Monday, October 6, 2008
John McCain and Ambien
Is he sleep-driving through the campaign?
After the last three weeks of erratic and unpredictable behavior from presidential candidate John McCain, it seems reasonable to revisit an issue first raised in May by ABC News: Is McCain’s use of the drug Ambien as a sleep aide affecting his behavior and judgment?
After the press was allowed a brief look at candidate McCain’s medical records earlier this year, Dr. Peter A. Fotinakes of the St. Joseph Sleep Disorders Center in Orange, California, told ABC News that, while Ambien was generally a safe medication, “Taking more than the recommended dosage of Ambien or combining it with other sedative-hypnotics--for example, alcohol—may result in amnesia, fugue states, and sleep walking.”
Ambien’s official website lists other reported effects: “A variety of abnormal thinking and behavior changes have been reported to occur in association with the use of sedative/hypnotics. Some of these changes may be characterized by decreased inhibition (e.g. aggressiveness and extroversion that seemed out of character)....”
In addition, some users have reported bizarre personality changes such as excessive agitation and depersonalization (a dissociative disorder in which the patients self-perception is disrupted). A very small percentage of patients suffer hallucinations attributed to Ambien.
However, the most baffling side effect of Ambien is so-called “sleep-driving,” in which a person on Ambien drives a car, even though they are not fully awake, and then suffers amnesia about the event afterwards. Combining alcohol and Ambien increases the risks of such amnesiac behaviors, variations of which can include “preparing and eating food, making phone calls, or having sex,” all without conscious awareness, according to the Ambien website.
And there are particular caveats associated with the use of Ambien in elderly patients. “Impaired motor and/or cognitive performance after repeated exposure or unusual sensitivity to sedative/hypnotic drugs is a concern in the treatment of elderly and/or debilitated patients.... These patients should be closely monitored.”
Finally, Ambien users may also experience some of the following central and peripheral nervous system side effects: Confusion, vertigo, euphoria, agitation, difficulty concentrating, emotional lability, and “decreased cognition.” Ambien causes withdrawal symptoms when abruptly discontinued. Moreover, like the benzodiazepines, it can be addictive for some people.
Last year, the U.S. Food and Drug Administration (FDA) tightened labeling regulations on the newer sleep drugs like Ambien to reflect the possibility of these strange behaviors. In 2006, a class action suit was filed against Sanofi-Aventis, the makers of Ambien.