From the Research
The dose of zopiclone can be increased from the standard 7.5mg to a maximum of 10mg only in cases where the lower dose has proven ineffective and the patient continues to experience significant insomnia that impacts daily functioning, as supported by the most recent study 1. This dose increase should be considered only for adult patients under 65 years with no hepatic or renal impairment, and who are not taking medications that might interact with zopiclone.
- Elderly patients, those with liver or kidney problems, and patients with respiratory conditions should remain on lower doses (3.75mg-5mg) due to increased sensitivity to the drug's effects.
- Any dose increase should be temporary, as zopiclone is intended for short-term use (2-4 weeks maximum) due to risks of tolerance, dependence, and withdrawal symptoms. The increased dose works by enhancing the effect of GABA, an inhibitory neurotransmitter in the brain, providing stronger sedation, but this comes with heightened risks of side effects including daytime drowsiness, cognitive impairment, and increased fall risk, particularly in older adults, as noted in 1. However, the most recent and highest quality study 1 suggests that zopiclone can be effective in treating insomnia in patients with Alzheimer's disease, but with careful consideration of the potential risks and benefits. It's also worth noting that the study 2 found that zopiclone 7.5 mg was the optimal therapeutic dose, with some additional benefit occurring with zopiclone 11.25 mg, but with increased side effects at higher doses. Overall, the decision to increase the dose of zopiclone should be made on a case-by-case basis, taking into account the individual patient's needs and medical history, and with careful monitoring for potential side effects, as recommended by 3, 4, 5, 2.