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Published on: November 12, 2014
Withdrawal from benzodiazepines by initially switching to zopiclone
1Department of Psychiatry, Sleep Research Laboratory, The Toronto Hospital, Western Division, 399 Bathurst Street, Toronto M5T 2S8, Canada.
Summary
Switching to zopiclone, a cyclopyrrolone hypnotic, improved sleep and alertness during withdrawal. Immediate substitution (abuttal) proved most effective with no serious side effects, aiding benzodiazepine withdrawal.
Area of Science:
- Pharmacology
- Sleep Medicine
- Clinical Psychology
Background:
- Hypnotic medications, often with broad actions, can cause significant withdrawal problems, including rebound insomnia.
- These withdrawal effects are linked to the diverse pharmacological actions of many commonly prescribed hypnotics.
Purpose of the Study:
- To evaluate if switching to zopiclone, a hypnotic with a narrower action profile and different chemical class, reduces withdrawal symptoms.
- To compare three switching methods: gap, abuttal, and overlap, for transitioning patients from previous hypnotics to zopiclone.
Main Methods:
- A randomized controlled trial involving 134 patients undergoing hypnotic withdrawal.
- Patients were switched from their previous hypnotic to zopiclone using one of three defined methods: gap, abuttal, or overlap.
Main Results:
- Zopiclone administration was associated with improved sleep quality and increased patient alertness.
- The abuttal method, involving immediate substitution with zopiclone, demonstrated superior outcomes compared to gap or overlap methods.
- No severe adverse events were reported in patients treated with zopiclone during the study.
Conclusions:
- Zopiclone is a viable and effective option for managing benzodiazepine withdrawal, offering improved sleep and alertness.
- The abuttal (immediate substitution) strategy is the optimal method for switching patients to zopiclone to minimize withdrawal complications.
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