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It's damn hard to find a reliable sleep aid that can be used in the long-term without fear of ill-health effects.
The really effective sleep aids have frightening side effects like withdrawal and dependence, and even neurotoxicity. I'm talking about drugs like GHB.
The sleep aids that are relatively benign are only modestly effective. They're often not helpful for people with serious, intractable insomnia.
Lunesta (eszopiclone) occupies a kind of middle ground. It's not the worst offender. There are prescription sleep aids on the market with harsher side effects.
I'm not qualified to provide to provide medical advice. But if I was, I would tell people to start with sleep aids with the lowest downside risk. Supplements like lavender, and lifestyle interventions like partaking in regular, vigorous exercise can really help resolve sleep issues.
But there are some folks who won't sleep no matter how much exercise they get. That's when you look to prescription sleep aids. The health consequences of chronic low sleep quality and sleep restriction are dire.
Lunesta Side Effects - Just How Bad Are They?
Before we jump in to Lunesta's adverse effect profile:
What is Eszopiclone (Lunesta)?
Eszopiclone is a non-benzodiazepine hypnotic agent belonging to the cyclopyrrolone class of chemical agents.
It is a white to light yellow crystalline solid formulated as film coated tablets for oral administration.
Eszopiclone is indicated for the treatment of insomnia. It decreases sleep latency (the time it takes you to fall asleep) and improves sleep maintenance when administered before bedtime.
In brief, lunesta is a z-drug, similar to Ambien (zolpidem), that alleviates insomnia by activating GABA receptors.
Worrisome Lunesta Side Effects
By and large the most concerning side effects of Lunesta are neurological.
One double-blind, placebo-controlled study reported an association between eszopiclone use and profound amnesia and psychomotor impairment.
Study participants were subjected to a battery of tests designed to evaluate:
- psychomotor coordination, correlated with the ability to maintain a motor vehicle in the driving lane
- working memory
- self-perception of sedation and coordination following consumption of eszopiclone the previous night
The authors concluded that eszopiclone resulted in next morning- psychomotor and memory impairment that was most severe 7.5h post administration and was still clinically meaningful nearly 12 hours later.
According to the FDA, there's no question that Eszopiclone is linked to withdrawal and dependence with long-term use.
This is not surprising; z-drugs like Lunesta (eszopiclone) bind the GABA receptor. GABAergic drugs are well-known to be habit-forming, the most famous example being Xanax.
In one 6 month double-blind study, participants treated with eszopiclone experienced clinically relevant levels of anxiety following discontinuation.
Other less frequent symptoms associated with discontinuation were:
- abnormal dreams
Study participants also reported rebound-insomnia after discontinuing Lunesta (eszopiclone).
On the first night after stopping Lunesta, both sleep latency and sleep efficiency were impaired. (Sleep latency is the time it takes you to fall asleep from the moment your head hits the pillow. Sleep efficiency is the percentage of time you're actually sleeping verses the time you spend in bed).
Moreover, the numbers of awakenings during the night were increased.
Eszopiclone's withdrawal symptoms are textbook and predictable. Eszopiclone use for extended periods leads to pharmacodynamic tolerance, which is exacerbated by its short elimination half-life. (It tends to be the case that drugs with short half-lives have more abuse potential).
Does Alcohol Interact With Eszopiclone?
The FDA reports that alchohol has a profound effect on individuals taking eszopiclone. Specifically, an additive effect on psychomotor performance was seen with co-administration of eszopiclone and ethanol 0.70 g/kg for up to 4 hours after ethanol administration. On that note, ethanol consumption should be avoided when taking Lunesta.
Should You Take Lunesta (Eszopiclone) For Insomnia?
Eszopiclone is an effective non-benzodiazepine hypnotic. There's no doubt that the drug improves quality of life in people suffering from insomnia.
It's true that Lunesta (eszopiclone) is linked to some frightening side effects. But patients should stick to their treatment regimen because they're physician has decided that the benefits outweigh the risks.
Every drug has side effects. Hence, prescribing medicine is always a cost/benefit analysis done by the physician.
Nevertheless, individuals taking Lunesta should be aware of the possible side effects. You should also report side effects to your physician. Your physician may discontinue Lunesta or adjust your dose depending on what you report. Some side effects aren't tolerable and others are life-threatening.
