A quick look how Ambien actually works. This is why it so successfully

[BleedingHeartPatriot]

promotes sleep.

It affects multiple chemical and neuro-muscular actions that are directly tied to our sleep/wake cycle.

Here's a description of its action...

Subunit modulation of the GABAA receptor chloride channel macromolecular complex is hypothesized to be responsible for sedative, anticonvulsant, anxiolytic, and myorelaxant drug properties.
>snip
....it interacts with a GABA-BZ receptor complex and shares some of the pharmacological properties of the benzodiazepines.

That's it. Just hit as many neurological functions as possible and you are guaranteed to be "knocked out". And stay that way for a while.

However, the human brain is a complex organ. And, when you have this combination of actions, there's no telling how each potentiates the other, especially from person to person.

It appears that the Reticular Activating System, which is a driver for our sleep/wake cycle, is kicking in when a certain threshold occurs for some of those who take Ambien.

It's essentially the brain "fighting" the multiple effects of Ambien by trying to wake up the body. Of course, because the drug's so potent, somnolence, rather than full wakefulness occurs.

When the doctors I work with prescribe Ambien, which is infrequently, it is with lots of discussion with the patients about all this and a continued focus on the underlying physical, emotional or mental reason for the insomnia.

So, yes, it can help with sleep. And, it can be quite dangerous. One of our doctors, who rarely prescribes it, calls it the "Russian roulette of sleep medications."

Just throwing in my two cents on the Ambien discussion. MKJ




http://www.drkoop.com/druglibrary/93/ambien-clinical_pharmacology.html

[elehhhhna]

1. Hub's doc gave him some after shoulder surgery "to help sleep"...

jeez! I thought it was killing him. Snoring like a jet-moose and unable to be awakened. Made him throw that stuff away.

[BleedingHeartPatriot]

2. I'm still predicting it will be pulled from the market. It's just too hit

and miss in people's reactions to the sleep medication cocktail. MKJ

[elehhhhna]

7. Cliff Baxter was on Ambien when he shot (?) himself. (Enron)

[pnwmom]

3. Thank you so much for the clear information. n/t

[BleedingHeartPatriot]

5. YW, it's always nice to have to facts. :-) n/t

MKJ

[sam sarrha]

4. how many unplanned babies are made during Ambian Nympyo dates...??

i was reading and article called,'if you take Ambian it is only a matter of time before you have an Ambian date.' It seems the postmenopausal husbands dont mind so much when their wives wake them up in the middle of the night and 'Did things no woman i ever met did.!!' and it is good for a couple dates a month if you are lucky. :boring: :party: :boring: :woohoo:

[BleedingHeartPatriot]

6. ROFL. Ambien truly is a chemical "cocktail"!

Do the wives remember it, too? MKJ

[sam sarrha]

8. No the wives dont.... but the husbands never will...!!

[sam sarrha]

9. Tryptophan, an amino Acid.. seems to work very well... Link>>

http://www.naturdoctor.com/Chapters/Research/insomnia_tryptophan.html

http://www.vrp.com i got some Ornithine/Arginine 25/75 1000mg from these guys really cheap back in 1984 when i had arthritis like symptoms, i was totally freezing up at 38 years old,it runs in our family. i couldn't walk without 3 canes and couldn't hold on to the canes.. within a week i had no symptoms.. being a research biologist i investigated into this amino acid.. is is a precursor to T Cell receptor inhibiter's.. it is the T Cells that attack the joints not being able to identify those tissues as a non invader.

I quit taking A/O and the symptoms returned withing6 weeks.. i started taking a gram once or twice a month and have not had any problems since. several people i have told about it have had good results..

it is patentable and really cheap so there will be no research done on it..

i am not prescribing anything, i checked this stuff out in the Handbook of chemistry and physics.. and other reference books.. do the same,

i am just sharing a personal experience that ended a Lot of suffering that others are also suffering.. many unaware of alternate options

[eppur_se_muova]

20. If you say only one thing about tryptophan, say that it's found in turkey.

Hence the drowsiness after those big Thanksgiving day dinners. This is how the effect of tryptophan was established, IIRC.

[The Stranger]

10. Someone in the know care to provide info on natural alternatives?

Thanks.

[noonwitch]

11. There's always Cannibas Sativa

I've heard it helps people sleep.

Seriously, though, I've heard that chamomile tea will help you sleep. I don't know, I don't have problems sleeping. When I do, I find that benadryl works pretty well, but that's not exactly a natural alternative.

[SoCalDem]

23. Tv commercials put me to sleep

:)

[Liberal Veteran]

13. My pet peeve: Natural is not a synonym of "good".

In fact, given that you usually end up taking more than just the active chemical with a "natural" alternative, the odds of something going wrong are just as great.

