Posted by ed_uk on April 13, 2005, at 18:03:30
Americans should not be surprised if they suffer worse withdrawal symptoms from Lunesta than from Ambien!!!!
Eszopiclone (Lunesta) is the active component of the older sleeping drug zopiclone (Imovane, Zimovane). Zopiclone has been widely prescribed in the UK since the 1980s.
Zopiclone (Imovane etc) may cause greater 'rebound symptoms' than zolpidem (Ambien)............
J Int Med Res. 2001 May-Jun;29(3):163-77.
A double-blind comparative study of zolpidem versus zopiclone in the treatment of chronic primary insomnia.
Tsutsui S; Zolipidem Study Group.
Department of Psychosomatic Medicine, Toho University Medical School, Omori Hospital, Japan.
Zolpidem (10 mg/day) and zopiclone (7.5 mg/day), administered at night, were compared in a 14-day, double-blind, equivalence trial on 479 chronic primary insomniacs (zolpidem, 231; zopiclone, 248) throughout Japan, with a 1-week follow-up to assess rebound. The primary endpoint was the investigators' rating of global improvement of sleep disorders. A total of 32 patients in the zolpidem group (13.9%) and 45 patients in the zopiclone group (18.1%) withdrew from the study before the end of the treatment. In the zolpidem group, 67.9% (142/209) of patients were rated at least 'moderately improved' versus 61.6% (135/219) with zopiclone, zolpidem being at least as effective as zopiclone (90% confidence interval: -1.7, 14.3). With zolpidem, sleep onset latency improved in significantly more patients (85.8% versus 77.5%) and significantly fewer patients showed aggravated sleep onset latency relative to baseline at follow-up (4.5% versus 15.4%). Significantly fewer patients receiving zolpidem experienced drug-related adverse events (31.3% versus 45.3%), with bitter taste representing 5.8% (six of 104) of such complaints with zolpidem compared with 39.9% (69/173) with zopiclone. In conclusion, zolpidem was at least as effective as zopiclone, ****showed significantly less rebound on discontinuation**** and was better tolerated.
It is hypothesised that zolpidem (Ambien) may be less likely to cause physical dependence (tolerance and withdrawal symptoms) than the benzodiazepines because it is more selective for the omega-1 receptor. Zopiclone is less selective for the omega-1 receptor than zolpidem (Ambien) and so it might be expected to be associated with a higher incidence of physical dependence. Eszopiclone (Lunesta) appears to be almost virtually identical to zopiclone, I cannot imagine that it has any true clinical advantages over zopiclone.
Ed.
poster:ed_uk
thread:483849
URL: http://www.dr-bob.org/babble/20050413/msgs/483849.html