Can a sleeping pill really be responsible?
ABC canceled Roseanne Barr’s eponymous television reboot yesterday after the actress posted a racist tweet referring to former Obama advisor Valerie Jarrett. Hours later, Barr tweeted that she had been “ambien tweeting” and had made an “egregious” and “indefensible” mistake.
Later, in a now-deleted tweet, the comedian referenced the prescription sleep medication again: “Not giving excuses for what I did (tweeted) but I’ve done weird stuff while on ambien—cracked eggs on the wall at 2 am etc.”
Barr certainly isn’t the first person to credit Ambien for her unusual behavior, and it’s true that the drug is known to have some pretty weird side effects. But because Barr has a history of making controversial and racially charged comments, the Internet isn’t buying her attempt to deflect blame.
Neither is Ambien’s parent company, Sanofi Aventis. The drugmaker tweeted a response this morning, noting that people of all races, religions, and nationalities work for the pharmaceutical brand. “While all pharmaceutical treatments have side effects,” the tweet read, “racism is not a known side effect of any Sanofi medication.”
In light of Barr’s comments, Health asked Cathy Anne Goldstein, MD, assistant professor of sleep medicine and neurology at the University of Michigan, whether sleeping pills can really make people do and say inappropriate things. Here’s what she says can—and can’t—be attributed to these types of drugs.
What happens when you take Ambien?
Ambien is a type of drug called a benzodiazepine receptor agonist, also known as non-benzodiazepines. “By acting on the benzodiazepine receptors in the brain, these drugs make people very sleepy,” says Dr. Goldstein. “Because of that, they’re used to treat insomnia in the short term,” she says.
These drugs target the same brain receptors as an older class of drugs, called benzodiazepines, but they do so in a slightly more specific manner. As such, they’re safer for people with breathing problems, typically cause less daytime sleepiness and grogginess, and have a lower risk of abuse or dependence than their earlier counterparts like Valium and Xanax.
What are the known side effects?
In addition to making people sleepy, Ambien can also make people amnesic—meaning they can experience black-out periods in which they don’t remember things they said or did. “This happens more when it’s combined with alcohol or taken in doses that are higher than recommended,” says Dr. Goldstein, “but anyone who takes Ambien is at risk of having an event like this.” Those amnesic states can sometimes involve abnormal behaviors, known as parasomnias. “Sleepwalking, talking, binge eating, driving—even sleep emailing has been reported,” says Dr. Goldstein. “You’re up and moving around and physically able to do these complex behaviors, but you have no memory of them later.”
Taking Ambien outside of your normal sleep hours—if you’re trying to take a nap in the middle of the day, for example—can also increase the risk of parasomnias and amnesic episodes. That’s one reason doctors recommend only taking the drug before going to bed at night.
Identifying someone in the midst of an Ambien-induced parasomnia usually isn’t difficult, says Dr. Goldstein. “They’re not typically going to be mistaken for somebody in a normal state,” she says. “They’re going to appear confused, have abnormal motor control, they’re going to be unsteady.”
Not everyone who takes Ambien experiences these side effects; studies have estimated that only between 1% and 5% of users have reported amnesic behaviors. Experts say these numbers are likely underestimated, however, since people don’t always know that such behaviors have occurred.
Once a person does have an amnesic episode, they should stop taking the drug, says Dr. Goldstein. “I consider it an absolute contraindication,” she says. “I actually list it as an allergy in their file; I really don’t want them getting that drug again.” Anyone with a previous history of sleepwalking, night terrors, or other parasomnias should avoid taking Ambien, as well.
What about other drugs?
Ambien seems to be the most commonly referenced drug in reports about parasomnias and amnesic episodes, says Dr. Goldstein. But it’s unclear whether there’s something specific about its formulation that makes these side effects more likely, or if it’s simply because it's prescribed more frequently than other sleep medications.
The generic version of Ambien, zolpidem, can also cause the same side effects, as can other drugs in the same class—like Lunesta (eszopiclone) and Sonata (zaleplon). The older benzodiazepines can also cause cognitive impairment and memory loss.
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Can these drugs make you say things you don’t believe?
In March, actor Sean Penn admitted to taking Ambien before a bizarre appearance on The Late Show With Stephen Colbert. Last year, after Tiger Woods was arrested for driving under the influence, it was revealed he had Ambien (as well as other prescription drugs) in his system. And today, social media is full of stories about things people did while on Ambien—from initiating sex with a spouse to hallucinating aliens to buying three pairs of the same shoes on Amazon.
These commenters were quick to point out, however, that the drug didn’t make them say or do racist things. So can a mind-altering drug trigger racism or other intolerant behavior? “That’s really an unanswerable question,” says Dr. Goldstein. “It’s not really something we can study; we don’t know what’s in the deep-down of people’s true beliefs.”
She likens Ambien’s effects to those of alcohol. “People say, ‘Oh, alcohol made me do this,’ and sometimes we really don’t know if this is something completely and entirely new to them or if it’s something in their subconscious, private thoughts,” she adds.
But while it’s not always possible to say whether a person’s specific behaviors can be attributed to taking a sleeping pill, she does make one important distinction. “If that is the case and Ambien really was responsible,” she says, “we would expect people not to remember those behaviors.”