Tuesday, May 12, 2009

The Ambien Effect

I take a lot of very nasty medications due to issues of body beyond my control. Some of them are stimulants, or have the side effect of being a stimulant. When you take prescriptions such as these, emotional stability and sleeping become prime issues. And so my doctors, years ago, prescribed me mood stabilizers, and gave me a prescription to sleep by.

This information is from the New York Times:

With a tendency to stare zombie-like and run into stationary objects, a new species of impaired motorist is hitting the roads: the Ambien driver.

Ambien, the nation's best-selling prescription sleeping pill, is showing up with regularity as a factor in traffic arrests, sometimes involving drivers who later say they were sleep-driving and have no memory of taking the wheel after taking the drug. (
http://ambienlawsuit.com/ )
I was and remain grateful for the help. It's one thing to not sleep for a day-or-three, or even for a week to ten days, but it's an entirely different matter when you may not get more than two to three disrupted hours of sleep a night for a month or more. I started taking Ambien with pleasure. I suddenly was able to get a full eight and wake up unimpaired.

From the Washington Post:

Sleep researchers have reported an unusual number of incidents of sleepwalking in people taking Ambien, the top-selling sleep aid in the U.S. The Food and Drug Administration has received similar reports. Some incidents involve eating or driving while asleep; some have led to criminal charges. No conclusive link between the drug and the incidents has been established.

· Ambien maker Sanofi-Aventis says the side effect is rare and the medication is safe and effective when used as directed. The label strongly cautions patients not to use alcohol while taking the drug. ( http://www.washingtonpost.com/wp-dyn/content/article/2006/03/13/AR2006031301315.html )

I went on like this for years. Taking one Ambien CR at bedtime without issue. Expecting to get a good night's sleep and reap the benefits of the same the next morning. Respectable people like Colin Powell were taking it; why shouldn't I?

From the Washington Post:

The case of lifelong insomnia sufferer Janet Makinen is typical of the Ambien incidents.
The 55-year-old resident of Dade City, Fla., said she took Ambien nightly for six years. During that time, she regularly got out of bed after having fallen asleep, went to the kitchen and ate, she said.

"I went from wearing a size 1 to wearing a size 12," Makinen said. "I would eat raw eggs. I would eat a half-gallon of ice cream. I would eat a bag of potato chips, a loaf of bread."

She would find evidence of her night eating afterward, she said, but had no memory of doing it. ( http://www.washingtonpost.com/wp-dyn/content/article/2006/03/13/AR2006031301317.html )

I first had a gut feeling something was not quite right about eight months ago. Suddenly I had nightmares. And the feeling that I might not have been in bed all night long. But I could remember nothing, so I dismissed the idea as ludicrous.

From the Washington Post:

Ambien may render some people unable to awaken completely even when something significant disturbs their sleep, so they enter the state of partial arousal, some experts say. "It is the case, perhaps, of an unstoppable force meeting an immovable object," said Michael Sateia, chief of the Section of Sleep Medicine at Dartmouth-Hitchcock Medical Center in Lebanon, N.H., and past president of the American Academy of Sleep Medicine.

According to Stacia Sailer, medical director of the Sleep Disorders Center at the University of Massachusetts, Amherst, some people taking sleep medications (not just Ambien) can, in that partial state of arousal, carry out many routine activities. The case of Lt. Judith Renee Lasswell, 39, a Navy intelligence officer stationed in Tampa, included several bizarre incidents, including a case of alleged shoplifting that threatens her military career.

According to the complaint in the class-action suit, she once wandered into the intelligence center where she works talking incoherently, and her colleagues led her back to bed. She said she has no memories of the episode.

But most damaging was an incident last September when, after taking Ambien, Lasswell said she sleepwalked into the base exchange, carrying several DVDs which she had purchased previously or rented from the base library. After returning an "X-Files" DVD to receive store credit, she was approached by base police, who claimed she had taken the DVD off the shelf, failed to pay for it and returned it for credit. She was handcuffed and charged with shoplifting DVDs and a candle.

Lasswell said she has no memory of the incidents.

According to the complaint, Lasswell's top-secret security clearance was subsequently revoked, and she faces larceny charges and a dishonorable discharge. A 17-year Navy veteran, she risks losing her pension and severance pay.

"I've never had a problem before in my life until I took Ambien, and it's literally ruined my career and everything I ever worked for," Lasswell said in a statement. "I have gaps in memory from the whole time I was on Ambien, which is very terrifying."

