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Case Reports
. 2007 Dec;53(12):2124-9.

Zopiclone: is it a pharmacologic agent for abuse?

Nevio Cimolai  1
Affiliations
Case Reports

Zopiclone: is it a pharmacologic agent for abuse?

Nevio Cimolai. Can Fam Physician. 2007 Dec.

Abstract
in English, French

Objective: To determine whether the hypnosedative drug zopiclone could be an agent for abuse.

Sources of information: Using MEDLINE and PubMed, English-language medical literature was systematically reviewed for reports of direct drug abuse and addiction. A review was also conducted for clinical trials or patient series that discussed issues of addiction or rebound effects.

Main message: Evidence of drug abuse and dependency was found in case reports and small patient series. Dependency symptoms of severe rebound, severe anxiety, tremor, palpitations, tachycardia, and seizures were observed in some patients after withdrawal. Abuse occurred more commonly among patients with previous drug abuse or psychiatric illnesses. Many clinical trials have found evidence of rebound insomnia after recommended dosages were stopped, albeit for a minority of patients. Comparative studies of zopiclone and benzodiazepines or other "Z" drugs are conflicting.

Conclusion: Zopiclone has the potential for being an agent of abuse and addiction. While many have suggested that the addictive potential for this and other "Z" drugs is less than for most benzodiazepines, caution should be taken when prescribing this agent for insomnia. Ideally, prescriptions should be given for a short period of time and within the recommended dosage guidelines.

OBJECTIF: Déterminer si l’agent hypnosédatif zopiclone présente un risque d’accoutumance.

SOURCE DE L’INFORMATION: À l’aide de MEDLINE et de PubMed, on a effectué une revue systématique de la littérature anglaise sur des cas de toxicomanie et d’accoutumance de ce type. On a également relevé les essais cliniques et les séries de patients relatifs à l’accoutumance et àl’effet rebond.

PRINCIPAL MESSAGE: On a trouvé des rapports de cas et des petites séries de patients décrivant des cas de toxicomanie et d’accoutumance. Chez certains patients en sevrage, on a observé de graves symptômes de rebond et d’anxiété, de tremblement, de palpitations, de tachycardie et de convulsions. Les patients avec antécédents de toxicomanie ou de maladie psychiatrique étaient plus susceptibles de toxicomanie. Plusieurs essais cliniques ont observé chez un petit nombre de patients de l’insomnie rebond à l’arrêt d’un traitement aux doses recommandées. Les études comparant la zopiclone aux benzodiazépines et aux autres médicaments de type «Z» sont contradictoires.

CONCLUSION: La zopiclone a le potentiel d’entraîner de l’accoutumance et de la toxicomanie. Même si plusieurs auteurs donnent à penser que le risque de toxicomanie avec cet agent et les autres médicaments de type «Z» est moins élevé qu’avec la plupart des benzodiazépines, il y a lieu d’être prudent lorsqu’on le prescrit pour l’insomnie. Idéalement, ces prescriptions devraient être de courte durée et respecter les doses recommandées.

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Comment in

  • Addictive evidence.
    Fleming JA, Samuels CH, MacFarlane J, Morehouse R. Fleming JA, et al. Can Fam Physician. 2008 Mar;54(3):346-8; author reply 348. Can Fam Physician. 2008. PMID: 18337525 Free PMC article. No abstract available.

References

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