The most popular sleep drugs today are commonly called the “Z-Drugs”, and Ambien is the most familiar of them all. You’ve probably heard of the various other brand names as well:
- Sonata (Zaleplon)
- Imonvane (Zopiclone)
- Lunesta (Eszopiclone)
- and Ambien (Zolpidem)
For sleep, these drugs have more or less replaced their older cousins, the benzodiazapines or “benzos”. These are drugs with trade names like Xanax, Zoloft, Ativan, Halcion, Valium and many, many others.
These new “Z Drugs” are classified as non-benzodiazapines because although they are molecularly different than their predecessors, but they act in the same way on the same parts of our brain.
The Two Major Difference Between Z-Drugs and Benzos
While both the Z-Drugs and benzos act on four of your brain’s GABAA receptors, the Z drugs are more selective in their targeting of which receptors they excite. This sounds a bit technical, but it really isn’t once you understand that the four different areas elicit four different responses from our bodies:
- alpha 1 – the hypnotic and anticonvulsant receptor
- alpha 2 – the muscle relaxation receptor (some anxiety and anticonvulsant action too)
- alpha 3 – the anxiety and anticonvulsant receptor
- alpha 5 – the memory/amnesia receptor (makes you forget you were awake)
The old style benzos (Xanax, Valium et al) act on all four receptors about the same level, at the same time – so that’s why they have all these major side effects if taken for sleep.
Imovane and Lunesta (Zopiclone and Eszopiclone) act on all these same receptors too (alpha 1,2,3,5) – so the only real difference with the benzos is their half life (explained later). That’s why you don’t see them used much for sleep anymore.
Sonata and Ambien (Zaleplon and Zolpidem) have a high affinity for the alpha-1 receptor (hypnotic – the sleep enhancer), a low to moderate affinity for the alpha 2/3 receptors (muscle relaxation and anxiety) and almost no affinity for the alpha-5 receptor (memory/amnesia). This is the reason that these two drugs are now the most frequently prescribed sleeping meds – they promote the sleeping effect, and not much else (although recent reports of Ambien users exhibiting strange “amnesia-like”behaviorhas put some of this into doubt).
These drugs have another major difference with the old benzos in that they have a very short half life (the time it takes to eliminate them from your body). Benzos can have a half life of 2-200 hours (depending on the specific drug), while the Z Drugs all have a half life range of 2-6 hours.
The most used, Sonata and Ambien, have a 2 hour half life .
They’re Just As Addictive – Withdrawal From the Z Drugs
After long term use (greater than a few weeks) these drugs will cause a physical dependence. So when it’s time to quit, it causes problems. Withdrawal from the Z Drugs is something your doctor will probably never bring up with you – but it’s abig deal!
With their very short half life, it means that you could be withdrawing from a Z-Drug every morning! The withdrawal symptoms might include anxiety, muscle spasms, nausea, headaches, and many other symptoms – symptoms very similar to benzo withdrawal.
The best way to withdraw from a Z-Drug is the same way you would withdraw from a benzodiazapine:
- First, talk with your doctor and tell him/her that you want to get off the drug!
- Have them switch you to another drug, a benzo, at the same potency level. Diazepam (Valium) is recommended. It has a long half life (up to 100 hours), and it’s easy to taper to a progressively smaller dose. You won’t go through withdrawal symptoms after a few hours of not taking the drug, because much of it is still in your system.
- Once your body adapts to the new drug, slowly start to reduce the dose. Week by week, month by month. This is a long process, and has to be thought out carefully. If you do a search online for “non-benzodiazapine withdrawal” you’ll find all kinds of help with the specifics of a taper plan. You have to include your doctor in this plan – because they will be the one writing the prescriptions for you.
- If your doctor won’t play ball with you – find another doctor.
The new Z-Drugs are prescribed all the time for sleep disorders – and they come with a bunch of unwanted side effects (like sleep walking and amnesia). Sooner or later, you’ll discover that their harm outweighs their benefit, and you’ll want to quit.
Sleeping pills of any description (prescription or over-the-counter) only mask the problem – they do nothing to cure it!
Posted by Doug at BuildBetterSleep.com