Zopiclone is a prescription medication used to treat insomnia. It belongs to a class of medications called nonbenzodiazepine hypnotics. The recommended dosage of zopiclone for adults is 7.5 mg taken by mouth before bedtime. This article will examine whether it is safe to take 15 mg of zopiclone, which is double the commonly recommended dosage.
What is zopiclone?
Zopiclone (brand names Imovane, Zimovane) is a sedative-hypnotic medication used to treat insomnia. It works by binding to GABA receptors in the brain, which promotes sleepiness and reduces brain activity. This enables people to fall asleep more easily and sleep through the night.
Some key facts about zopiclone:
– It is classified as a nonbenzodiazepine hypnotic drug. This means it has a similar mechanism of action as benzodiazepines (Valium, Xanax) but has a slightly different chemical structure.
– It is available by prescription only and sold as tablets in doses of 3.75 mg and 7.5 mg.
– The recommended starting dose for adults is 3.75-7.5 mg taken by mouth at bedtime. This dose can be adjusted up to a maximum of 7.5 mg if needed.
– It is intended for short-term use only. The recommended treatment duration is 2-4 weeks. Long-term use requires caution due to the risk of dependence and tolerance.
– It works quickly, usually inducing sleep within 15-30 minutes of taking the tablet.
– The effects last for 6-8 hours but may persist into the next day in some people.
What are the therapeutic uses of zopiclone?
The main use of zopiclone is to treat insomnia, specifically:
– Difficulty falling asleep
– Waking up frequently during the night
– Early morning awakenings
It can help people fall asleep faster, stay asleep longer, and improve sleep quality. This makes it helpful for insomnia related to:
– Stress, anxiety, depression
– Disruptions to sleep schedule (jet lag, shift work)
– Other medical or psychiatric conditions
Zopiclone may also be prescribed “off-label” for:
– Severe anxiety before medical procedures
– Alcohol withdrawal
– Muscle spasms or seizures
However, the evidence for these uses is limited and zopiclone is only approved by regulatory agencies for insomnia.
How does zopiclone work?
Zopiclone belongs to a class of medications called cyclopyrrolones. It works by binding to GABA (gamma-aminobutyric acid) receptors in the brain.
GABA is the brain’s main inhibitory neurotransmitter, meaning it blocks or dampens nerve signals. This results in a calming, sedative effect.
By activating GABA receptors, zopiclone:
– Promotes sleepiness and relaxation
– Reduces time spent awake at night
– Increases total sleep time
– Enhances sleep quality
This GABA-enhancing action induces the key features of quality sleep: decreased alertness, slower brain wave activity, relaxed muscles, and suppression of arousal and anxiety.
What is the recommended safe dosage?
The recommended starting dosage of zopiclone for adults is 3.75-7.5 mg taken by mouth at bedtime. The effective dosage for most people is 7.5 mg.
Lower doses of 3.75-5 mg may be prescribed for elderly patients and those with liver impairment.
The maximum recommended nightly dosage is 7.5 mg.
Patients should start with the lowest dose that works for them and only increase if the desired effects are not achieved. The goal is to use the lowest effective dose.
Taking more than 7.5 mg per day is considered higher than the maximum recommended amount and may increase the risk of side effects.
What are the potential risks of taking 15 mg of zopiclone?
Taking 15 mg of zopiclone would be double the maximum recommended nightly dosage. Potential risks of exceeding the recommended zopiclone dosage include:
– Excessive drowsiness, sedation: Higher doses amplify the sleep-inducing effects of zopiclone. This can lead to prolonged drowsiness, lack of coordination, slow reflexes and an inability to concentrate the next day.
– Complex sleep behaviors: Zopiclone can sometimes cause abnormal sleep behaviors like sleepwalking, sleep driving, sleep eating which have risks of falls, accidents, and injuries. The risk likely increases with higher doses.
– Respiratory depression: High doses of zopiclone may slow breathing rate and responsiveness to elevated carbon dioxide levels. This raises the danger of dangerous changes in oxygen and carbon dioxide levels in the blood.
