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Ambien CR cause depression?
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Ambien CR cause depression?

I had recently posted how my boyfriend had seemed depressed, but ever since he quit taking ambien to sleep at night the past two days he has been a completely different person. He's more like himself and not so down. He had actually gotten to where his voice was just a monotone it was almost like talking to a robot. Today he's had more spirit in his voice if that makes sense. Was just wondering if anyone else had the same experience or is he just having a good day?
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446474_tn?1404424777
Ambien CR Extended-Release Tablets

'All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Ambien CR Extended-Release Tablets:

Dizziness; drowsiness (including daytime drowsiness); "drugged" feeling; dry mouth; headache; muscle aches; nausea; nose or throat irritation; sluggishness; stomach upset; weakness.

Seek medical attention right away if any of these SEVERE side effects occur when using Ambien CR Extended-Release Tablets:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the hands, legs, mouth, face, lips, eyes, throat, or tongue; throat closing; unusual hoarseness); abnormal thinking; behavior changes; chest pain; confusion; decreased coordination; difficulty swallowing or breathing; fainting; fast or irregular heartbeat; hallucinations; memory problems (eg, memory loss); mental or mood changes (eg, aggression, agitation, anxiety); new or worsening depression; severe dizziness; shortness of breath; suicidal thoughts or actions; vision changes.'

Hector
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148588_tn?1415247401
My experience with quitting Ambien had not so much to do with depression as falling asleep at inapproriate times (i.e in the middle of the afternoon while driving). Can't hurt to be extra vigilant for the first couple weeks and use another benzo' or pseudobenzo'  to help wean off of it, especially if he's been using it for an extended period of time.
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Avatar_m_tn
Sleeping Pill Death Toll May Top 500,000
By Charles Bankhead, Staff Writer, MedPage Today

Published: February 27, 2012

Reviewed by Zalman S. Agus, MD; Emeritus Professor, Perelman School of Medicine at the University of Pennsylvania and Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner

The use of hypnotic sleep aids was associated with a three- to five-fold higher mortality risk compared with the risk for nonusers, even when the prescription was for a small number of pills, investigators reported.

A prescription for 0.4 to 18 doses per year was associated with a mortality hazard ratio of 3.60 compared with patients who had no prescriptions for hypnotics.

The hazard jumped to 5.32 for patients prescribed more than 132 doses a year, investigators reported online in BMJ Open.

"Rough order-of-magnitude estimates ... suggest that in 2010, hypnotics may have been associated with 320,000 to 507,000 excess deaths in the U.S. alone," Daniel F. Kripke, MD, of the Scripps Clinic in La Jolla, Calif., and co-authors wrote. "From this nonrandomized study, we cannot be certain what portion of the mortality associated with hypnotics may have been attributable to these drugs, but the consistency of our estimates across a spectrum of health and disease suggests that the mortality effect of hypnotics was substantial."

Patients who used hypnotics most often also had an increased risk of cancer, with an overall cancer increase of 35% among those prescribed high doses.

More than 30 years ago, investigators in an American Cancer Society-supported study showed that both cigarette smoking and hypnotic use were associated with excess mortality (Arch Gen Psychiatry 1979; 36: 103-116). But the link to hypnotics was largely discounted because the study was not designed primarily to examine these drugs, Kripke and colleagues wrote.

Subsequently, at least two dozen studies examined the mortality risk associated with hypnotic use, and two-thirds of the studies demonstrated significant (P<0.05) associations. Lack of uniformity across the studies precluded a meta-analysis, but 22 of the reports showed a mortality hazard ratio that exceeded 1.0, the authors continued.

Previous studies had several notable limitations, including limited information on the specific types of drugs, confounding with tranquilizers, lack of monitoring of the quantities of drugs provided to patients, and limited data on newer short-acting hypnotics, such as zolpidem, zaleplon, and eszopiclone (Lunesta).

To address some of the limitations of previous work, Kripke and colleagues performed a matched-cohort study based on longitudinal data from a large U.S. health system.

