Physical dependence on zopiclone: case reports
BMJ 1998; 316 doi: https://doi.org/10.1136/bmj.316.7125.117 (Published 10 January 1998) Cite this as: BMJ 1998;316:117
All rapid responses
Rapid responses are electronic comments to the editor. They enable our users to debate issues raised in articles published on bmj.com. A rapid response is first posted online. If you need the URL (web address) of an individual response, simply click on the response headline and copy the URL from the browser window. A proportion of responses will, after editing, be published online and in the print journal as letters, which are indexed in PubMed. Rapid responses are not indexed in PubMed and they are not journal articles. The BMJ reserves the right to remove responses which are being wilfully misrepresented as published articles or when it is brought to our attention that a response spreads misinformation.
From March 2022, the word limit for rapid responses will be 600 words not including references and author details. We will no longer post responses that exceed this limit.
The word limit for letters selected from posted responses remains 300 words.
I am extensive personal experience of zociclone over a three year
period. At
the beginning of that period (Summer 2004) I was prescribed escitalopram
as
an anti-depressant and subsequently zopiclone as an adjuvant to assist
with
the insmonnia symptoms that were commonly believed to be a side effect of
my mainline SSRI therapy.
I have taken zopicline intermettingly since. My experience is that
cessation of
use after a long period (say, greater than 6 weeks) of the 7.5mg dose
leads
invariably to rebound insomnia. On this basis I have an on the whole
shifted
to "as and when needed" with zopicline, taking it in particular to improve
sleep patterns and regularity. At the height of my depression, and
admitted
when I gave less thought and care to the potential consequences, I would
"double up" to 15mg or even 22.5mg.
My concern is that one builds up not only a dependence upon the drug,
but
also a large degree of tolerance, which leads to a desire to takes more
(and
sometimes significantly more) than the prescribed dose. I have certainly
read
accounts on the internet of indivdiuals taking doses in the order of 75mg
and
even individuals using the drug as a daytime anxiolytic.
I have also witnessed a friend who has suffered insomnia for many
years
being prescribed the drug. Very soon following the initial prescription
he had
increased his nightly dosage to 15mg and then beyond. If he had had a
"bad
day at the office" his usual "cure" was to retreat to his bedroom with a
bottle
of scotch and about 5 x 7.5mg zopiclone pilss.
I can report that I have also observed a state of mind resembling a
"euphoria"
in some respects amongst those whom I have witnessed taking the drug, but
then not retiring to be immediately. My observation, is that the
zopiclone
induced drowsiness can be fought and a "break through phase" intered
during which the subject can commit relatively outrageous acts (akin to
those
one might expect to observe in an individual who has self-intoxicated with
alcohol). Reports from those individuals of their antics the following
morning
is often met with suprise suggesting at least a degree of retrograde
amnesia.
Competing interests:
None declared
Competing interests: No competing interests
I have taken Zoplicone for several years now. I am allowed 30 a
month, if I need them. I never had any of the side effects these people
are talking about. I have taken sleeping pills since I was 16, I am now
39. I think that these people are like me.... addicted to any kind of
sleeping aid and are only blaming Zoplicone for any reason. Not sure if
they are sluffing off their problems on the company, or if they really
think it is the fault of Zoplicone's makers. I really like Zoplicone, it
gets me to sleep fast, without any hangover effects. I think that they
are looking to blame anyone for their problems but themselves. I know
what it is like to be addicted to sleeping aids, since I have been for
many years, and it is no ones fault. So blaming the company is silly.
Thanks, Val.
Competing interests:
None declared
Competing interests: No competing interests
This has happened to me.
The withdrawal period is extremely dangerous - with close shaves with
fitting.
I would be concerned to read that this is a safe drug.
Competing interests:
None declared
Competing interests: No competing interests
I have been taking Zopiclone for close to fifteen years due to too
many sleepless nights. The only other medications I take are the
hormone therapy pills - Premarin and Progestrone. I take half of a
7.5 mg Zoplclone every night and once a week take the full 7.5 mg.
A few months ago I felt that I should try to live without the sleeping
pill and I spent four nights fully awake, even after trying breathing
exercises, reflexology, hot milk, going to the living room and
reading while drinking camomile tea - nothing seemed to work so I
concluded that quality of life was more important than quantity of
life and returned to the previous regime. On the night of the half-
pill dose, I calmly go to sleep soon after retiring but often wake up
three hours later, completely refreshed. I often get up and do my
most creative thinking or read for the next couple of hours, then
return to bed and have colourful and exciting dreams. On the
weekly dose of one full pill, I seem to have a normal night's rest.
What might be of interest is that twice, on holidays visiting
friends, I inadvertently took a Zopiclone in the morning instead of
the hormone pills and was able to spend the day and evening as if
I hadn't made such a mistake, staying fully awake with no visible
signs of drowsiness. This makes me wonder if I am
psychologically addicted. I am not worried about it as I treasure
feeling rested and enjoy life to the fullest.
Competing interests:
None declared
Competing interests: No competing interests
Re: The Risk of the Ever-Decreasing Zopiclone Circle
I have been weaning myself off long term use of Nitrzapam by
substituting Diazepam reducing the latter from 30mg daily to 10mg daily.
At the point of reaching 20mg of diazepam I found it hard to reduce by
another 2mg without experiencing insomnia. When I told my GP this he
prescribed Zopiclone 7.5mg nightly assuring me here was no risk of
dependence. Within a couple of weeks I noticed that while my sleep was
reinstated - and better than for a long time - I was feeling fatigued and
listless until midday. I also started feeling depressed for no reason.
I reduced my dose to half a tablet and still slep alright but still
experienced fatigue and depression. By now I had been prescribed the drug
for 2 months and decidd to stop it. For three nights I had sleeplessnes
worst than ever. I then found out that this drug is known to be addictive
and to have a withdrawal syndrome similar to benzodiazipines on Professor
Ashton's Website.http://www.benzo.org.uk/manual/index.htm
I felt betrayd by my doctor. Although I have now been on half a
tablet [3.75mg] nightly for two weeks I have been taking Zopiclone for 11
weeks and imagine I will have to substitute it with diazeapam 5mg- 8mg
over a 10 wek period thus losing a lot of ground I had gained in reducing
diazepam as a way to quit nitrezapam.
Why aren't GPs more informed - or do they have too little regard or
information for patients who wish to stop benzodiazipine medication? I had
to show my GP Professor Ashton's manual to work out with his approval a
withdrawal protocol. He was ignorant of the build up of the original drug
through its compund half life.
Competing interests:
None declared
Competing interests: No competing interests