– Worse hangover effect: Next morning drowsiness, dizziness and impairment may persist longer into the next day compared to a standard dose. This increases the chance of accidents.
– Tolerance and dependence: Taking zopiclone for longer than advised or at higher than recommended doses increases the risk of building tolerance to its effects. This leads to reliance on the drug and withdrawal symptoms if it is stopped suddenly.
– Overdose and toxicity: Very high doses of zopiclone severely depress the central nervous system. Overdose can lead to coma, dangerously slowed heart rate and breathing, hypothermia and death.
What are the side effects of zopiclone?
The most common side effects of taking zopiclone at recommended doses include:
– Morning drowsiness, grogginess
– Headache
– Dizziness
– Unpleasant metallic taste in mouth
– Dry mouth, throat
– Nausea, upset stomach, diarrhea
– Fatigue
Higher than recommended doses are more likely to produce side effects like:
– Prolonged drowsiness the next day
– Impaired concentration and memory
– Lack of muscle coordination
– Confusion
– Agitation or irritability
Rarer side effects that may occur with zopiclone include:
– Allergic reactions (rash, itching, swelling)
– Sleepwalking or engaging in other activities while asleep
– Hallucinations
– Changes in libido
– Nightmares
– Aggression
The risk of side effects generally increases at higher dosages. Elderly people may also be more sensitive to the effects and side effects of zopiclone.
How long does zopiclone stay in your system?
Zopiclone is absorbed rapidly after oral ingestion, reaching peak concentrations in the blood within 1.5-2 hours. It has an elimination half-life of approximately 5 hours in healthy adults. This is the time it takes for blood concentration levels to decrease by 50%.
Most of the drug is eliminated from the body within 24 hours:
– 80% excreted in urine
– 11% in feces
The effects on the brain typically last for about 6-8 hours after taking zopiclone.
However, residual blood concentrations may remain for over 24 hours in some individuals, particularly with higher doses. This extends the window of potential impairment.
In rare cases, traces of zopiclone may be detectable in urine for 2-4 days after taking a single dose.
The elderly and those with liver impairment tend to eliminate the drug more slowly.
Can you overdose on zopiclone?
Yes, it is possible to experience zopiclone overdose if excessive doses are taken.
An overdose can occur intentionally via a deliberate overdose or accidentally through taking more than the recommended amount.
Signs of zopiclone overdose may include:
– Marked drowsiness, sedation
– Slurred speech
– Confusion
– Dizziness
– Poor coordination
– Slowed breathing
– Coma
– Respiratory depression
In severe cases, zopiclone overdose can lead to:
– Respiratory arrest
– Cardiac arrest
– Death
The risk of fatal overdose increases if zopiclone is taken with alcohol or other central nervous system depressants like opioids, anti-anxiety meds or antipsychotics.
Seeking immediate medical help is crucial for suspected zopiclone overdose. Supportive treatments may include:
– Activated charcoal to prevent absorption
– Breathing support
– IV fluids
– Medications to increase blood pressure
Can you take 15 mg of zopiclone for insomnia?
It is not recommended to regularly take 15 mg of zopiclone for insomnia, as this exceeds the maximum advised dosage.
While some people may take higher than recommended doses hoping for better insomnia relief, there is little evidence that very high doses lead to added benefit.
However, there is substantial evidence that exceeding the recommended zopiclone dosage increases the risk of side effects, dependence, and toxicity.
The usual dosage range of 3.75-7.5 mg is sufficient for most people to fall asleep and stay asleep. Higher doses are more likely to produce excessive drowsiness, cognitive impairment, and complicate insomnia management.
It is better to consult a doctor about adjusting the timing, formulation, or combination with other medications rather than simply increasing the zopiclone dose on your own.
What are the risks of taking 15 mg of zopiclone long-term?
Taking 15 mg of zopiclone regularly over the long-term has significant risks:
– Dependence: Chronic high-dose use can lead to physical and psychological dependence. Stopping suddenly could result in withdrawal symptoms like rebound insomnia, anxiety, sweating, racing heart rate, tremors.
