From the Research
Zopiclone should be used for the shortest duration possible, ideally not exceeding 2-4 weeks, to minimize the risk of dependence and other adverse effects. PRN, which stands for "pro re nata" or "as needed," indicates that the medication should only be taken when necessary rather than on a regular schedule. The goal is to use zopiclone minimally to avoid dependence, with no more than 2-3 times per week, and a maximum of 8-12 tablets per month 1, 2.
Key Considerations
- Zopiclone is indicated for short-term use and should not be prescribed for more than 4 weeks 1.
- Prolonged use can lead to tolerance, dependence, and withdrawal symptoms upon discontinuation.
- Cognitive Behavioral Therapy for Insomnia (CBT-I) is a recommended first-line intervention for insomnia and can be an effective alternative to pharmacotherapy 3.
- Zopiclone works by enhancing the effect of GABA, an inhibitory neurotransmitter in the brain that promotes sleep, but its use should be carefully managed to avoid adverse effects.
Recommendations
- Use zopiclone only as needed and for the shortest duration possible.
- Do not exceed 2-4 weeks of continuous use without consulting a healthcare provider.
- Consider alternative treatments, such as CBT-I, for chronic insomnia.
- Monitor for signs of dependence and withdrawal symptoms when discontinuing zopiclone.
Evidence Summary
The evidence from studies 1, 2, 4, 5, 3 supports the use of zopiclone for short-term treatment of insomnia, with a focus on minimizing dependence and adverse effects. The most recent and highest quality study 3 highlights the importance of CBT-I as a first-line intervention for insomnia, providing a valuable alternative to pharmacotherapy.