Pharmacology of Eszopiclone
The precise mechanism of action of eszopiclone is not known but it is thought to be similar to other clinically available non-benzodiazepine hypnotic. Specifically, it is assumed to interact with GABA-receptor complexes showing affinity for binding domains located close to or allosterically coupled to benzodiazepine receptors, ultimately enhancing the activity of these receptors.
What are the Dosages of Eszopiclone?
Lunesta tablets are available in dosages of 1mg, 2mg, or 3mg of eszopiclone and are formulated using the following inactive ingredients: calcium phosphate, colloidal silicon dioxide, croscarmellose sodium, hypromellose, lactose, magnesium stearate, microcrystalline cellulose, polyethylene glycol, titanium dioxide, and triacetin.
What are the Adverse-Effects of Eszopiclone?
As with every clinically available medication eszopiclone comes with its unwanted side effects. The side effects following have been generated following in detail analysis of the clinical trials conducted in order for the drug to gain approval from the Food and Drug Administration (FDA), as reported by patients involved in the study:
Lunesta's Adverse Events
Lunesta's side effect profile is not so different from other drugs in the same class (e.g., Ambien).
Dizziness, Migraines, Drowsiness
Ataxia, Hypesthesia, Hypertonia, Decreased reflexes and Incoordination, Memory Impairment, Neurosis, Involuntary Eye Movement and Paresthesias
Abnormal movement of the limbs, Hyperesthesia, Hypokinesia, Neuritis, Neuropathy, Stupor and Tremor
Post-marketing reports: Alteration of the perception of smell
Anxiety, Confusion, Depression, Hallucinations, Abnormal Dreams and Nervousness
Difficulty in concentrating, Agitation, Apathy, Excessive emotional reactions and frequent mood changes, Hostility, Insomnia
Hallucinations have been reported to occur more frequently with higher doses of eszopiclone.
Accumulation of fluids in the peripheral vascular system
High Blood Pressure
Inflammation of the veins due to a thrombus (Thrombophlebitis)
Acne, Hair loss (Alopecia), Cellulitis, Contact Dermatitis, Dry Skin, Eczema, Skin Discoloration, Excess Sweating, Hives
Erethyma multiforme, Boils, Excessive bodily hair growth, Maculopapular Rash, Vesicolobullous Rash, Angioedema
The incidents of a simple rash occurs in a dose-dependent manner.
Unpleasant taste in the mouth and Diarrhea
Dry mouth, Indigestion, Nausea, Vomiting
Gallstones, Bad Breath, Dark-Colored Stools, Mouth Ulcerations, Increased Thirst, and Ulcerative Stomatitis
Colitis, Difficulty in swallowing, gastritis, rectal hemorrhage, stomach ulcers, inflammation of the mouth, swelling of the tongue
Menstrual Cramps, Increases in the size of male breast tissue, Decreases in sex drive
Absence of menstrual periods, Breast Engorgement, Breast Enlargement, Breast Neoplasm, Breast Pain, Cystitis, Painful Urination, female lactation, Passing of blood in the urine, Kidney Stones, Kidney Pain, Mastitis, Bloody menstrual periods, Urinary Frequency, Uterine Hemorrhage, Urinary Incontinence, Vaginal Hemorrhage and Vaginitis
Low output of urine, Kidney Infections, Urethritis
Anemia, Inflammation of the lymph nodes
Hepatitis, Enlargement of the liver, liver damage
Herpes zoster related infection
Loss of appetite, increased cholesterol levels in the blood, increased appetite, weight changes
Dehydration, gout, increased lipids in the blood, decreased blood potassium levels
Arthritis, Bursitis, Joint Disorder (mainly swelling, stiffness, and pain), Leg Cramps, Muscle Weakness, Neck Rigidity and Muscle Twitching
Arthrosis, Myopathy, Back pain, Muscle pain
Conjunctivitis, Dry Eyes
Inflammation of the Iris, Dilation of the pupils, sensitivity to light, dropping eye lid
Asthma, Bronchitis, Difficulty breathing, Nosebleeds, Hiccups, Laryngitis,
Very rare: Pharyngitis, Rhinitis
Rare cases of allergic reactions have been reported following ingestion of Lunesta tablets. Specifically, swelling of the tongue, glottis, larynx along with dyspnea and throat closing have been reported all of which are indicative of anaphylactic shock.
Other Adverse Effects
Earache, Face swelling, Fever, Heat stroke, Hernias, Fatigue, Otitis Externa, Otitis Media, Ringing in the ears, Vertigo, Vestibular Disorder
Accidental Injuries, Pain