These days, we are bombarded with advertisements for prescription drugs. Many of our patients are taking these drugs. According to Fortune magazine, total 2007 revenue for the pharmaceutical industry was more than half a trillion dollars and its profits were more than $79 billion. As chiropractors, we need to be informed about these prescription drugs so we can educate our patients about their effects, side effects and dangers, as well as suggest safer alternatives when appropriate. (Don't count on their medical doctor or pharmacist to fully inform them.)
Ambien and Ambien CR (Zolpidem tartrate) are prescribed for the treatment of insomnia.1 Ambien increases gamma-aminobutyric acid (GABA), a neurotransmitter that is believed to decrease electrical activity in the brain. Ambien is manufactured by Sanofi-Aventis, the number-one pharmaceutical company in Europe and among the top five in the world.2
Ambien's Web site offers a coupon for $20.00 off your next five prescriptions of Ambien and advocates more than just short periods of taking their drug, despite the fact that its use is recommended for a maximum of 10 days.2 CVS Pharmacy in Bozeman, Mont., where I practice, charges $53.59 for a 10 day supply of 10 mg. tablets.
My PDR lists more than 150 potential adverse side effects from Ambien, including arthritis, back pain, sciatica, joint pain, muscle pain, joint degeneration, migraine headaches, muscle spasm, gouty arthritis, thinking abnormalities, unconsciousness, loss of bladder control, kidney failure and heart attack.3 And Sanofi-Aventis' consumer Web site on Ambien warns that while taking the drug, you could get out of bed, drive your car, make and eat food, talk on the phone, sleep walk or have sex without being aware of what you are doing or having any memory of what you did upon awakening the next morning.2 That sounds dangerous to me.
Psychological factors account for 50 percent of sleep problems. It would make sense to deal with those problems by natural means rather than medicating ourselves. Lifestyle changes can be helpful in reducing insomnia, including regular aerobic exercise and avoiding caffeine and alcohol, particularly later in the day. Passion flower, valarian root, skullcap and chamomile are botanicals that are helpful in inducing sleep.4
I have had good success treating my insomnia patients with 5-hydroxy-tryptophan, an amino acid that is a precursor to serotonin. Tryptophan is best taken with carbohydrates prior to bedtime. High-protein foods should be avoided with tryptophan, as they compete for absorption.
References
- Official Ambien information site.www.ambien.com
- Consumer Web site on Ambien. www.sanofi-aventis.com
- Sifton DW, et al., eds. The PDR Pocket Guide to Prescription Drugs. New York: Simon and Schuster, pp. 65-8.
- Murray MP, Pizzorno JE. Encyclopedia of Natural Medicine. Rocklin, Calif: Prima Publishing, pp. 391-4.
