Effects of eszopiclone: A Synthesis of Findings from 28 Studies

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Original Abstract of the Article

Major Research Findings

Eszopiclone is a non-benzodiazepine hypnotic medication used to treat insomnia. Many studies have shown that eszopiclone improves sleep quality and increases sleep duration. 21 , 12 , 4

Eszopiclone has been shown to increase sleep spindles, which are important for memory consolidation during sleep. 3

Eszopiclone has been shown to have shorter residual effects compared to other sleep medications. 21 , 22

Eszopiclone may improve sleep quality and reduce cognitive decline in elderly patients with Alzheimer's disease and sleep disorders. 4

Eszopiclone may be effective in treating persistent negative symptoms in patients with schizophrenia. 19

Eszopiclone may be effective in treating insomnia in patients with schizophrenia. 25 , 12

Eszopiclone may be effective in treating sleep disturbances associated with menopause. 6

Eszopiclone may be effective in treating sleep disturbances associated with chronic pain. 15

Eszopiclone may be effective when used in conjunction with antidepressants for treating major depressive disorder. 7

Eszopiclone may improve adherence to CPAP therapy. 14

Eszopiclone may have fewer side effects and shorter residual effects such as drowsiness compared to zopiclone. 21 , 1 , 22

Eszopiclone may be safe for use in elderly individuals. 28 , 22

Benefits and Risks

Benefits Summary

Eszopiclone is an effective medication for treating insomnia. It improves sleep quality, increases sleep duration, and may improve sleep-related cognitive function. 21 , 12 , 4 , 7 , 14

Eszopiclone has shorter residual effects compared to other sleep medications. 21 , 1 , 22

Eszopiclone may have fewer side effects and shorter residual effects such as drowsiness compared to zopiclone. 21 , 1 , 22

Eszopiclone may be safe for use in elderly individuals. 28 , 22

Risks Summary

As with other sleep medications, eszopiclone can pose risks such as dependence, tolerance, and withdrawal symptoms. 24 , 5

Eszopiclone may cause side effects such as drowsiness, dizziness, impaired attention, and impaired judgment. 21 , 7 , 20 ,

Eszopiclone may have increased side effects in elderly individuals and patients with liver dysfunction. 28 , 22

Eszopiclone should not be used by pregnant or breastfeeding women. 28

Eszopiclone should be used with caution when combined with alcohol or other medications. 28

Comparison Between Studies

Commonalities in Studies

Many studies have shown that eszopiclone improves sleep quality and increases sleep duration. 21 , 12 , 4 , 7 , 14 , 25 , 6 , 15

Differences in Studies

The effects of eszopiclone may vary depending on the patient's age, condition, and dosage. 28 , 22

Some studies suggest that eszopiclone has fewer side effects and shorter residual effects such as drowsiness compared to other sleep medications. 21 , 1 , 22

Some studies suggest that eszopiclone may be effective for treating certain conditions. 19 , 12 , 4 , 6 , 15 , 7

Consistency and Inconsistencies in Results

While eszopiclone is an effective treatment for insomnia, some studies suggest that its effects may be limited. 25

Studies also suggest that eszopiclone may pose risks such as dependence and tolerance. 24 , 5

Points to Consider When Applying Findings to Daily Life

Eszopiclone is an effective medication for treating insomnia, but it is important to consider the risks of dependence, tolerance, and side effects. 24 , 5

Always follow your doctor's instructions and take the correct dosage of eszopiclone. 5

Eszopiclone should be used with caution when combined with alcohol or other medications. 28

Pregnant or breastfeeding women should not use eszopiclone. 28

Limitations of Current Research

There is still not enough research on the effects of eszopiclone. 25 , 6 , 15

In particular, there is a lack of research on the long-term effects and safety of eszopiclone. 28 , 24

While eszopiclone may be effective for treating various conditions, the effects may vary depending on the patient. 19 , 12 , 4 , 6 , 15 , 7

Future Research Directions

Research is needed on the long-term effects and safety of eszopiclone. 28 , 24

Research is needed to investigate whether eszopiclone is effective for treating various conditions. 19 , 12 , 4 , 6 , 15 , 7

Research is needed on the optimal dosage and administration methods for eszopiclone. 5

Conclusion

Eszopiclone is an effective medication for treating insomnia, but it is important to consider the risks of dependence, tolerance, and side effects. 24 , 5

Always follow your doctor's instructions and take the correct dosage of eszopiclone. 5

Eszopiclone should be used with caution when combined with alcohol or other medications. 28

Pregnant or breastfeeding women should not use eszopiclone. 28

Literature analysis of 28 papers
Positive Content
21
Neutral Content
2
Negative Content
5
Article Type
6
3
2
9
27
1.

Eszopiclone versus zopiclone in the treatment of insomnia.