– Tolerance: Over time, your body gets used to zopiclone’s effects. This means you need increasingly higher doses to get the same sleep-promoting effects, which worsens dependency issues.
– Cognitive impairment: Regular overuse impacts daytime brain function, affecting memory, focus, concentration, alertness and ability to react quickly. This raises the chance of accidents and injuries.
– Mental health: There may be an increased risk of depression from the sedating effects of high-dose zopiclone altering neurotransmitter levels long-term. Paradoxical reactions like worse insomnia, agitation, or aggression can also occur.
– Respiratory issues: Repeated high doses increase the risk of severely slowed or irregular breathing patterns, drops in blood oxygen, andassociated health consequences.
– Rebound insomnia: Stopping zopiclone after regular overuse often leads to a temporary worsening of insomnia for a few nights. This reinforces dependency on the medication.
– Drug interactions: Higher blood concentrations of zopiclone increase the chance of additive side effects when combined with other central nervous system depressants like alcohol, opioids, or antipsychotics.
In summary, exceeding the recommended zopiclone dosage on a persistent basis may lead to impaired functioning and detrimental effects on physical and mental health. It is better to optimize standard dosing under medical supervision.
What are alternatives to taking an excessive dose of zopiclone?
Rather than taking more than the recommended amount of zopiclone, safer alternatives for insomnia include:
– Optimizing standard dosage: Take the usual dosage of 3.75-7.5 mg at the ideal timing to maximize effects and minimize next day drowsiness.
– Switching formulations: The controlled-release tablet may help maintain sleep longer compared to immediate release.
– Combination therapy: Adding a low dose of another medication like melatonin or an antidepressant may boost effects without needing a higher zopiclone dose.
– Non-drug strategies: Improve sleep hygiene habits like limiting blue light exposure at night, avoiding alcohol before bedtime, maintaining a regular sleep-wake schedule. Cognitive behavioral therapy for insomnia is also effective.
– Assessing other issues: Consider if factors like untreated medical conditions, medications, mental health disorder, or substance use are worsening the insomnia and address them.
– Seeking guidance: Have your doctor review all current medications and medical conditions for potential insomnia triggers. They may adjust therapies, recommend specialist referral or prescribe alternative medications if zopiclone is not optimal.
– Temporary use: Limit zopiclone use to transient periods of worse insomnia. This avoids habit-forming chronic use.
Using the lowest effective zopiclone dose along with non-pharmacological strategies and medical guidance is the optimal approach for managing insomnia safely.
When should someone see a doctor about zopiclone dosage?
You should consult a doctor or pharmacist if:
– You are uncertain about the right zopiclone dosage for your needs
– Your current dose doesn’t seem to be working well or as long as it used to
– You experience significant side effects
– You find it hard to stick to the recommended dosage regimen
– Your insomnia persists despite using zopiclone
– You need to take zopiclone regularly for longer than advised
– You have difficulty reducing your zopiclone dose
– You experience worsening insomnia, anxiety, or other issues when trying to stop taking zopiclone
– You are combining zopiclone with other sedating substances like alcohol, opioids, or certain psychiatric medications
– You have breathing issues, sleep behaviors, thinking problems or other concerning symptoms while on zopiclone
Your doctor can review your full medical history, sleep situation, and medication regimen. They may adjust the dose, switch medications, or recommend specialist assessment if needed to improve sleep and reduce risks.
Conclusion
In most cases, taking 15 mg of zopiclone exceeds the recommended maximum nightly dosage for adults.
While some people may take higher than advised doses hoping for better insomnia relief, there is limited evidence of added benefits.
On the other hand, exceeding the recommended zopiclone dosage substantially increases the risks of excessive sedation, cognitive and psychomotor impairment, respiratory depression, dependence, tolerance, and adverse effects. These risks amplify with longer-term high-dose use.
It is generally safer to optimize treatment using standard zopiclone doses of 3.75-7.5 mg taken for short periods, along with non-drug strategies and medical guidance.
Consulting a doctor is advisable if you are regularly needing to take more than the recommended amount of zopiclone for insomnia or are experiencing problems with its use. They can help adjust your regimen to improve sleep and reduce medication risks.
