Ambien psychosis?

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This past month I have had two patients with serious adverse effects of taking zolpidem (Ambien). Both A/O normally who became apparently psychotic, one violent and completely out of control (requiring sheriffs and the Baker act), and another, an end of life pt who became convinced that she had killed someone years ago and was repeatedly calling 911 because she wanted to turn herself in because of 'immense guilt'. She was awake and seemingly totally lucid, called 911 3x, called her daughter begging her to get the police for her because she needed to confess to this murder... I was sure the police were going to come and that she would tell them what she "did" and they'd arrest her. Both patients 'woke up' from these events hours later, not remembering why any of it happened or what made them do it. Ambien was attributed to be the causing factor in each incident.

I've searched this site for Ambien related topics but couldn't find any regarding these nightmares and psychotic behaviors people report. Maybe it is just coincidence that in the past month I've had two really bad cases with Ambien in patients who are alert and oriented? Does anyone else have any experiences with this?

Specializes in LTC Rehab Med/Surg.

I always ask my geriatric pts if they've ever taken Ambien before giving. If they say "no", I always keep an extra careful eye on them because I've seen Ambien do crazy things to older pts.

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Yikes, I am worried about taking it now. My doctor prescribed 10 mg because of my insomnia. I will often stay up past 2 am and cannot sleep. The Ambien works, but I do notice that I eat alot more before I fall asleep and have gained weight. My husband will not wake up at night, so I wonder if I am doing anything in my sleep, like eating. I use it maybe once or twice a week, usually on weekends when I know I can sleep in. I feel "drugged" when I first wake up, but after an hour or so it wears off.

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Specializes in L&D.

Bgexotics, have you tried taking half an Ambien? I find that it works just as well, and I remember what I did the night before! :imdbb:

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Specializes in NICU Transport/NICU.

My 93 y/o grandfather took it post hip surgery. He was still kind of wacked out form the anesthesia and we thought it would knock him out. Needless to say, I was up until 6am with him doing everything I could to keep him from climbing out of bed all night long.

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Specializes in chemical dependency detox/psych.

My MIL was prescribed Ambien the last time she was in the hospital. We ended up with a 2 am call from the nurses, and my husband had to go and pretty much hold his mom, as she was convinced that there were evil circus performers who were coming in her room to hurt her. Fun times.

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Specializes in Geriatrics, Transplant, Education.

Yes I have! I had a normally A&Ox3 woman (in her 90s) go absolutely batty on it. Working with the elderly, I'm very cautious about using it. Most commonly we use Trazodone or Ativan for sleep. Mostly Trazodone, usually Ativan if they were on it before.

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drugs affect everyone diffrently

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Specializes in Community Health.

YES, I've been on quite a few medications in my lifetime and have never experienced anything like I did on Ambien.

The first time I took it, I was about 15-I attacked my father with a broom because I hallucinated that he was a giant dragonfly. I still vividly remember the hallucination too :eek:.

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Specializes in Oncology.

There's a list of drugs that need to be used very cautiously in older people. I'm curious if Ambien is on it, but can't for the life of me remember the name of the list. Anyone remember?

We rarely have patients over 70. I wonder if that's why I've never seen psychosis from it.

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Specializes in CVICU.

Personally speaking about Ambien, I used to take it occasionally for insomnia. I would get up and make whole meals in the kitchen and not remember it until I woke up in the morning to find a kitchen full of dirty dishes. I once even bought some stuff on eBay and didn't know it until the package showed up at my door! My girlfriend said I would wake up and have entire conversations with her, but I wouldn't remember any of it in the morning.

Aside from that, I have had NUMEROUS patients go bananas after taking Ambien. One patient who had been completely alert and oriented prior to taking it pulled out his dialysis line in the middle of getting SLED. Another patient got confused and thought it was time to get up and go to dinner at 0300 (he kept asking for a couple of hours). He ended up halfway out of bed after taking it. Thankfully he didn't accidentally pull out his new LVAD! The worst experience I had was a 80-something lady, who went from sweet to evil within 30 minutes of taking it. She actually ended up drawing blood on my poor new orient! Keep in mind, these are only a few of my examples!

The saddest thing that has happened related to Ambien, is the death of a friend of mine who took it for insomnia. One night after taking it, she got up and went for a drive in her car on the wrong side of the interstate. She did not have on her seatbelt. She had an accident and died. It was very tragic. Keep in mind, this girl was very familiar with the area, and would not have "accidentally" driven on the wrong side of the road. In addition, her toxicology screen showed Ambien as the only drug in her system. I wholly believe she would still be alive had she not been taking this medication.

My rule of thumb with Ambien is this: If you are over the age of 60, I will not give it to you unless you have taken it before and the doctor has scheduled it for you. For some reason, the elderly seem to be more hostile and aggressive than younger people after taking it. Younger people seem to have more of the "sleep walking" effects. In general, I am hesitant to give it to anyone who hasn't taken it because I have seen so many things go wrong. I will try just about anything else listed under a patient's PRNs for sleep because it seems like 3/4 of the time something bad happens after a patient takes it. If a doctor suggests Ambien for sleep, I will ask for another med for my patient. I HATE AMBIEN.

On a side note, my father takes it every night for sleep and has no problem. I guess if it works, it works, but IMHO, too many people have problems with it, and it's not safe.

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Specializes in Oncology.
There's a list of drugs that need to be used very cautiously in older people. I'm curious if Ambien is on it, but can't for the life of me remember the name of the list. Anyone remember?

We rarely have patients over 70. I wonder if that's why I've never seen psychosis from it.

Found it! It's the Beers List and it's not on it.

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Specializes in Community Health.

You know now that I think of it, my sister also had a very bizarre reaction to it-she would sleepwalk. My experience was that it put me into a weird, semi conscious state-where my mind was awake but my body was asleep. This happens to me from time to time anyways, but the Ambien made it much worse.

My sister was later diagnosed with narcolepsy, and I am scheduling a sleep study to figure out if I have a sleep disorder myself. It would be interesting if they did a study on people who have these reactions, to see if it might be an interaction between the medication and an underlying disorder...It would make sense if that is the case. I know elderly have a lot of paroxysmal reactions to meds because of their decreased ability to metabolize and excrete medications but their reaction to ambien is so bizarre I really am curious about what causes it.

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