Eszopiclone

Eszopiclone: a hypnotic for falling and staying asleep

Eszopiclone is a hypnotic, a medicine that induces sleep, and it is used to treat insomnia in people who cannot fall asleep, stay asleep, or both. Chemically it is not a benzodiazepine, yet it acts on the same GABA system in the brain, the main calming signal, and the effect is to slow brain activity enough for sleep to start. Eszopiclone is sold as a tablet taken by mouth.

The eszopiclone range

Two tablet products carry this ingredient. Hypnite comes in 1mg, 2mg and 3mg under a brand-style name, and is also sold as plain Eszopiclone tablets. Fulnite is the narrowest option, a single 2mg tablet. Since both are tablets of one ingredient, strength and name are the ways they differ; you pick the one that matches the amount you want and the name you recognise. For a shorter-acting alternative that helps with falling asleep only, see the zaleplon page, and for body-clock problems see melatonin.

Using eszopiclone

The usual pattern is a single tablet at bedtime, or in bed after trying unsuccessfully to fall asleep. Allow 7 to 8 hours in bed afterwards. A heavy, high-fat meal around the time of the tablet is best avoided, as are grapefruit and grapefruit juice. Sleep is expected to improve within 7 to 10 days of starting. After long use, stopping suddenly can cause anxiety, unusual dreams, cramps, nausea and sweating, and rarely seizures; trouble sleeping may return for one or two nights. Tablets are kept in their original container, in a dry place.

Side effects, interactions and warnings

Headache, daytime drowsiness, dizziness, dry mouth and an unpleasant taste in the mouth are the reported common effects. Daytime alertness can drop and the risk of falls rises, particularly when getting out of bed at night, so avoid driving until you know how it affects you.

The most serious risk is complex sleep behaviour: people have driven, prepared and eaten food, made phone calls or had sex while not fully awake, and remembered nothing afterwards. Stop taking it if this happens. Mood and behaviour changes such as aggression, hallucinations and new or worse depression are also listed. Alcohol and other sedating medicines add to the effect, and some antifungal and antibiotic medicines, including ketoconazole and clarithromycin, can raise eszopiclone levels in the body.