Datura has been used historically as everything from a knock-out drug to an aphrodisiac. But it can also induce hallucinations, respiratory distress, heart attacks and many other things considering the number of alkaloids it contains (the three biggies in that are atropine, hyoscyamine and scopolamine which are all marketed separately for diffently indications).

St. John's Wort increases the effects of many prescription medications including Plavix which is used to thin the blood and can lead to unstoppable bleeding if taken together.

Be as wary of "natural alternatives" as you are with ANY medication.

[BuddhaGirl]

15. chamomile tea, valerian, hops, lemon balm, melatonin

there are lots of natural supplements that can help with sleep - you can find them at a health food store.

[Liberal Veteran]

12. It doesn't really guarantee you'll be knocked out.

I've taken it AND stayed awake with it.

I hate to keep beating a dead horse, but there is ALWAYS going to be a small percentage of people who react a little differently to a medication.

The one thing about Ambien is that it has a very short half life of 2.5 hours. It does the job of helping you get to sleep and then your liver processes it away fairly quickly.

A couple of reports of people who are sleep eating or sleep walking are being blown out of proportion. Ambien has been around for 15 years and if it were that big of a problem, there would be thousands upon thousands of reports of strange occurences.

I've noticed a tendency among some people to pounce on every odd report involving a medications (such as this Kennedy thing and I suspect there is more to it than what he has said) as an excuse to jump on their soap box and bash the living hell out of the pharmaceutical companies.

When you have percentage of incidence which is somewhere in the neighborhood of 1 incident out of a few million, that's pretty safe. It's safer than peanut butter in that respect.

If people went by deaths and anaphylactic reactions to peanut butter the same way people freak out about the tiniest report of a medication incidence, no doubt people would be calling for the head of Jif for peddling poison.

Logically and mathematically and practically, Ambien is about safe a drug as any on the market.

Let cooler heads prevail.

[BleedingHeartPatriot]

14. You make very good points. The wild-card with Ambien, is the

"Nyquil" approach. As you know, as you add one medication property to another, to another, as Ambien does, the odds of a bad reaction to one of these properties increases exponentially.

Certainly, we're seeing an increase in anecdotal descriptions of adverse effects. I think the concern is that these side effects are dangerous, due to the somnolent, amnesiac behaviors associated with the RAS threshold response.

Those particular effects are definitely concerning. I understand that there should be a NEJM study released in the next month or two which will provide metrics to these incidents.

MKJ

[pnwmom]

16. There is no way to know the real safety statistics, since there is no

after-market systematic approach to collecting adverse reports. Doctors are free to report adverse effects if they want to. Most don't bother, or even know when they occur.

During the testing of the drug, about 4% of subjects stopped the medication because of bothersome side effects, but as the drug co acknowledges, the percentage with problems after release to the general market (as opposed to a controlled study) cannot be predicted.

[BleedingHeartPatriot]

24. The two most recent medical practices I worked in had very clear,

sytematic guidelines for reporting adverse effects of medications to the FDA.

In both places, our Clinical Pharmaceutical Doctorate staff had devised reporting guidelines and were able to track these, not only through voluntary reporting, but through our electronic medical records, as well.

They also compiled reports, which they presented quarterly, to the clinicians.

This is a not an isolated model. This is part and parcel of federal guidelines and any clinic setting could be audited to insure compliance with this statute.:shrug:

MKJ

[pnwmom]

26. Top Sleep Medicine expert from Dartmouth College disagrees

http://www.washingtonpost.com/wp-dyn/content/article/2006/03/13/AR2006031301317.html

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.

"Sateia says a lack of solid data on post-approval side effects makes it impossible to know whether the company's estimation of the rate is accurate.

After a drug is approved and marketed in the United States, the FDA accepts (but does not actively solicit) reports of side effects from doctors, patients and drug makers. FDA adverse event report databases contain sleepwalking reports from 1997 through June 2005. (Ambien has been available in the United States since 1993, but sleepwalking events per se were not reported before 1997.)"

My questions: How many small clinics have doctorate level staff devising and monitoring adverse effects reporting? And how can an auditor tell if patients report all adverse effects to doctors, or if doctors write down all adverse effects that their patients tell them about?

I have NEVER had a physician say that he/she was going to report an adverse effect, and in the most serious case (my child had problems for a week after a vaccine), I KNOW the reaction wasn't reported. (My doctor said that the reaction last too long to be a reaction to the vaccine.) My mother's problem with Ambien also wasn't reported.

So I would love to know the specifics of the statute you're referring to.

