From the Guidelines
Eszopiclone is sold under the trade name Lunesta in the United States. It is a non-benzodiazepine sedative-hypnotic medication primarily used for the treatment of insomnia, as suggested by the American Academy of Sleep Medicine clinical practice guideline 1. Lunesta is available in 1 mg, 2 mg, and 3 mg tablets, with typical starting doses of 1 mg for elderly patients and 2 mg for adults, taken immediately before bedtime. The maximum recommended dose is 3 mg. Patients should ensure they have 7-8 hours available for sleep after taking this medication to avoid next-day impairment. Eszopiclone works by enhancing the activity of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter in the brain that promotes sleep. Common side effects include unpleasant taste, headache, dizziness, and morning drowsiness. As a controlled substance (Schedule IV), it has potential for dependence and should be used for short-term treatment when possible, as noted in the Annals of Internal Medicine study 1. Outside the US, eszopiclone may be marketed under different trade names in various countries.
Some key points to consider when prescribing eszopiclone include:
- The American Academy of Sleep Medicine suggests using eszopiclone as a treatment for sleep onset and sleep maintenance insomnia in adults 1
- The medication should be used with caution in older adults due to the risk of cognitive and behavioral changes, as well as infrequent but serious harms, as reported in the Annals of Internal Medicine study 1
- Patients should be advised to take the medication immediately before bedtime and to have 7-8 hours available for sleep to avoid next-day impairment
- The maximum recommended dose is 3 mg, and the medication should be used for short-term treatment when possible due to its potential for dependence.
From the Research
Eszopiclone Trade Name
Key Characteristics of Eszopiclone
- Eszopiclone is a nonbenzodiazepine hypnotic agent 2, 3
- It is approved in the US as an oral, once-nightly therapy for insomnia in adults 2, 3
- Eszopiclone is rapidly absorbed after oral administration without any next-day clinical residual effects being detected 2, 3
Efficacy and Safety of Eszopiclone
- Eszopiclone significantly improves both sleep onset and sleep maintenance compared with placebo in adult and elderly patients with primary insomnia 2, 3, 5
- It is generally well tolerated, with no evidence of tolerance during 12 months of treatment and no rebound insomnia or serious withdrawal effects on discontinuation 2, 3
- Common adverse events include unpleasant taste, dry mouth, somnolence, and dizziness 5