Author: PintoLuciano Ribeiro, BittencourtLia Rita Azeredo, TreptowErika Cristine, BragaLuciano Rotella, TufikSergio

Sleep improvement
Insomnia

Eszopiclone demonstrated efficacy comparable to that of zopiclone in the treatment of insomnia, increasing total sleep time as well as sleep efficiency according to polysomnography. The primary efficacy analysis demonstrated the non-inferiority of eszopiclone over zopiclone. Analysis of objective parameters assessed by polysomnography showed that eszopiclone increased total sleep time and also improved sleep efficiency.

Clinical Trial, Phase IIIA Phase III trial is a trial that further rigorously verifies the efficacy and safety of a new drug or treatment, whose efficacy and safety have been confirmed in a Phase II trial, in a large number of patients, and evaluates whether it is superior to existing treatments.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

3.

The effects of eszopiclone on sleep spindles and memory consolidation in schizophrenia: a randomized placebo-controlled trial.

Author: WamsleyErin J, ShinnAnn K, TuckerMatthew A, OnoKim E, McKinleySophia K, ElyAlice V, GoffDonald C, StickgoldRobert, ManoachDara S

Memory consolidation improvement
Schizophrenia treatment

This study investigated whether the non-benzodiazepine hypnotic eszopiclone could increase sleep spindles, which are reduced in schizophrenia, and thereby improve memory consolidation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

4.

Effects of eszopiclone on sleep quality and cognitive function in elderly patients with Alzheimer's disease and sleep disorder: A randomized controlled trial.

Author: HuoShuyu, ChengLin, LiShuying, XuFulu

Cognitive function
Eszopiclone
Improved sleep

This prospective study investigated the effects of eszopiclone on sleep quality and cognitive function in elderly patients with Alzheimer's disease (AD) and sleep disorders. The study found that eszopiclone was effective in improving sleep quality, cognitive function, and daily living skills compared to alprazolam.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

5.

Alliance for Sleep Clinical Practice Guideline on Switching or Deprescribing Hypnotic Medications for Insomnia.

Author: WatsonNathaniel F, BencaRuth M, KrystalAndrew D, McCallWilliam V, NeubauerDavid N

Insomnia treatment

These guidelines provide evidence-based recommendations for deprescribing or transitioning between insomnia medications. Tapering is recommended for benzodiazepines and some Z-drugs, but not for other classes of insomnia medications.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

6.

Pharmacologic and hormonal treatments for menopausal sleep disturbances: A network meta-analysis of 43 randomized controlled trials and 32,271 menopausal women.

Author: ChengYu-Shian, TsengPing-Tao, WuMing-Kung, TuYu-Kang, WuYi-Cheng, LiDian-Jeng, ChenTien-Yu, SuKuan-Pin, StubbsBrendon, CarvalhoAndre F, LinPao-Yen, MatsuokaYutaka J, ChenYen-Wen, SunCheuk-Kwan, ShiueYow-Ling

Menopausal sleep disturbance treatment
Adverse event-related discontinuation

This network meta-analysis investigated the efficacy and tolerability of pharmacologic and hormonal interventions for menopausal sleep disturbances. Melatonin-fluoxetine showed therapeutic effects against sleep disturbances compared to placebo. Gabapentin, oral combined hormone therapy, and bazedoxifene-conjugated estrogens were effective for vasomotor symptoms.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

7.

Efficacy and tolerability of Z-drug adjunction to antidepressant treatment for major depressive disorder: a systematic review and meta-analysis of randomized controlled trials.

Author: KishiTaro, MatsunagaShinji, IwataNakao

Effective treatment
Z-drugs improve MDD
Adverse events
Dizziness

This meta-analysis of six studies (n = 2089) found that Z-drug adjunctive therapy improves the treatment efficacy for major depressive disorder (MDD) compared with placebo or antidepressants alone. The remission rate was significantly higher in the Z-drug + antidepressants group (NNT = 10). However, Z-drug + antidepressants was associated with a higher incidence of adverse events, particularly dizziness (NNH = 25).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

8.

The Dual Orexin Receptor Antagonist DORA-22 Improves Mild Stress-induced Sleep Disruption During the Natural Sleep Phase of Nocturnal Rats.

Author: GambleMackenzie C, KatsukiFumi, McCoyJohn G, StreckerRobert E, McKennaJames T

Hypnotic efficacy
Minimal lingering effects
Hypersomnolence

DORA-22, a dual orexinergic antagonist, promoted sleep in rodent models of sleep disturbance in the light period, analogous to when sleep disruption occurs in humans. Lower doses of DORA-22 showed minimal lingering hypnotic effects, suggesting a potential benefit in reducing hypersomnolence.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

9.

