The two drugs are both nonbenzodiazepine hypnotic agents and work in almost the same way. They bind to the same receptor, the benzodiazepine binding site of the GABA-A receptor, to cause sedation. Drugs work by binding to receptors, and a helpful way to visualise this is to imagine the receptors as locks and the drugs as keys. More than one key can open a lock, which explains why zolpidem and zopiclone act on the same receptor. They both increase GABA levels, which leads to their sedative effects.
But whenever there are two similar drugs, the question arises: which is better?
A double-blind comparative study of Zolpidem versus Zopiclone in the treatment of chronic primary insomnia was carried out in 479 patients who were either given zolpidem 10mg or zopiclone 7.5mg once daily. The results showed that zolpidem was at least as effective as zopiclone.
The study also found that sleep onset latency, the time it takes to fall asleep, was improved in significantly more patients (85.8% versus 77.5%) and considerably fewer patients experienced drug-related side effects (31.3% versus 45.3%).
The side effect of experiencing a bitter taste after taking the tablet was experienced in 5.8% of the zolpidem cohort compared to 39.9% of the zopiclone group. To summarise, the study found that zolpidem was at least as effective as zopiclone, showed significantly less rebound on discontinuation and was better tolerated.1
Zolpidem
Zolpidem is a drug that is used to treat short-term insomnia. It belongs to a class of drugs known as the “Z drugs”, among this class of drugs is the other popular short-term hypnotic, zopiclone. Zolpidem is a sedative hypnotic drug which acts on the brain to increase GABA levels causing a sedative and calming effect. It is a nonbenzodiazepine but binds to the alpha type of the benzodiazepine receptor.
Zolpidem dosage
Zolpidem is available as a tablet in two strengths: 5 mg and 10mg. The usual dose for an adult struggling with insomnia is one 10mg tablet at bedtime for up to four weeks. In the elderly, the dose is usually reduced to the 5mg tablet.
Does Zolpidem cause addiction?
Zolpidem is a medication intended for short-term use, typically not exceeding 4 weeks. Although generally perceived as safe and non-addictive, prolonged usage can result in misuse and dependency, potentially triggering severe withdrawal symptoms upon cessation of use.
How long does Zolpidem take to work?
This medication starts to act within one hour, so taking it just before bedtime is essential. Avoid taking Zolpidem with or after a meal, as this may delay its effectiveness.
When to take Zolpidem?
Take Zolpidem if you have sufficient time for a complete night’s sleep, ideally lasting seven to eight hours. Waking up prematurely may lead to memory impairment and hinder your ability to safely perform tasks that demand alertness, such as driving or operating machinery.
Zopiclone
Zopiclone, marketed under the brand name Zimovane, is a nonbenzodiazepine hypnotic agent used to treat insomnia. Like zolpidem, it belongs to the “Z drugs” family and binds to the same receptor as zolpidem, the alpha type of the benzodiazepine receptor, where it works to increase GABA levels, thereby causing sedation.
Zopiclone Dosage
Zopiclone has two strengths: the 3.75mg tablet and the 7.5mg tablet. The usual dose for an adult with short-term insomnia is one 7.5mg tablet at nighttime. At the same time, the 3.75mg tablet is the preferred dosage for the elderly.
Does Zopiclone Cause Addiction?
Zopiclone, like Zolpidem, is a medication intended for short-term use, typically not exceeding four weeks. Although generally perceived as safe and non-addictive, prolonged usage can result in misuse and dependency, potentially triggering severe withdrawal symptoms upon cessation of use.
How long does it take for Zopiclone to work?
This medication starts to act within one hour, so taking it just before bedtime is essential. Avoid taking Zopiclone with or after a meal, as this may delay its effectiveness.
Can I take Zopiclone and Alcohol?
It’s not advisable to consume alcohol while using Zopiclone. Combining these substances can induce deep sleep, making it challenging to awaken.
How and when to take Zopiclone
Take Zopiclone immediately before going to bed. Refrain from taking the medication if you awaken during the night. Swallow the tablet whole with a glass of water; avoid crushing or chewing it. You may take Zopiclone with or without food. It’s not intended for daily use; only take it when necessary.
Can I buy Zolpidem and Zopiclone in the UK?
No, both of these drugs are prescription-only medicines (POMs) and hence can only be obtained on a prescription. Your GP can write a prescription for either Zolpidem or Zopiclone and provide you with a NHS prescription where you can get it dispensed form any community pharmacy of your choice. You may not have to pay for this prescription if you are exempt. However, if you cannot get an NHS prescription from your GP, you can contact a private doctor or prescriber who can issue you with a private prescription. Unfortunately, since this is a private service, it usually entails a cost for both the consultation and the prescription.
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References:
- Tsutsui, S. and Zolpidem Study Group, 2001. A double-blind comparative study of zolpidem versus zopiclone in the treatment of chronic primary insomnia. Journal of international medical research, 29(3), pp.163-177.
