What is the ideal dose of zopiclone (nonbenzodiazepine hypnotic agent) for insomnia?

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From the Research

The recommended starting dose of zopiclone for sleep difficulties in adults is 7.5 mg taken orally right before bedtime, as supported by the most recent and highest quality study 1.

Key Considerations

  • For elderly patients or those with liver or kidney problems, a lower dose of 3.75 mg is typically advised.
  • Zopiclone should be used for the shortest duration possible, generally not exceeding 2-4 weeks, to avoid dependence and tolerance.
  • The medication works by enhancing the effect of GABA, a neurotransmitter that inhibits brain activity, helping to induce sleep.
  • Patients should avoid alcohol while taking zopiclone as it can dangerously increase sedation.
  • Common side effects include a metallic taste in the mouth, dry mouth, and daytime drowsiness.

Important Precautions

  • It's essential to take zopiclone only when you have 7-8 hours available for sleep to avoid residual morning drowsiness that could affect driving or operating machinery.
  • If sleep problems persist beyond a few weeks, consult a healthcare provider as underlying issues may need to be addressed rather than continuing medication.

Evidence-Based Recommendations

  • A study published in 2017 1 compared the effectiveness of cognitive-behavior therapy and zopiclone for chronic insomnia, finding that both treatments produced similar improvements in sleep quality, but cognitive-behavior therapy had a more lasting effect after treatment was stopped.
  • Another study published in 2016 2 reviewed the safety and efficacy of sleep medicines in older adults, recommending that cognitive behavioral therapy should always be the first line of treatment, and medications like zopiclone should be used as last resorts due to their potential for dependence and adverse effects.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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