Eszopiclone (Lunesta): a new nonbenzodiazepine hypnotic agent

Randomized, placebo-controlled trials have shown that eszopiclone, a newly available nonbenzodiazepine hypnotic, effectively treats the symptoms of insomnia. Its pharmacokinetic and pharmacodynamic parameters are similar to those of the other currently available nonbenzodiazepine hypnotics (i.e., zolpidem and zaleplon). The unique quality of eszopiclone lies in its product labeling. It is not restricted to short-term use, unlike both zolpidem and zaleplon. Dosing of eszopiclone should begin at 2 mg for nonelderly patients and may be initiated at or increased to 3 mg if clinically indicated. The 3-mg nightly dose is more effective at sleep maintenance. Eszopiclone is well tolerated, with the main treatment-emergent side effects being unpleasant taste, headache, and dizziness. No studies comparing eszopiclone with nonpharmacologic insomnia treatments or other hypnotic agents, including zolpidem and zaleplon, are currently available.