In January, Lasswell requested a polygraph test to support her defense in the military judicial process. According to the test report, a copy of which was provided by Lask, Lasswell denied intending to steal and falsely claiming store credit, and said she did not remember the events related to the incident. The polygraph examiner found "no deception" in her responses, according to the report. (
http://www.washingtonpost.com/wp-dyn/content/article/2006/03/13/AR2006031301317.html )

About six months ago, I awoke to find a box of Special K in my bed with me. Still factory sealed so I hadn't eaten anything, but it was disquieting to find it there at all. I decided to tell my Therapist that I had a feeling I might be sleepwalking. He told me to talk to my doctor, and reference the Ambien.

I didn't. It was just too crazy; me sleepwalking. And the Ambien? How could that be? I had taken it for years with no issue. At least I think there wasn't an issue.

From Medical News Today:

posted by Dr. Arnold Swathier on 20 Mar 2006 at 6:05 am

I have lots of patients on Ambien. At least half experience either sleepwalking, memory loss or problems driving. For the makers to say these side-effects are rare, is a joke!!! (
http://www.medicalnewstoday.com/youropinions.php?opinionid=8726&p=2 )

Later that month, my Rheumotologist refused to refill my Ambien prescription unless I came in to see him. At the appointment, he was fairly insistent that I try a different sleeping medication. He did not mention the sleepwalking reports. I didn't mention my suspicions about myself either.

I was agreeable to trying anything he suggested, but after two weeks on the new med during which I was terribly groggy all day long, we agreed that it wasn't working out well, and he said to go back to taking Ambien.

From the Wisconsin Law Journal:

The main characteristic of Ambien-impaired drivers was that they drove well below the speed limit and kept driving until they hit something, according to Johnson.

“The slow speed was very common, and essentially driving until you couldn’t drive anymore. They tended to run into a stationary object, like a light pole or parked car,” he said.

In five cases in which no alcohol or other drugs were found, Johnson said, police reported that the Ambien-impaired drivers shared the same zombie-like characteristics.
“They seemed very much disoriented; their eyes wouldn’t focus on individuals,” he said. “They would just look right through a person.” (
http://www.wislawjournal.com/archive/2006/0426/ambien.html )

My Ambien was becoming less effective. It would sometimes take a couple of hours to work. I was not sleeping for a satisfactory length of time. And my nightmares became profuse.

From Fox News:

Perhaps the strangest of these behaviors is sleep eating. It was first reported in 2002 by Michael H. Silber, MD, co-director of the Mayo Clinic Sleep Disorder Center. Silber is the president-elect of the American Academy of Sleep Medicine.

"What happens is the patients get out of bed, walk to the kitchen, prepare food -- often sloppily, and often with strange, high-calorie ingredients," Silber tells WebMD. "They have microwave food sometimes. They eat in a very sloppy way, either in the kitchen or after taking the food back to bed. And they have no memory of it. They wake to find a mess in the kitchen or crumbs in the bed."

In each case, Silber says, the patient took Ambien as prescribed. At the time of the 2002 report, Silber had seen no more than five cases. He now has seen some 20 cases of sleep eating in patients who took Ambien as directed.

"It could be injurious -- but I have not had anyone who set the kitchen on fire," Silber says. "The most important thing is the severe embarrassment and discomfort these patients experience. And some put on a lot of weight due to high-caloric sleep eating. We have some patients who have had it happen often -- in one patient, more than once a night." (
http://www.foxnews.com/story/0,2933,188040,00.html )

I started having periods of time just before the medicine worked that I was conscious, but would go into the kitchen and eat pretty-much anything in sight. I didn't care. My weight started increasing significantly. But the weight gain was still out of line with what I know I ate. I cared when I got on the scale each morning. And I cared as my clothes grew tighter.

From CBS News:

Rhode Island Sen. Patrick Kennedy said he was asleep when he crashed his car, also in 2006, before the warning labels for sleep driving. He claimed he was not drunk, but blamed it on Ambien. (
http://wcbstv.com/health/sleep.driving.ambien.2.1007314.html )

My sleep patterns became more erratic. I would also regularly look for food in my refrigerator that I "knew" was there, but it wasn't. Since there was no evidence of me having eaten it (no wrappers), I figured that I probably was mistaken about my inventory.

I started waking up in the morning with scrapes, bumps, and bruises. I had no explanation how they occurred. I would also often wake up with my condo in disarray. Objects moved, beads spilled, TV remotes missing.

I suspected that I might have started sleepwalking on a regular basis, but did not tell anyone. Crazy people sleepwalk. I did not want to be identified as nuts.

From the Post Crescent:

OSHKOSH — A sleep aid that a Black Wolf woman believes contributed to the disappearance and ultimate death of her husband has previously been linked to episodes of erratic behavior including sleepwalking and sleep-driving.

