Key Points
- Some OTC drugs like melatonin, antihistamines, and valerian root could be good alternatives to Ambien for insomnia.
- Any drug or supplement, even OTC medications, carries risks and side effects, and some of them can be serious.
- The best non-medication intervention for insomnia is sleep hygiene and lifestyle changes to encourage your body to rest naturally.
What Is Ambien?
Ambien is the brand name for zolpidem, a prescription medication used to treat insomnia. While it is generally considered safe when used as directed for short-term treatment, it can lead to dependence or misuse, especially in individuals with a history of substance use disorders.
This prescription sleep medication is also associated with serious and potentially disturbing side effects such as sleepwalking, sleep-driving, and other sleep activities. [1] There may be some over-the-counter drugs that can have similar effects and might be safer than Ambien.
What Is the Closest Thing to Ambien Over the Counter?
There are several alternatives to Ambien (zolpidem) that can be obtained over the counter or without a prescription. Some of them include melatonin, antihistamines, valerian root, and cannabinoids. However, how well these alternatives work could depend on the individual.
Before taking these drugs, it could be important to learn more about them, including any potential side effects. Be sure to talk to your doctor about any new drugs you’re taking, even OTC medications, since they could have serious side effects or drug interactions.
Is Melatonin Good for Insomnia Treatment?
Melatonin is a hormone that occurs naturally in the human body. It prepares the body to sleep, so taking more melatonin via supplement would help with insomnia. The Natural Medicines Comprehensive Database rates melatonin as “likely effective.”[2] However, there are some drawbacks and side effects of taking melatonin as a dietary supplement. Here’s what you need to know.
Who Should Avoid Melatonin?
The FDA regulates melatonin supplements, which may be safer than other sleep supplements, especially for short-term use. [3] Still, melatonin supplements aren’t safe for everyone. If you are pregnant or breastfeeding, you should avoid taking melatonin. Certain drugs taken with melatonin can also cause adverse effects.
Is It Safe to Take Melatonin with a Medical Condition?
Here are some other conditions that can be worsened by melatonin dietary supplements: [4]
- Depression
- High blood pressure
- Seizure disorders
- Bleeding disorders
If you’ve had an organ transplant, you should also avoid melatonin since it can decrease immunity.
Is It Safe to Take Melatonin with Other Medications?
Some medications may have negative interactions with melatonin. If you are taking these drugs, ask your doctor if it’s safe to take synthetic melatonin or melatonin as a dietary supplement: [5]
- Luvox (fluvoxamine
- Desoxyn (methamphetamine)
- Diabetes medications
- High blood pressure medications
- Anticonvulsants
- Immunosuppressants
- Anticoagulants
- Sedatives
This is not an exhaustive list. Always talk to your doctor before adding dietary supplements to your medication regimen.
What Are the Side Effects of Melatonin?
Most sleep medications and supplements have some side effects you must be aware of. Here are some of the side effects associated with melatonin dietary supplements: [6]
- Excessive drowsiness
- Nausea
- Dizziness
- Headache
Are Antihistamines Good Substitutes for Ambien?
Antihistamines are typically used for allergies, cold, and flu. Different types of antihistamines include diphenhydramine, chlorpheniramine, and doxylamine. You may recognize them by their brand names, such as Benadryl or Nyquil. These OTC medications aren’t generally recommended for cases of chronic insomnia. Not all antihistamines cause sleepiness, though, and the effects can vary from person to person.
Who Should Avoid Antihistamines?
Antihistamines aren’t suitable for everyone. Older adults, for example, should avoid antihistamine use because it could increase the risk of dementia for people over the age of 65. [7] People with certain health conditions should also steer clear of these over-the-counter drugs.
Adverse Effects of Antihistamines with Certain Medical Conditions
Avoid antihistamine use if you have any of the following mental health conditions: [8]
- Enlarged prostate
- Narrow-angle glaucoma
- Liver disease
- Asthma or other respiratory issues
- Bladder-neck obstruction
- Stenosing peptic ulcer
What Are the Side Effects of Antihistamines?
As with all over-the-counter medications, there can be side effects to be aware of. Some of these may include: [9]
- Grogginess
- Dry mouth
- Nausea
- Increased heart rate
- Loss of balance/coordination
- Ringing ears
- Abdominal pain
Is Valerian Root A Good Substitute for Ambien?
Valerian root is a plant, so it could be a natural alternative to prescription sleeping pills or other medications for sleep disorders. Some people who have trouble sleeping report that it helps them fall asleep faster and stay asleep longer. Still, studies on the effectiveness of valerian root show mixed results. [10]
There are other drawbacks to this “sleep medicine,” too. For example, natural remedies aren’t monitored by the Food and Drug Administration in the same way that OTC and prescription drugs are, so there’s no guarantee they’re completely safe. Like other treatment options for better sleep, there could also be side effects to deal with.
Who Should Avoid Taking Valerian Root?
Certain medications can interact with valerian root, so ask your healthcare provider if you’re taking medicine for any of the following conditions: [11]
- High blood pressure
- Psychiatric disorders
- Asthma or allergies
- Heartburn
- Cancer
- Seizures
- Migraines
- Psoriasis
- Arthritis
- Autoimmune disorders
- Erectile dysfunction
This is not an exhaustive list. Always ask your doctor before adding a supplement to your medication regimen.
What Are the Side Effects of Valerian Root?
Some of the most serious side effects of valerian root include allergic reactions and liver problems. Other common side effects may include: [12]
- Sleepiness or drowsiness the next day
- Unsettling dreams
- Dry mouth
- Headache
- Upset stomach
- Cognitive problems
- Agitation
If you’re allergic to valerian root and experiencing breathing problems, call 911 or go to the nearest emergency room.
Is Cannabinol (CBN) A Good Alternative to Ambien?
With the expansion of cannabis legalization in some states, products containing cannabinol (CBN) may be available at dispensaries. However, they are not federally regulated or approved as over-the-counter medications. But should you use it for insomnia or other sleep disorders? It’s too soon to say. Research into the effects of cannabinol is still in its early stages. It may be best to avoid it altogether until experts know more. [13]
Who Should Avoid CBN?
CBN could worsen the symptoms of mental health conditions in some cases, so people with anxiety, depression, or PTSD, for instance, should be especially cautious. You should also avoid CBN if you: [14]
- Have a history of substance misuse (drugs or alcohol)
- Are younger than 25
- Are pregnant or breastfeeding
CBN might cause a positive drug test result, especially if the product contains THC or is contaminated with THC. This could be problematic if you’re on probation or in the job market. Obtaining CBN from a source other than a state-authorized dispensary could also be considered a crime.
What Are the Side Effects of CBN?
Cannabinoid is made from THC, so it may have some of the same side effects, although it’s considered a minor form. Some side effects to be aware of may include: [15]
- Worsening of mental health conditions
- Increased heart rate
Studies are ongoing to uncover additional side effects of CBN.
Try Sleep Hygiene First
Any medication you take to help you sleep will inevitably have risks, whether it’s potential drug interactions or dangerous side effects. At the very least, you’ll likely be drowsy the next day after taking a sleep medication, over-the-counter or otherwise. Before substituting another pill for Ambien, try practicing good sleep hygiene first.
You can start by waking up and going to bed at the same time each night, avoiding screens, and ensuring your sleeping environment is dark and cool. Your circadian rhythms might take care of the rest. If you try a medicine or supplement for sleep problems, talk to your doctor or other healthcare provider first.