Sometimes I can't sleep for an entire week. I'll feel like an alien; anything will make me cry, I'm paranoid, I hallucinate. It is insanity at its finest (and a choice torture method).
Earlier this spring, I had one of these weeks. I tried all the natural methods you can think of: yoga, meditation, Valerian root tea. On the sixth day of no sleep, when I found myself scraping for Benadryl crumbs in my purse and chugging half a hard cider in the hopes it might give me an hour of shut eye, I knew it was time to see a doctor. He prescribed me Ambien.
And it worked, if I took my prescribed 10 mg and tucked myself in bed straight away. But if I got distracted and stayed up for whatever reason, the Ambien made me energized and creative. I'd stay up writing emotional love poems. As VICE has reported, Ambien (zolpidem tartrate) is a weird drug. An extreme example of its "paradoxal reaction" is the drug's ability to wake up coma patients.
During one of my Ambien-riddled nights of Tumblr poetry, I started to search for fellow so-called "Ambien artists." I met Ryan, a 30-year-old photographer turned iPad Ambien artist from Minnesota who takes 10 mg for chronic insomnia. "If I'm working on art, normally there's a purpose to it. But when I'm on Ambien, the whole purpose is to pass time [until I fall asleep]. When I look at the art the next day, there's a lot of emotion put into it. You're seeing into that dreamlike state," says Ryan. "What you're seeing [on Ambien] and what you're going to see the next morning are two completely different things, but I think that's what makes it interesting. When I'm working on it, it's like the greatest piece of artwork!"
To learn more about the unintended creative consequences of Ambien, I spoke with addiction psychiatrist Dr. Alkesh Patel of Mountainside Treatment Center about the mechanisms responsible for my shitty love poems and how Ambien artists may have other underlying diagnoses responsible for our bad art.
VICE: Sometimes Ambien will make me super creative. I'll write weird poems. There are internet groups on Ambien art who report to have the same trippy, creative urges. Could you speak to the mechanisms that would cause that?
Dr. Alkesh Patel: Ambien is a sedative hypnotic, which means basically it's a sleep aid. It is very helpful in the treatment of insomnia. It's been used often times by patients because it decreases what we call "sleep latency," which means the time from when you take the pill to the time you actually fall asleep, and that's where most of the evidence is for Ambien. Ambien works really well in a lot of people, but you can have these types of adverse side effects. Everyone is different. The people who have reported [creative tendancies] or bizarre behaviors like sleep walking or bouts of increased energy are having what we call the "paradoxal reaction," when sedatives do the total opposite of what you expect them to do.
Who might experience this?
This can happen in people who have been on other sedatives and now have changed to Ambien; this can happen to people who have never been on sedatives and this is their first time on Ambien. If it does happen, the mechanism of action could be that it is activating other receptors' mechanisms in the brain. Or, just like antidepressants and other medications that calm you down and help with depression, they can actually cause manic symptoms. This happens if [the drug] works on the other receptor systems in the brain rather than the receptor system that it's supposed to work on, which is the GABA receptor system.
Just like antidepressants and other medications that calm you down and help with depression, Ambien can actually cause manic symptoms.
Yeah. It seems like if I take Ambien and just close my eyes, I fall asleep fine, but if I get sidetracked then the next thing I know I'll be plowing through chapters of my first book.
These things are not uncommon. A lot of people with amnesia will do that and [not remember it]. People sometimes remember, but I wouldn't be at all surprised that there's amnesia around it. The other explanation that may account for that is that sometimes drugs can work on other receptor mechanisms, and there may be other underlying issues going on. I have a lot of patients who have depression and part of their depression is insomnia. Or they have a different type of mood disorder that cycles a lot, like bipolar depression, and one of the symptoms is insomnia. If you give a medication that may not be specifically targeted for [other disorders], but is indicated only for sleep initiation, you may actually be shaking up the underlying issue, which could be something else. You may actually not be addressing the insomnia, which is part of the bigger disorder.
My 10 mg pills don't seem to be working as well anymore. Can you develop a tolerance to Ambien?
You do develop a tolerance to a sedative, just like you can develop a tolerance to taking benzodiazepines like Klonopin or Xanax. You have been activating those receptors for a while, and those receptors where the drug binds on the cells in the brain are kind of like, "OK, there's a lot of Ambien going on, or there's a lot of Xanax in the system, we don't need to capture everybody. We're going to go ahead and hide out inside the cell where you can't find us." We call that reuptake. There's a neurochemical change that happens when you take medications for a while; they may not feel like they're being responsive as much. And sedatives are one of those medications where you may develop a tolerance. Ideally, Ambien is usually given short-term. The clinical trials were in support of taking it maybe four to five weeks.
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