Both secobarbital, or Seconal, and zolpidem, or Ambien, are medications that are commonly prescribed for the treatment of insomnia when other nonmedical treatment cannot be fully implemented or are not effective.

Though both drugs are similar, each has some characteristics that may make it more or less appropriate for the individual in need of regular, restful sleep. For example, secobarbital is classified as a barbiturate and may also be used to quell the anxiety of a patient before surgery. Comparatively, zolpidem is classified as a sedative-hypnotic drug and is rarely prescribed for any other purpose than the treatment of insomnia. Depending on the effect each of these drugs has on the individual and the use of other medications that may or may not create negative interactions, either Seconal or Ambien may be the better choice.

insomnia help

Function

Secobarbital Secobarbital is a barbiturate that works by slowing down the activity in the brain. This has the effect of allowing the brain and the body to relax enough to fall and stay asleep.

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Ambien Zolpidem is prescribed for the purpose of treating those who have a hard time falling or staying asleep. It is a sedative-hypnotic drug, and it works by slowing down the activity in the brain, which in turn allows the rest of the body to slow down enough to fall asleep.

Dosage Recommendations

Secobarbital

Secobarbital comes in the form of capsules and should be taken before bed when it is prescribed to treat insomnia. It is important to take the drug exactly when and how it is prescribed. It is expected that insomnia should improve within a week to 10 days after starting the prescription. If this is not the case or if there are any issues, including a more difficult time falling asleep or any complications, it is recommended that patients call their doctors.

Seconal should only be taken for the treatment of insomnia for a short period of time, as it loses its efficacy after about two weeks, and the risk of addiction increases as physical tolerance develops.

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Ambien

Ambien may be prescribed in tablet form, in a regular or extended-release version. Zolpidem is also sold as a sublingual tablet and as an oral spray. In any form, it is recommended that patients take the medication immediately before going to bed and plan to stay in bed for at least eight hours.

It is only recommended that patients use Ambien for a short period of time, usually about two weeks. It is expected that sleep issues will stop within 10 days after taking the first dose; however, if this is not the case or if insomnia worsens, patients are advised to call their doctors.

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Missed Dose

Secobarbital

If you miss a dose of Seconal and find that you are unable to sleep, it is okay to take the missed dose when you realize it that night. It is not recommended, however, to take a double dose the following night.

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Ambien

Ambien is to be taken on an “as-needed” basis, which means that if the patient forgets to take the dose at the usual time, it is fine to take it later as long as they will still be able to stay in bed for the prescribed number of hours. It is not recommended to double the dose the following night.

Side Effects

Secobarbital

There are a number of potential side effects that may come with the use of Seconal. These can include:

  • Continued difficulty falling asleep or staying asleep
  • Headache
  • Nightmares
  • Nervousness
  • Restlessness or agitation
  • Confusion
  • Dizziness
  • Nausea and vomiting
  • Constipation or diarrhea

If any of those side effects are experienced, patients are advised to contact their doctors. Additionally, if any of the following serious side effects occur, immediate medical assistance may be necessary:

  • Hives or rash
  • Itching or swelling, especially of the face, throat, eyes, or extremities
  • Difficulty swallowing or hoarseness
  • Slowed or labored breathing
  • Slowed heartbeat
  • Hallucinations
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Ambien

Ambien may cause any number of side effects, including:

  • Headache
  • Lightheadedness or dizziness
  • Gas and stomach pain
  • Muscle pain
  • Nausea
  • Diarrhea or constipation
  • Heartburn
  • Dry mouth and/or throat
  • Red eyes
  • Difficulty with balance and walking
  • Odd dreams
  • Altered appetite
  • Shaking
  • Pain, tingling, or numbness in extremities
  • Pain, ringing, or itching ears
  • Pain in neck, back, or joints

If these side effects persist or if the following serious side effects occur, patients should call their doctors and/or receive emergency medical care:

  • Hives or rash
  • Itching or swelling, especially of the throat, lips, tongue or face
  • Difficulty breathing or swallowing, especially due to throat swelling
  • Hoarseness
  • Nausea and vomiting
  • Chest pain
  • Pounding heartbeat
  • Vision problems

Considerations

Secobarbital

Some medications and nutritional supplements do not mix well with Seconal. Any use of the following should be reported to the prescribing physician:

  • Blood thinning drugs or supplements (e.g., warfarin or fish oil supplements)
  • Antihistamines
  • Hormone replacement therapy
  • MAO inhibitors
  • Antihistamines
  • Doxycycline
  • Painkillers
  • Antidepressants
  • Birth control pills
  • Muscle relaxants
  • OTC medications for colds or allergies
  • Some seizure medications
  • Oral steroids
  • Sedatives, tranquilizers, or sleeping pills

Patients are also encouraged to note whether or not they are living with porphyria, asthma, or another condition that makes it difficult to breathe, and/or liver or kidney disease. These conditions as well as a state of pregnancy or breastfeeding may require avoiding the use of Seconal. Certain types of contraception may be rendered ineffective by the use of Seconal. Older adults may prefer a medication that comes with fewer risks, especially if they are taking other sedative medications. Those who undergo surgery while taking Seconal should make sure it is known that they are on the medication.

Similarly, heavy alcohol use or use of any illicit substances as well as suicidal thoughts or tendencies may mean that Seconal would not be a safe or effective choice; thus, these issues should be disclosed to the doctor. In fact, all use of alcohol is advised against while taking Seconal due to the potential for overdose and worsened side effects.

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Ambien

Use of Ambien can exacerbate symptoms of underlying disorders or alter the efficacy of medications or supplements. Patients should tell the prescribing physician if they are taking any of the following:

  • Antidepressants
  • Ketoconazole
  • OTC medications for allergies or colds
  • Anti-anxiety medications
  • Painkillers
  • Anticonvulsants
  • Medications to manage mental health symptoms
  • Rifampin
  • Sedatives
  • Other sleeping pills
  • Tranquilizers

It is important to avoid taking more than one sleeping pill each night. For example, taking two different kinds of sleeping pills or waking up and taking a second sleeping pill is not recommended.

Certain disorders may make the use of Ambien more dangerous. For example, those who have ever struggled with an alcohol or drug use disorder, or who drink heavily or use any illicit substances currently, may be at risk when taking Ambien. Similarly, those who are diagnosed with certain mental illnesses or who struggle with suicidal thoughts or behaviors may not benefit from use of Ambien. Also, people who are pregnant, diagnosed with sleep apnea or struggle with heavy snorting, have asthma or other disorders that make breathing difficult, or have been diagnosed with myasthenia gravis, kidney disease, or liver disease may be harmed by the use of Ambien.

Anyone who is currently taking Ambien and about to undergo surgery of any kind should disclose the use of Ambien to the doctor or dentist.

Behavior under the Influence

Secobarbital

There have been a number of reports of patients who were under the influence of Seconal engaging in a range of activities that they did not remember the next day. In a state of partial sleep, many would drive their cars, make and eat food, call people, have sex, and engage in other activities but have no memory of the events in the morning. This is obviously highly unsafe, and if a patient finds that this happens to them while taking the medication, they should immediately call their doctor.

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Ambien

It is not uncommon for users of Ambien to report engaging in activities after taking the drug that they do not remember the next morning. From driving a car to making and eating food to having sex or making phone calls, people have awoken with no memory of the events. Engaging in such behaviors in a blackout state can be extremely dangerous, and immediate cessation of use is recommended if this happens.

Additionally, changes in behavior and emotional state have been reported while taking Ambien. Though it is not clear whether or not these changes are directly related to the use of Ambien, if they persist and/or are disruptive, it can be an indication that the drug is not a positive choice. For those who exhibit aggressive or odd behaviors, experience hallucinations or out-of-body experiences, have a hard time concentrating or remembering things, or develop an issue with anxiety, depression, or suicidal thoughts, it is important to immediately contact the prescribing doctor.