[BleedingHeartPatriot]

27. It sounds as if the physician, in your case, didn't believe it was a

reaction.

That said, if a diagnosis of a medication reaction is made, it is coded in the record, whether paper or computer.

That code (ICD-9) is the tracking mechanism.

The Clinical Pharm D's are common at most large practices. They are specifically trained to manage exactly this type of data in the clinical setting.

If those reactions are not coded correctly, we are in violation of a host of regulatory agencies statutes. I'll PM you and I can get that information from the Pharm D in my clinic.

I'm really surprised that your physician denied that your child had a reaction. Was it an MMR?

Many medications have been pulled from the shelves due to verified, documented and tracked information. The Rotovirus vaccine was pulled specifically because of documented reactions in children after receiving it.

This is a regulatory requirement that will continue to get stricter as time goes on. MKJ

[KAT119]

22. 'Coffea Cruda' a homeopathic natural med for sleeplessness due to mental

hyperactivity works great for me & family members. Boiron Company-sold @ health food stores worldwide. Dissolve 5 pellets in mouth before sleep and awaken 7-8 hours later deeply rested:-)

[BuddhaGirl]

28. I have used coffea cruda as well

and it worked wonderfully for me :D

[MsTryska]

17. Ambien makes me feel alzheimer-ish the next day.

it does knock you out though.


i was thinking about taking it while on a trans-oceanic flight, but then realized that if soemthing were ot happen to the plane, i might not be able to go into survival mode that quickly.


so i'm hoping for some xanax from my doc instead.

[pnwmom]

18. A lot of travelers do that, but it is NOT recommended, for exactly that

reason. Also, if people are making connections in a "zombie" state, mistakes can be made. But I'm not sure if any sleeping pill would be a good idea in that situation. Your doctor can tell you.

[MsTryska]

19. Yeah - i think all sleeping pills are going to run the same risks...

that's why i'm thinking more of a sedative (like xanax or valium. soemthing to mellow me out past my 4-hour coach-class threshold.

[patcox2]

30. I wouldn't take ambien on a flight, but xanax is perfect for travel.

Ever been woken up after taking ambien? Its horrible, physically and mentally, you are like a zombie, its painful being awake.

Xanax for travel is the best; if I take it, I can fall asleep anywhere, any time, but I can also be wide awake if I want to. I fly to europe a lot, and it really helps, I can sleep through the flight, get up and get to the hotel, nap, and still be alert when I go to dinner that night.

[patcox2]

21. And marijuana has how many psychoactive compounds in it?

I like ambien. It works great for me, no side effects, except you do not want to get waked up in the middle of the night.

[BleedingHeartPatriot]

25. THC? n/t

MKJ

[patcox2]

29. "THCs", there are hundreds of varieties of THC related chemicals.

nt

[Mr_Spock]

31. Marijuana is not like Ambien : therefore, Ambien is good.

I like your logic!

Why don't you want to get waked up in the middle of the night?

[patcox2]

32. I am mocking the conclusion that ambien is bad

simply because it contains a lot of components that affect a lot of processes. Lots of drugs do that.

You would not want to be woken from an ambien induced sleep because its painful, you feel like you weigh a ton and you have suddenly become stupid.

[Mr_Spock]

34. I've experienced the strange & scary world of Ambien sleep

It was so freightening - each time I've taken it I have had the most awful experiences; and unlike normal dreams, it was so real that I was not aware I was dreaming. I had dreams that I went out of my house and arbitrarily attacked people - I was so unaware of my body that I was not sure that I was or could have actually left my bed. Apparently some people do get out of bed and do things. I certainly don't want to go to jail because I did something crazy in a sleep state.

The first time I took it I was not aware of how strong its effects could be and I nearly fell down a flight of stairs as I forcebly dragged my unwilling body to the bed. The past three times I have only taken half a pill, but the "reality bites" dreams are way to real and I cannot wake from them - I found at least one of them psychologically damaging for hours after I woke up. BTW, I understood your "mocking" - just thought I'd smirk right back at ya :D

[seemunkee]

33. Caused major hallucinations with my daughter

Didn't knock her out, made her agitated and started seeing people in the house that weren't there, little blue snowmen, and other weirdness.

[Mr_Spock]

35. I can relate to that

After taking it myself, there is no strange state of being that I would not believe as recounted by someone who took Ambien. I can't begin to describe the super real and physically freightening dreams that I experienced, ever after I cut down to 1/2 pill.

[SOS]

36. My wife too

She was in the bathroom at 6 AM screaming that she was on fire, pouring water on herself.
Went to the ER, diagnosed as Ambien hallucinations.
That drug went into the garbage the minute we got home.