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Concept
Eszopiclone
Summary
Eszopiclone, sold under the brand name Lunesta among others, is a medication used in the treatment of insomnia. Evidence supports slight to moderate benefit up to six months. It is taken by mouth.
Common side effects include headache, dry mouth, nausea, and dizziness. Severe side effects may include suicidal thoughts, hallucinations, and angioedema. Rapid decreasing of the dose may result in withdrawal. Eszopiclone is classified as a nonbenzodiazepine or Z-drug and a sedative and hypnotic of the cyclopyrrolone group. It is the S-stereoisomer of zopiclone. It works by interacting with the GABA receptors.
Approved for medical use in the United States in 2004, eszopiclone is available as a generic medication. In 2020, it was the 232nd most commonly prescribed medication in the United States, with more than 1 million prescriptions. Eszopiclone is not sold in the European Union, as of 2009, the European Medicines Agency (EMA) ruled that it was too similar to zopiclone to be considered a new active substance.
A 2018 Cochrane review found that it produced moderate improvement in sleep onset and maintenance. The authors suggest that where preferred non-pharmacological treatment strategies have been exhausted, eszopiclone provides an efficient treatment for insomnia. In 2014, the US Food and Drug Administration asked that the starting dose be lowered from 2 milligrams to 1 milligram after it was observed in a study that even eight hours after taking the drug at night, some people were not able to cope with their next-day activities like driving and other activities that require full alertness.
Eszopiclone is slightly effective in the treatment of insomnia where difficulty in falling asleep is the primary complaint. The benefit over placebo was found to be of questionable clinical significance. Although the drug effect and the placebo response were rather small and of questionable clinical importance, the two together produce a reasonably large clinical response.
Official source
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