Next-Day Impairment

Secobarbital

Taking Seconal may make the user drowsy the next day and impair the ability to drive safely or otherwise function well at work and at home. It is important that patients avoid engaging in any activity that requires full alertness – especially driving – until they are sure that they are fully awake and alert.

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Ambien

The day after taking Ambien, many patients experience a decreased ability to focus and report feeling drowsy and less alert. Some find that it is more difficult to perform simple tasks, and it should be noted that it may not be safe to drive a car or operate machinery. In fact, if the extended-release version of Ambien is taken, it is important to avoid driving or operating heavy machinery altogether the following day.

Addiction Potential

Secobarbital

Seconal is not only a prescription medication used for the treatment of insomnia, but also a drug that is sold on the street under names such as , and more. If used outside of a doctor’s prescription or for longer than a couple weeks, there is a high risk of the development of an addiction defined by:

  • A physical tolerance (e.g., requiring more and more of the drug in order to achieve the original effects)
  • Cravings for the drug
  • Withdrawal symptoms that are both psychological and physical in nature when without the pills
  • An inability to stop taking the drug despite negative consequences of use
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Ambien

Zolpidem in any form can be addictive; thus, it is important that patients follow a doctor’s prescription exactly and avoid taking a larger or more frequent dose than prescribed. Limiting the use of Ambien to two weeks can help to avoid the development of a substance abuse problem. It is also recommended to avoid drinking any alcohol while taking Ambien as it can worsen the side effects experienced and potentially increase the risk of developing or worsening a substance use disorder.

Withdrawal

Secobarbital

Withdrawal symptoms can occur with physical dependence, which can strike anyone who takes Seconal for a long period of time. When both physical dependence and psychological dependence are in evidence and/or the dose of the Seconal is very high, it is important that the patient seek medical detox treatment. Small dose physical dependencies can be managed with a slow tapering of the dose over time under a doctor’s supervision, but when the patient experiences cravings as well as extreme psychological symptoms when without the drug, it is necessary to seek 24-hour medical monitoring and support.

Withdrawal symptoms may include an initial phase of symptoms that lasts for up to two days, followed by 1-2 weeks of a full-blown withdrawal syndrome, depending on the dose. Withdrawal symptoms may include:

  • Twitching
  • Tremors
  • Weakness
  • Anxiety
  • Dizziness
  • Altered vision
  • Nausea and vomiting
  • Rebound insomnia
  • Seizures
  • Extreme confusion
  • Psychosis

It is not recommended that any patient stop using Seconal without medical monitoring and support due to the potentially fatal nature of the withdrawal syndrome if complications arise.

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Ambien

For patients who have taken Ambien for more than two weeks, a tapering down of the dose is recommended rather than abrupt cessation of use. It is normal to have a difficult time falling asleep for the first couple of nights after cessation of use but the problem should pass on its own without further treatment. Physical dependence can trigger a host of withdrawal symptoms that can be difficult to manage, especially if psychological dependence (or addiction to Ambien) is an issue as well.

Withdrawal symptoms may include:

  • Feeling flushed and tired
  • Heavy sweating
  • Lightheadedness
  • Stomach cramping, nausea, and vomiting
  • Muscle pain
  • Rebound insomnia
  • Shakiness
  • Nervousness or panic attack
  • Uncontrollable crying
  • Seizures

In the case of Ambien addiction, medical detox followed by intensive therapeutic is recommended.

Detox and Addiction Treatment

When addiction strikes, whether the drug of choice is Ambien or Seconal, professional addiction treatment that includes medical detox as well as intensive therapeutic intervention is recommended. Therapy should address underlying issues of trauma as well as co-occurring mental health disorders, but it should also address insomnia as well, especially if the sleep disorder is not directly related to a mental health issue. Learning how to fall asleep naturally by implementing lifestyle changes, and learning how to manage the stress and anxiety that may contribute to difficulty falling asleep or staying asleep, can play a critical role in helping clients who struggle with insomnia to build a new life for themselves in recovery and lessen the likelihood of relapse.

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