gunner asked
Can I skip a day of Ambien CR 12.5 mg? I have been taking it for 2 days.
Answer
Ambien (zolpidem), a schedule IV controlled substance, has been reported to cause physical dependence and withdrawal symptoms if stopped abruptly after taking the medication consistently for long periods of time. If they do occur, they tend to happen within 48 hours of discontinuing the drug. However, most studies, and the prescribing information for the drug, state that withdrawal symptoms are relatively uncommon (less than 1% incidence) and generally not serious.
In regard to skipping doses of Ambien, that usually will not present a problem if you take medication on an "as needed" basis, and not every night. Even then, withdrawal symptoms, if they would occur, tend to happen more than 24 hours after a missed dose (but within 48 hours of discontinuation). In fact, Ambien generally is not recommended to be taken consistently so skipping doses is preferred, for most individuals.
Nevertheless, some studies, and the Canadian labeling for Ambien, recommend tapering (i.e. slowly decreasing your dose over time) for individuals who have taken the drug for more than 3 to 4 weeks and want to stop taking it. If you have been on Ambien for a short amount of time, 1 to 2 days, withdrawal reactions would be rare.
There is no single recommended way to appropriately taper Ambien and it is best to speak with your doctor regarding the most practical approaches for you. One study recommends to slowly decrease your dose over a 8 week period or simply switching to another medication for insomnia, such as trazodone or mirtazapine.
Summary
- Long term use of Ambien is associated with physical dependence and may cause withdrawal symptoms if stopped abruptly.
- Withdrawal symptoms however, are relatively rare.
- Taking Ambien on an "as needed" basis is recommended over consistent dosing.
- In certain situations, slowly tapering the dose of Ambien is recommended.
