Zopiclone - is a non-benzodiazepine hypnotic drug (Z-drugs) used as for insomnia treatment. Available in pharmacies under the brand name Imovane, Somnol, Piklodorm. Non-benzodiazepine hypnotic of new generation with minimal effect on sleep structure.

The analysis of clinical trial data presented by FDA regarding Z-drugs has shown that the sedative hypnotics twice increase the risk of depression, compared to placebo.

Zopiclone causes benzodiazepines-like changes in EEG and sleep architecture, and also causes sleep disturbances after discontinuation of its use, as relapse effect. The group of non-benzodiazepine hypnotics include its full analogs namely Sonata, and Lunesta, but they don’t offer any advantages and are quite rare.

In the process of accommodation, active metabolites are formed: N-oxide zopiclone and N-demethyl zopiclone, the identification of which helps to establish the cause of suicide committer's death. Zopiclone became a favorite drug of drug addicts for its ‘mix’ compilation. Let’s say a human is in a weakened physical state, that means that a dose of 90 mg may be the minimum lethal dose of zopiclone.

Zopiclone is made only to induce sleep. The drug has a short half-life - about 3 hours therefore it is possible to keep normal sleep structure and its efficiency. It doesn’t provoke postsomnic violations: no feeling of weakness and drowsiness the next morning. Readmission of zopiclone is not accompanied by accumulation. Zopiclone exerts less side effects than most traditional hypnotic drugs.

Use for insomnia treatment

Nowadays, non-benzodiazepine hypnotics are the best choice for the unsystematic treatment of insomnia. The etiology of insomnia is still not clear and there is still no effective treatment. Hypnotics are not a cure of the disease, and what is more, after the drug's discontinuation pharmacotherapy symptoms of sleep disorders may be aggravated. Only an expert can assign specific treatment.

If insomnia is temporal and caused by external factors (stress, etc.) the use of hypnotics on the non-permanent basis is justified. This makes it easier to restore the correct mode of the day, especially after the holidays.

Dosage

The average therapeutic dose constitutes 7.5 mg orally before sleep, in cases of severe insomnia, the dose can be increased up to 15 mg. The action begins in 20-30 minutes. Elderly patients, as well as those with abnormal liver function should take 3.75 mg. This drug may cause addiction and withdrawal symptoms with worsening of insomnia, so according to the recommendations of Compendium of Pharmaceuticals and Specialties, the drug should not be use for longer than 7-10 days in a row, while according to the official instruction - not more than for 45 days.

Contraindications

Hypersensitivity, respiratory insufficiency, pregnancy (especially I and III trimester), breast-feeding, age under 18 years old.

Restrictions

Sleep apnea, myasthenia gravis, severe hepatic insufficiency.

Side effects

Nervous system and sensory organs: drowsiness, lethargy, fatigue, headache, dizziness, irritability, confusion (more common in the elderly), depressed mood, muscle weakness, incoordination, diplopia, memory impairment, paradoxical reactions (increased insomnia, nightmares, nervousness, excitement, aggression, temper tantrums, hallucinations).

Other: bitter or metallic taste in the mouth, dry mouth, nausea, vomiting, allergic skin reactions, changes in libido, anterograde amnesia.

Possible addiction, drug dependence, withdrawal syndrome, including rebound insomnia.

Precautions

Due to the possibility of drug addiction, use for a long period may be assigned only by a doctor, in exceptional cases. If insomnia persists for 4 weeks, the physician should be informed. The risk of addiction, physical or psychological dependence grows in case violation of the prescribed dosage or treatment length (more than 4 weeks).

End the course gradually, since it may cause resumption of insomnia, frequent awakening, headache and muscle pain, anxiety, excitement, confusion, irritability.