Pharmacotherapeutic management of insomnia and effects on sleep processes, neural plasticity, and brain systems modulating stress: A narrative review.

Author: PalaginiLaura, BianchiniCarlotta

Physiological sleep
Regulate stress system

Triazolam, a short-acting benzodiazepine, and eszopiclone, a Z-drug, have been shown to regulate the stress system and produce more physiological sleep, potentially without impairing sleep processes and related neural plasticity.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

10.

Zolpidem: Efficacy and Side Effects for Insomnia.

Author: EdinoffAmber N, WuNatalie, GhaffarYahya T, PrejeanRosemary, GremillionRachel, CogburnMark, ChamiAzem A, KayeAdam M, KayeAlan D

Insomnia treatment
Side effects

Insomnia is a common sleep disorder characterized by difficulty initiating or maintaining sleep or nonrestorative sleep. The most effective treatments involve cognitive behavioral therapy in conjunction with pharmacotherapy. Zolpidem is one of the most used hypnotics for insomnia, but it has a wide variety of adverse effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

11.

Comparative risk of fracture in community-dwelling older adults initiating suvorexant versus Z-drugs: Results from LIFE study.

Author: AdomiMotohiko, MaedaMegumi, MurataFumiko, FukudaHaruhisa

Comparable fracture risk
Increased fracture risk

This retrospective cohort study of 16,148 suvorexant new users and 54,327 Z-drugs new users found that suvorexant has a generally comparable risk of fracture as compared to Z-drugs.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

12.

The impact of eszopiclone on sleep and cognition in patients with schizophrenia and insomnia: a double-blind, randomized, placebo-controlled trial.

Author: TekCenk, PalmeseLaura B, KrystalAndrew D, SrihariVinod H, DeGeorgePamela C, ReutenauerErin L, GuloksuzSinan

Improved cognition
Improved sleep
Schizophrenia-related insomnia treatment

Eszopiclone improved sleep quality and cognitive function in patients with schizophrenia-related insomnia in a double-blind placebo-controlled study.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

13.

Patients' Knowledge of Key Messaging in Drug Safety Communications for Zolpidem and Eszopiclone: A National Survey.

Author: KesselheimAaron S, SinhaMichael S, RauschPaula, LuZhigang, TessemaFrazer A, LappinBrian M, ZhouEsther H, Dal PanGerald J, ZwanzigerLee, RamanadhamAmy, LoughlinAnita, EngerCheryl, AvornJerry, CampbellEric G

Improved sleep
Increased awareness
Limited understanding

A survey of patients taking zolpidem or eszopiclone revealed that while two-thirds reported hearing about drug safety information, only two-thirds of zolpidem users and half of eszopiclone users remembered the key messages in the Drug Safety Communications (DSCs). This highlights the need for better communication of DSCs to ensure patients understand the safety information regarding their medications.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

14.

Effects of a short course of eszopiclone on continuous positive airway pressure adherence: a randomized trial.

Author: LettieriChristopher J, ShahAnita A, HolleyAaron B, KellyWilliam F, ChangAudrey S, RoopStuart A,

CPAP adherence

A short course of eszopiclone during the first 2 weeks of CPAP improved adherence and led to fewer patients discontinuing therapy compared to placebo.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

15.

Analgesic efficacy of sleep-promoting pharmacotherapy in patients with chronic pain: a systematic review and meta-analysis.

Author: AnderssonEmelie, KanderThomas, WernerMads U, ChoJoshua H, KosekEva, BjurströmMartin F

Improved sleep quality
Reduced pain intensity

Sleep problems are linked to increased pain sensitivity and may worsen chronic pain. This review of 10 studies found that sleep-promoting medications, particularly melatonin, can reduce pain intensity in people with chronic pain compared to placebo.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

16.

Past-year use or misuse of an opioid is associated with use of a sedative-hypnotic medication: a US National Survey on Drug Use and Health (NSDUH) study.

Author: TubbsAndrew S, GhaniSadia B, NapsMichelle, GrandnerMichael A, SteinMichael D, ChakravortySubhajit

Opioid use
Sleep disturbance

This study examined the prevalence of past-year sedative-hypnotic use among individuals who used/misused opioids. The results showed that persons who used or misused opioids in the past year were more likely to report sedative-hypnotic use compared to those who did not use opioids.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, U.S. Gov't, Non-P.H.S.Research funding provided by US government agencies other than the Public Health Service.

Language : English

17.

Methodological approaches to evaluate the impact of FDA drug safety communications.

Author: KesselheimAaron S, CampbellEric G, SchneeweissSebastian, RauschPaula, LappinBrian M, ZhouEsther H, SeegerJohn D, BrownsteinJohn S, WoloshinSteven, SchwartzLisa M, ToomeyTimothy, Dal PanGerald J, AvornJerry

Zolpidem side effects

This article discusses the importance of post-approval drug safety communications (DSCs) issued by the FDA. It explores how DSCs convey information to patients and physicians and the factors that influence the effectiveness of communication.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, Non-P.H.S.Research funding provided by US government agencies other than the Public Health Service.

