Meds to given instead of ambien?

Nurses General Nursing

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I gave a patient ambien because the pt. requested something to help her sleep. This is in an ICU recently extubated (day shift). Currently on 2L NC. Pretty much at this point just making sure she remains stable then transfering her to another unit. But anyway I gave her ambien thinking it would help her sleep and it did for about 30 min until she woke up and started trying to take her gown of and "re-dress herself." Though she was technically oriented x3 she could tell me where she was, who she was and situation. She thought she had a dress on and thought she had to call the person who mows her lawn. What medication would have been more appropirate? Any suggestions?

Specializes in Critical Care.

Oh, and someone mentioned melatonin. I've never seen it in in the hospital, but I like it a lot. I've used it at home a few times. Works well. But long term or high doses are supposed to cause changes with the levels of progesterone and estradiol.

But I bet that most docs don't prescribe it since it is a herbal medicine, lol

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Specializes in PACU, OR.
Oh, and someone mentioned melatonin. I've never seen it in in the hospital, but I like it a lot. I've used it at home a few times. Works well. But long term or high doses are supposed to cause changes with the levels of progesterone and estradiol.

But I bet that most docs don't prescribe it since it is a herbal medicine, lol

At my age, progesterone & estradiol levels are not too much of a problem :rolleyes: but I would like to find some natural somnolent that does not make me feel like a zombie the next day! My insomnia is only mild and occasional...do you perhaps have a trade name for reference? A lot of the stuff you guys get is not available on our market.

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Specializes in LTC.

I was the person who mentioned melatonin. I don't work in a hospital, but in a TCU.

Melatonin is the new sleeping med being used on our unit. About two months ago the most prescribed sleeping pill was trazodone. Our patients have to sign consents for psychotropic medications saying that they understand the side effects and consent to us giving the medication. About two months ago we had a rash of patients who refused to sign the consent forms, but still wanted a sleeper at night. We came up with melatonin as an alternative. It has worked so well that it's now become our house NP/MDs standard sleeping pill.

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Specializes in ICU, Telemetry, PACU, Med-Surg.

At our facility we give a lot of xanax and halcion for sleep.

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Besides what everyone else has mentioned, if worse comes to worse, you could always just have the patient purchase an over-the-counter (OTC) drug from CVS or another big-name pharmacy. That's what a couple doctors suggested to me two years ago, after both Ambien and Trazadone had me oversleeping and hallucinating. (And yeah, I had similar experiences on Ambien. Like, waking up in the middle of the night and stripping, trashing lingerie and scarves, speaking to my family in a harsh and thoughtless way, and a lot more -- it was all unintentional. I didn't even know it was happening until the next day.)

So finally, the first doc said, "They do sell the OTC meds at CVS or Walgreen's. You could pick one or two up. They work." And they do... although I don't need them anymore. Kept me asleep for 8-10 hours straight.

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Specializes in Home Health Care.

I've seen a lot of Sonata given .

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Specializes in Community, OB, Nursery.

Most of the time when we give a sleep aid, it's to one of our long term antepartum patients, so we're somewhat limited in what we can give. Our med of choice is Ambien, but I have also had a few patients (not many) tell me they apparently did things in their sleep they had no recollection of doing. Nothing like lighting candles, but still disconcerting.

We've also used 25-50mg Benadryl with good success.

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Specializes in Professional Development Specialist.

As a dayshift nurse I haven't given much ambien, I knew there were side effects but not that they were so prevalent. Interesting! I have seen melatonin fairly often. Our docs seem more likely to agree to melatonin than Benadryl.

Personally I used Benadryl a whole lot when I first started in nursing and was awake all night worrying about my patients and my next shift. :lol2:

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I have insomnia myself and have tried a lot of things......I hate Ambien personally. I makes me feel like I'm in the twilight zone and do things I have no recollection of and feeling like crud in the AM. I tried Lunesta and it was a lot better. No crazy side effects as long as I kept it low dose. But it's expensive and I lost my insurance. So I had to figure out how I was going to sleep---I had tried Benedryl a lot in the past and built up a tolerance to it basically. I decided to try Melatonin. It helped some but it was when I decided to take 50mg of Benedryl WITH the melatonin (6-9mg) that I found that really helped and left me with no side effects and feeling good in the AM. --For an ICU patient I would think avoiding any meds that have the risks Ambien and Lunesta have is a good idea. I tried Trazodone once--only 50 mg--and it made me sick to my stomach and I felt hung over in the AM. Again not good for an unstable ICU pt.

Benedryl/Melatonin seem to work as well if not better and are safer. And I have pretty bad insomnia. Talk to the docs and see what they think.

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Specializes in ICU.

Ambien can be a little scary in the older population. We have AAOx3 patients ripping out lines, trying to get OOb and not remembering a thing.

Restoril 15mg is pretty decent. Doesn't make them too loopy.

I personally am a fan of xanax. Helps me sleep like a charm personally. Tried Ambien only to be awake one hour later! Xanax relaxes me and put sme ot sleep at a small dose. but I guess that's not it's primary indication, but you need what works for a patient. A certian house MD at my facility will order benadryl... That would be funny for me, because i bounce off the walls with benadryl!

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Specializes in ORTHOPAEDICS-CERTIFIED SINCE 89.

Every body does realize you need an order from the doctor or NP before you can give any of these?

I personally have had that out of body experience with the Ambien CR. 1/2 tablet and I was eating ice cream on my sofa at 2 am in my husbands T shirt and my underpants. My gown was in the bathroom. I will NEVER take ambien again.

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Specializes in ICU, Telemetry.

From what I've seen, Ambien does this: 30% of patients take it well, it works, no wonkyness noted; 30% take it, and it does zip for them (I'm in that category, didn't even make me yawn); and about 40% seem to go stark raving bonkers (all the way from singing to their imaginary friends to galloping naked thru the nurse's station screaming "The British are Coming!"), but these same folks report how "well" they slept the next morning. I campaign for pretty much anything BUT Ambien in ICU, I'd rather give a Restoril/Benedryl combo. That will pretty much take down anybody that doesn't have a history of some sort of chemical dependency, and doesn't take out their resp. drive.

Of course, in ICU, we can always introduce you to our little friend Diprivan, but then you have to be on the mean old vent....and I've seen folks who needed 80 of dip to keep them from busting out of restraints and yanking their tube out, with boluses required if you were going to turn/reposition/bathe/dressing change....

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