Cherie Merkes believes the prescription sleep aid Ambien CR played a role in her husband Michael's disappearance more than two weeks ago, noting her husband began taking the medication just a few weeks before he disappeared.Michael Merkes body was found in the Fox River last week, just downstream from where he'd parked his car after leaving the Merkes' house on April 25.

If Michael Merkes, 55, did sleep-drive and sleepwalk his way into the Fox River as his wife believes he did, he would not be the first person to display the erratic behavior sometimes associated with the drug. (
http://www.postcrescent.com/article/20090511/APC0101/90511078/1979 )

Last Thursday morning, I awoke to find my condo in greater disorder than normal. I had a long scratch down my left hip. I walked into the kitchen to find three empty boxes of crackers, an empty baguette wrapper, and a 1/2 eaten carton of ice cream on the counter. This really frightened me, as I wouldn't ever bring those foods into my home. I live alone, so there's no way somebody else brought them in and ate them. Additionally I felt overstuffed.

The only conclusion I could come to was my worst-case nightmare. I must have driven to the market, bought those items, brought them home, and eaten them. All in my sleep. I have absolutely no recollection of any of this. But it got worse from there.

When I fired up my computer and checked my e-mail, there were all sorts of invoices from purchases made overnight. I don't like to shop under any circumstances, and certainly rarely-to-never over my computer. When I mentioned this to Eric later in the day, he told me that we had a phone conversation while I was placing one of the orders, and that I sounded perfectly rational. I don't remember that either.

That's where I drew the line. I made an appointment with my Internist for the next day to discuss the situation with him.

From Slate.com:

I did something recently that concerns me on many levels. I am under a large amount of stress because I'm in an unhappy marriage (which we're trying to work out) and because my company laid me off. I am under treatment for depression. A week ago, my doctor doubled the dosage of my antidepressant and, because I'm not sleeping well, he prescribed Ambien. On Saturday morning, I confused the vials and took two Ambien. I told my wife what happened and that I would probably sleep all day and went to bed. At around 10 p.m., my wife commented on how productive I had been: mowing the lawn, cleaning up, grocery shopping. I remembered none of this and said so. She said her only concern was that I left for "errands" and returned two hours later with nothing in hand. I talked to my doctor Monday, and he told me Ambien can cause amnesia and that some people have reported walking, driving, and cooking in their sleep. I know now what filled the missing two hours. This afternoon, I got a call from a woman who called me "lover" and asked when I wanted to come back. She called me her f--k buddy. This is a woman I had talked to only twice before in social situations. I do not even know where she lives; maybe I phoned her for directions. I do find her attractive, but I am stunned that I did something like this. My wife is vindictive, and if I say anything to her, it will end our marriage. I do not want to continue a relationship with the other woman. ( http://www.slate.com/id/2216714/ )

I saw Dr. R- early in the afternoon, and when he asked me what I was there about, I could hardly tell him the story. It was way too embarrassing. He responded by telling me that this is a way more common side effect than the drug company was admitting, and that I was "never to take Ambien again." He prescribed something else to help me sleep.

I queried him again. "You have other patients with the same issues?" He confirmed it. "And how is their mental status other than this? Are they generally sane?"

He responded, "Completely sane."

I have had three nights of only partial sleep on this new drug, but when I wake up in the morning, everything in my condo is where it belongs. My refrigerator seems fuller even though it's a few days since I went to the market. And I have not had any new bumps or bruises either.


LI Laura said...
This comment has been removed by the author.
LI Laura said...

Oops, hit the publish button too fast! Anyway, I suffer from insomnia, and usually only get 4 or 5 hours of sleep (I have problems falling asleep, not staying asleep. If I didn't have to get up for work, I would get a full 8 hours.) I have heard the reports about Ambien, but holy moley! I have not known someone personally who had all the symptoms. I'm glad your Dr. gave you a different med, although I'm sorry it doesn't work as well. I was already leery of trying the meds because of the sleep driving, sleep eating and sleep sex. After your experience, I think I will stick with the insomnia.

Anonymous said...

I'm glad you are off that drug now. I worried about you when you told me, you had to take it. I've read and heard so many horror stories about it.

Greg said...

I recently switched off of ambien to Lunesta. It works very well for me when I take it. Unfortunately, my sleep issue is compounded by my unwillingness to go to bed before 11pm, which when you get up at 5 makes taking the sleep aid a challenge to my morning commute.

Hope the sleep issue improves with the new meds.

janet said...

I walk in my sleep when I'm under stress, usually prolonged stress. The Spousal Unit has put objects in front of the door because he is afraid that I will walk out. Sleepwalking is not an act of crazy, it is just the brain taking over when one is unaware. I'm glad that you got help before anything really bad happened. I hope the new drug kicks in effectively, and soon.

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