Ambien should not be handed out ‘like candy,’ experts say of Ronny L. Jackson’s alleged practices

Ambien and the stimulant Provigil, which Tester said Jackson dispensed to help travelers awaken, are Schedule IV controlled substances in the government’s five-category ranking of drugs’ risk of abuse. But like any medication, they pose some risk, particularly in certain groups.

During a news conference in January, Jackson said, “When we travel from one time zone to another time zone on the other side of the planet, I recommend that everyone on the plane take a sleep aid at certain times so that we can try our best to get on the schedule of our destination.”

Anecdotes abound of people behaving strangely under the influence of Ambien and being unable to remember that behavior when the drug wears off. Chris Winter, a neurologist at Charlottesville Neurology and Sleep Medicine in Virginia and author of “The Sleep Solution,” said a patient of his on the drug emerged from her bedroom naked and held a lengthy conversation with her in-laws. In 2006, then-Rep. Patrick Kennedy (D-R.I.) crashed his car into a barrier near the Capitol, citing disorientation from Ambien and another medication.

Similarly, Provigil — first developed to treat narcolepsy — and its successor Nuvigil, now have the approval of the Food and Drug Administration for treatment of “shift work disorder,” a circadian-rhythm condition caused by work schedules that do not jibe with natural sleep patterns.

But it shouldn’t be prescribed in conjunction with Ambien, to help travelers stay awake, as Tester alleged, the experts said.

“For a sleep physician there is virtually no situation where we would be prescribing a hypnotic medication at night, like Ambien, and then a stimulating medication in the morning,” Goldstein said. “If somebody has residual sedation the next morning, the treatment is no more Ambien.”

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