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Is It Safe to Combine Zolpidem and Alcohol?

By Susan Abe
Updated May 17, 2024
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Zolpidem is a common sleep medication used for the treatment of insomnia. Its primary influence is on sleep onset, accelerating how quickly users fall asleep by hijacking the sedative component of the brain's gamma aminobutyric acid (GABA) neurotransmitter system. Alcohol is a central nervous system (CNS) depressant known for its qualities as a social lubricant by relaxing drinkers and lowering inhibitions. It also uses the brain's GABA system and has dose-dependent sedating qualities. Taking zolpidem and alcohol together is strongly discouraged by the medication's manufacturers and medical authorities because doing so could lead to multiple safety issues and dangerous side effects, including suppression of the brain's respiratory functions.

Despite its efficacy, zolpidem use has caused serious side effects for some people. Sleepwalking, driving while asleep, engaging in sexual activity and other actions performed during sleep have been reported by some individuals on this medication. These amnesia and "sleepwalking" types of side effects significantly increase if zolpidem and alcohol have both been ingested during the same general time frame. The combined effect of zolpidem and alcohol is synergistic — in other words, it is greater than simply adding together their individual effects would suggest. Each substance's side effects are therefore magnified by the other substance.

Zolpidem and alcohol also share other characteristics. Both can cause tolerance in individuals, a condition where greater amounts are required to achieve the same effect. They can also both cause physical dependence — or addiction — with dangerous physical side effects if the drug or substance is withdrawn abruptly. Unusual behavioral changes that are out of character for the individual can also affect users of zolpidem and alcohol. These abrupt personality changes can occur shortly after ingestion of zolpidem in susceptible individuals or after intoxication in the case of alcohol.

One of the gravest concerns for the medical community regarding the combination of zolpidem and alcohol is that of respiratory depression and death. For most healthy individuals, zolpidem is not an issue for respiratory function. Patients with preexisting respiratory disease or documented sleep apnea, however, can be at risk for significant respiratory depression while taking zolpidem. Respiratory depression is also a well-known consequence of overindulgence with alcohol; combined, zolpidem and alcohol present a very dangerous and significant risk for respiratory depression, suffocation and death. It is neither safe nor wise to combine these two substances according to all medical experts and references.

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