Additionally, any side effects mentioned are not a complete list of potential side effects or contraindications to taking any mentioned medications, and all risks and benefits of a medication should be discussed with an individual’s provider at an appointment, before starting, stopping or making changes to a medication regimen.

This video is INFORMATIVE ONLY - NOT MEDICAL ADVICE.

If you are researching a specific topic, please view our Youtube channel, click all videos and use the search function. Please also visit and follow us on instagram and FB: @RittenhousePsych.

www.RittenhousePA.com
www.ChrisPagnaniMD.com

All Comments (21)
  • @magamaga1827
    About 5 years ago kicked a 10 yr addiction cold turkey. Suffered from back/neck pain so ambien was really only way to sleep. After a few years, needed to add mg's by ordering pills online from black market as one 10mg legit ambien would have no effect. Then started adding alcohol. lol. Total mess. Sadly my mother developed Alzheimers/Dementia and needed full 24/7 care between me and my dad. I moved back to parent's house and cut out the ambien cold turkey. Had to. No choice. My mother was up at all hours of the night so would have been a waste of time. Low and behold, after 2 weeks, I reverted back to normal sleep patterns, usually falling asleep on my couch watching Tv late at night then moving to the bed. I still don't sleep great nowadays but I can get by without the Ambien. Sadly my mother passed but I believe her getting sick was a blessing in disguise from God to save my life.
  • getting off alcohol is child's play compared to benzodiazepines.
  • Thank you so much for this video. You did a great job, by the way. My dad is severely hooked on Ambien. It's such a real thing. He's withdrawing before his next dose. He's been so out of it and is using it more for pain relief to knock him out. We think it's causing his pain and making him worse. It's very scary. He's 75. We're trying to get him into treatment however, it might not be possible. He might not be ready yet. 🙏🏻
  • I was prescribed 2mg Xanax for sleep I was taking as prescribed for 10+ years. As of today I’m 12.5 years free from the Xanax handcuffs. It was very tough but well worth it ✊
  • I’m only 22 and I’ve been taking ambien since I was like 17. I’m really only addicted to the good feeling I get when it kicks in even though it doesn’t last long. I want to try to stop
  • @scuzznado6540
    I took 18 over the pat 5 days. Taking them correctly is not emphasized nearly enough. I feel drugged, anxious, hostile, have had terrible nightmares, and other effects I don't care to discuss. Please be careful people.
  • I get 10mg a day. Work 3 12hr shifts a week, night shift traveler. I been on ambien for like 15 years, on and off. Would say I spent 9 years total on during that period of time. So have stopped taking it 4 different times. And as u get older, it gets worse. I would get them to adjust schedules working night shift. But would abuse them too, its nice to just take some if u want to sleep. Then take another if u want to sleep longer. I would abuse first week i got refill, take like 2-3 on days I didn’t work. Then just try to take halves after work nights. I would always save a half for for days I worked. Well I left some in a hotel, couldn’t recover them. I had none saved up and had like 10 days until refill. It was awful. Just so agitated and short tempered. And I’m like the most non confrontational and easy going person. I had none to sleep in between work nights, no chance of falling asleep longer than a few mins at a time. If u come off ambien, just don’t plan on getting any sleep until ur completely exhausted. And don’t listen to much music before. Cause I literally hear songs playing over and over in my head. I randomly picked Amityville on a YouTube suggestion, and omg it’s awful. Just kept hearing Eminem say, “mentally ill from amityville” then would be able to recite whole song in my head and heard it once in last 10 years. Guess the call it earworms. I don’t ever remember having withdrawals before. Maybe hangovers from taking too many, never did I feel so depressed or angry like this. And I don’t remember songs and sounds messing with me. I can see how people go crazy and do some sick stuff from abusing drugs. I feel as u get older ur mind becomes weaker and more vulnerable. And it’s not the getting high part that creates mental illness, its the detoxing part.
  • You left out difficulty breathing... hyper-ventilating... headaches, nausea, flu-like symptoms, and body twitches, especially in the legs. And good luck trying to sleep. You're basically incompasitated until the withdrawl is over which can take months from Benzos. Nobody should ever be made to stop benzos cold turkey. You must slowly taper over a period of around a month or more. Depending on the person.
  • @ambernord2892
    Ambien is a sedative hypnotic, not a benzodiazepine. However, it works on the gaba receptors very similarly to a benzo. Just felt like it is important to clarify that.
  • Ambien and melatonin and wake up perfect and perky. No side affects, deeeeep REM sleep is what the body needs. Like eating a healthy salads, vegetables, good diet, exercise...meds like Ambien can offer a healthy nights rest. Works for me.
  • @sl4983
    Ssri's cause a strange feeling. They mess with you mentally. Ambien doesn't do that.
  • Been on 10mg Zolpidem for about 10 years. Started by using a pill splitter to cut in half to 5mg, added an otc “Unisom”. Now I’m at 5mg, currently splitting that, plus a Unisom. First few nights after each reduction was rough, but that passed. Hoping to eventually get off sleeping aids completely.
  • I wish you were my doctor ! Cold turkey abien and Ativan . I have Akasthisia from an ssri and have to taper klonopin . I’m in gods hands now ! Great videos !!!
  • Hi am addicted but my doses is much higher. I am starting the journey to taper off, also been on it for 10+ years.
  • Switch out Ambien with an SSRI??Thats like trading seed oils for Doritos! All I want is sleep and anxiety reduction from childhood trauma! Yeah I was prescribed Paxil and gained like 50 pounds. Paxil is like the hardest thing to wein off of but I did it why? Because i hated the weight gain, and I wasn’t depressed! People deserve a healthier solution!
  • @sl4983
    So, what if someone has been a long time user of a sleep med, it works absolutely perfectly for them, no side effects, completely restful sleep upon waking. Why should they stop?
  • @chryst9876
    I'm currently experiencing insomnia from Xanax withdrawals. I went to a doctor and he prescribed ambien for 10 days and melatonin for 30 days. He also told me to keep cutting down my Xanax dose. I took the melatonin last night and I'm still up. I'm scared to take the ambien because I dnt want to be dependent on it too. Would you suggest that I take the ambien while going through Xanax withdrawals because my main symptom in insomnia?
  • @harbinger2838
    I abuse. I'm taking 50 mg per day (24 hours). Once I stop and afte around 4-6 hour I break out in a cold sweat and then the fun begins. I've never seen it through but how long is this terrible withdrawal and then what happens??I'm sure you can free speak on utube.