A query of the database identified 10,531 adult patients who had at least one prescription for a hypnotic drug from Jan. 1, 2002 to Sept. 30, 2006. Using the same database, the authors matched the hypnotic-user group with 23,674 patients who did not have a prescription for a hypnotic during the period studied.

Three-fourths of patients prescribed a hypnotic had an explicitly stated sleep-related indication in their records.

Women (mean age 54) accounted for 63.9% of hypnotic users. Hypnotic users and the control group had been followed for about 2.5 years. The users had a mean morbidity score of 1.53. Zolpidem was the most commonly used hypnotic (4,338), followed by temazepam (2,076).

Overall, 6.1% of hypnotic users died during observation, compared with 1.2% of the nonusers. Hypnotic use was associated with a significantly increased mortality risk (P<0.001). The magnitude of the hazard ratio increased with the number of pills prescribed per year (P<0.001 for all comparisons versus nonusers):

    HR 3.60 for 0.4 to 132 pills

Separate analyses of the two most commonly used hypnotics showed a similar increase in the mortality hazard. For zolpidem the hazard increased from 3.93 for patients who took 5 mg/year to 130 mg/year, to 5.69 for patients who had prescriptions for >800 mg/year (P1,640 mg/year (P132 pills) had an increased cancer risk (HR 1.20, P=0.022; HR 1.35, P<0.001).

For individual drugs, only patients in the top category of zolpidem use had an increased cancer risk (HR 1.28, P=0.023), whereas the two top categories of temazepam use were associated with an increased mortality hazard (HR 1.44, P=0.024; HR 1.99, P<0.001).

The authors acknowledged limitations to this research, most notably that residual confounding could not be fully excluded "due to possible biases affecting which patients were prescribed hypnotics and due to possible imbalances in surveillance."

They also pointed out that cohort studies may demonstrate an association but do not necessarily imply causality. However, "the preferable randomized controlled trial method for assessing hypnotic risks may be impractical due to ethical and funding limitations," they said.

"The meager benefits of hypnotics, as critically reviewed by groups without financial interest, would not justify substantial risks," the authors wrote. "A consensus is developing that cognitive behavioral therapy of chronic insomnia may be more successful than hypnotics.

"Against meager benefits, it is prudent to weigh the evidence of mortality risks from the current study and 24 previous reports, in order to reconsider whether even short-term use of hypnotics, as given qualified approval in National Institute for Clinical Excellence guidance, is sufficiently safe," they added.

http://www.medpagetoday.com/PrimaryCare/SleepDisorders/31391
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766573_tn?1365170066
"The authors acknowledged limitations to this research, most notably that residual confounding could not be fully excluded "due to possible biases affecting which patients were prescribed hypnotics and due to possible imbalances in surveillance."
___________________________________

I think it is probably a good idea to appreciate "residual confounding" in articles like this:

http://www.pmean.com/10/ResidualConfounding.html



Then:
http://general-medicine.jwatch.org/cgi/content/full/2012/313/1
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2203249_tn?1338994046
Thanks. He hasn't been on ambien that long, he use to only take it occasionally when he just couldn't sleep because before this treatment he slept pretty good usually. He had been taking them more often recently due to not being able to sleep at night. He hasn't took any in 3 days now and has been a completely different person...THANK GOD! Has more energy and isn't so down feeling he says. Still waking up quiet a bit in the middle of the night but said it's better than feeling down all day long lol. Thanks for the suggestions and info...you guys are the best :)
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Avatar_m_tn
I took Ambien every day for many years. I stopped Ambien after reading the above article. I never posted it because, like all studies, it has its limitations and I didn't want to scare people. When I saw this thread I decided to post it. It's just another piece of information to hopefully help to inform people.

Mike
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Avatar_f_tn
My husband took Ambien for several years and did many things that he did not remember doing. At first it was little things like being up all night cleaning then things got worse, he began being being very aggressive towards me, our children and would acuse me of lying about what he had done. He started cutting himself and waking up the next morning wondering what had happened, but continued to take the Ambient. On April 6, 2012 I woke up and found he had committed suicide. I will live the rest of my life wondering if he really wanted yo die or if I would have found him in time if he would even remember. I was married to him for26 years and I know Ambient played apart in his suicide.
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