Language : English

18.

Differential sleep-promoting effects of dual orexin receptor antagonists and GABAA receptor modulators.

Author: GotterAnthony L, GarsonSusan L, StevensJoanne, MundenRegina L, FoxSteven V, TannenbaumPamela L, YaoLihang, KudukScott D, McDonaldTerrence, UslanerJason M, TyeSpencer J, ColemanPaul J, WinrowChristopher J, RengerJohn J

Sleep promotion

Insomnia is commonly treated with GABA receptor agonists, which promote sleep but also cause CNS depression. Dual orexin receptor antagonists (DORAs) are an alternative approach that target the orexin system, which promotes wakefulness. This study investigated the effects of these two mechanisms on sleep architecture and brain activity in animal models.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

19.

Eszopiclone for persistent negative symptoms in schizophrenia - An unintended N-of-1 study.

Author: MehtaUrvakhsh Meherwan, RavishankarVinutha, ThirthalliJagadisha

Schizophrenia treatment

This case report highlights the potential utility of eszopiclone, a specific γ-aminobutyric acid receptor binding drug, in treating persistent negative symptoms in a patient with chronic schizophrenia. The patient showed improvement in negative symptoms while on eszopiclone and worsening when unintentionally off treatment, suggesting a specific response to the drug and warranting further research.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

20.

Z-drugs and Falls: A Focused Review of the Literature.

Author: RybaNicole, RainessRebecca

Falls
Z-drug complications

This review examines the association between exposure to Z-drugs and the risk of falls, especially in the older population. A majority of the literature suggests an increased risk of falls with exposure to Z-drug use, especially zolpidem.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

21.

A method to assess the dissipation of the [corrected] residual effects of [corrected] hypnotics: eszopiclone versus zopiclone.

Author: BoyleJulia, GroegerJohn A, PaskaWalter, CooperJames A, RockettCarol, JonesSion, GandhiPaul, ScottJenny, AtzoriGiuseppe, DijkDerk-Jan

Next-day performance impairment

This study evaluated the next-day residual effects of eszopiclone and zopiclone, two sleep medications, compared to placebo. Both medications were associated with impaired performance the following day, although these effects diminished over time. While eszopiclone did not differ significantly from zopiclone on the primary endpoint, a post hoc analysis suggested eszopiclone may be associated with less impairment.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

23.

Emerging role of orexin antagonists in insomnia therapeutics: An update on SORAs and DORAs.

Author: KumarAnil, ChananaPriyanka, ChoudharySupriti

Anxiety
Cognitive dysfunction
Dependence
Hangover
Muscular atonia
Rebound insomnia
Respiratory inhibition
Tolerance

Orexin neuropeptides are regulators of transition between wakefulness and sleep. Orexin receptor antagonists are being developed as novel strategies for the treatment of sleep disorders.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

24.

Prevalence of and factors associated with acute withdrawal symptoms after 24 weeks of eszopiclone treatment in patients with chronic insomnia: a prospective, interventional study.

Author: InoueYuichi, TakaesuYoshikazu, KoebisMichinori

Dependence
Withdrawal symptoms

This review discusses the withdrawal symptoms associated with long-term use of benzodiazepines (BZDs). The review highlights the lack of clear data on the incidence, clinical manifestations, and triggering factors of BZD withdrawal symptoms at common clinical doses.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

25.

Z-drug for schizophrenia: A systematic review and meta-analysis.

Author: KishiTaro, InadaKen, MatsuiYuki, IwataNakao

Improved insomnia severity
Improved schizophrenia symptoms

This meta-analysis investigated the efficacy and safety of Z-drugs for the treatment of schizophrenia. The meta-analysis showed no significant differences in any outcome between pooled Z-drug and placebo treatment groups. However, one study showed that eszopiclone was superior to placebo in improving the Insomnia Severity Index scores.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.
Systematic ReviewA review that systematically collects, evaluates, and integrates relevant research to answer a specific research question.

Language : English

27.

Zolpidem and Eszopiclone Pre-medication for PSG: Effects on Staging, Titration, and Adherence.

Author: HolleyAaron B, LondereeWilliam A, SheikhKaren L, AndradaTeotimo F, PowellTyler A, KhramtsovAndrei, HostlerJordanna M

Improved sleep quality

This study compared the effects of eszopiclone and zolpidem, two non-benzodiazepine sedative hypnotics, on sleep quality and continuous positive airway pressure (CPAP) adherence in individuals with obstructive sleep apnea.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

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