We are also requiring a Contraindication, our strongest warning, to avoid use in patients who have previously experienced an episode of complex sleep behavior with eszopiclone
, zaleplon, and zolpidem." "We identified 66 cases of complex sleep behaviors occurring with these medicines over the past 26 years that resulted in serious injuries, including death," the FDA said.
A RCT found that eszopiclone
could significantly decrease wakeness and improve sleep quality of PD patients (quality score, 95%).
However, the benzodiazepine receptor agonists such as zaleplon, Zolpidem, and eszopiclone
, while lacking evidence in the pediatric population, may be worthwhile considerations as their varying half-lives allow for specificity in treating sleep-onset vs.
, Zolpidem, zaleplon) Gastric or * Aspirin (>325 mg/d) May exacerbate duodenal * NSAIDs existing ulcers or ulcers cause new or additional ulcers Chronic * NSAIDs May increase risk of kidney acute kidney injury disease and cause further decline of renal function Urinary * Estrogen (oral and Aggravation of incontinence transdermal) incontinence * Peripheral alpha-1 blockers * Diuretics * Cholinesterase inhibitors BPH * Anticholinergic drugs May cause urinary retention BPH, benign prostatic hyperplasia; CCBs, calcium channel blockers; CNS, central nervous system; COX, cyclooxygenase; NSAIDs, nonsteroidal anti-inflammatory drugs.
In addition, this recommendation is classified as "weak," and the associated evidence "low-quality." Medications reviewed included eszopiclone
, zaleplon, Zolpidem, orexin receptor antagonist, melatonin, ramelteon, and benzodiazepines.
This notion was supported by a multi-center, placebo-controlled study which reported that eszopiclone
3 mg, a nonbenzodiazepine hypnotic agent, resulted in significant improvement in functional capacity in RA based on the HAQ scores in four weeks of treatment.
The 2015 Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults added nonbenzodiazepine receptor agonist hypnotics (ie, Zolpidem, zaleplon, and eszopiclone
) as medications to avoid in patients who have dementia because of adverse CNS effects.
Lunesta, another hypnotic, marketed with a seductive green butterfly logo, had more than $350 million in sales in the United States in 2014, and that figure does not include the generic version, eszopiclone
, which generated another $43 million.
A recent meta-analysis32 showed that the risk of major congenital abnormalities was similar in children born to mothers with anxiety and depression but without any drug exposure in the first trimester when compared to children born to mothers who received diazepam, temazepam, eszopiclone
or other anxiolytic/hypnotics in the first trimester indicating that prescription of these drugs during early pregnancy may be safe in terms of risk of major congenital anomalies but further studies are needed to confirm safety.
After she was treated with psychoactive drugs, it was found that clonazepam tablets in the benzodiazepine class and dopamine antagonist olanzapine tablets aggravated double eyelid spasm; while eszopiclone
tablets as a specificity a-aminobutyric acid receptor binding drug alleviated this condition.
On the same day, he saw "private physician C," who referred him to a psychiatrist and a psychotherapist, and prescribed zopiclone, a sleep medication similar to Lunesta (eszopiclone
), the report says.