What is Zopiclone?
The medication Zopiclone is a non-benzodiazepine hypnotic agent used to treat insomnia (Loss of Sleep). It is a controlled or regulated drugs in most countries and possession of zopiclone without a prescription from a physician is illegal [1, 2].
Zopiclone drug acts on the same binding sites as benzodiazepines although there are minor differences on how they behave. Being non-benzodiazepine, there are less chances of drug addiction and habituation, although there have been reported cases of these occurrences.
Zopiclone should only be used as needed. and not to be taken continuously due to the possible risk of tolerance, dependence and addiction.
Side Effects of Zopiclone
Side effects associated with this medication include anxiety or restlessness in the daytime, severe drowsiness, skin rash, unusual behavior, mental depression and presence of hallucinations and illusions.
Brands of Zopiclone
Available brands of Zopiclone include Imovane and Zimovane and are manufactured by Sanofi-Aventis. Its active stereoisonomer, eszopiclone, is sold commercially [1, 2, 3].
Amount of Zopiclone Overdose
The therapeutic dose of zopiclone is 7.5 mg or 1 tablet. Some physicians even prescribe half tablets for patients with mild insomnia. Zopiclone is only taken when needed, and it is not for everyday use because of the chances of tolerance that would lead to overdosing when patients take more than the prescribed amount.
The toxic dose of Zopiclone is at 150mg or equivalent to ingesting 20 tablets. Zopiclone overdose is more severe when it is taken with opiates, alcohol, other CNS depressants and piperazine. The risk for fatal overdose also increases with hepatic failure because of the inability of the liver to bio transform, metabolize and excrete the drug from the body. [1, 2, 3, 4]
Zopiclone Overdose Signs & Symptoms
Zopiclone overdose may lead in the following symptoms:
Central Nervous System effects
Reduction in the function of the central nervous system include fatigue, impairment in concentration and anterograde amnesia. These individuals may either be irritable or with a depressed mood. Changes in the perception of taste and development of abnormal vision [2, 3, 4].
Gastrointestinal symptoms that may be experienced include abdominal pain, dyspepsia, hepatitis, nausea and vomiting. They are also at greater risk for viral infections. The individual may experience hypersensitivity reactions to zopiclone and include urticaria and development of rashes [2, 3, 4].
Treatment and Management
The initial priority when a patient has overdosed on Zopiclone is to bring them to the hospital as soon as possible. When they arrive in the emergency department, the initial priority is the Airway, Breathing and Circulation of the patient (ABC). There may be a need to perform an emergency endotracheal intubation if the patient can’t maintain respiration. An intravenous access should be established to administer medications as needed [2, 3, 4].
If the ingestion of zopiclone occurred less than an hour before the patient is brought to the hospital, a gastric lavage can be performed. A single dose of Activated charcoal may be given to the patient but the airway must be protected during the administration to prevent aspiration. Measures to enhance the elimination through the urine will be performed as well [2, 3, 4].
Administration of Flumazenil
Flumazenil is the antidote for zopiclone overdose because it competes with the receptor sites of zopiclone in the body, thereby displacing the zopiclone and prevents it from binding on the receptor sites. Flumazenil also displaces the zopiclone substances on the benzodiazepine receptor sites. This treatment rapidly reverses the symptoms of drug overdose [2, 3, 4].
Those who have intentionally ingested a toxic amount of Zopiclone must be referred to a psychiatrist for an evaluation. This may prevent the individual in attempting suicide in the future [2, 3, 4].
How to Prevent Zopiclone Toxicity?
Zopiclone must be taken as per the prescription of the physician to avoid the toxicity. Any adverse effects must be reported immediately to the physician. Sudden cessation of continued zopiclone use may lead to withdrawal symptoms so the best way to stop is to slowly taper off the medication. Bottles that contain the medication must be labeled properly and kept in places that are out of children’s reach to prevent ingesting them accidentally [1, 2, 3, 4].
What do you think about the overdose on Zopiclone? Feel free to share your thoughts in the comment section below.
References & More Information
- Allen, H. (2014, June 16). Zopiclone tablets (Zimovane). Retrieved from Patient.info: http://patient.info/medicine/zopiclone-tablets-zimovane
- World Health Organization Expert Committee on Drug Dependence. (2006). Zopiclone Critical Review. Retrieved from World Health Organization Expert Committee on Drug Dependence: http://www.who.int/medicines/areas/
- com. (2000, May 30). Zopiclone (Systemic). Retrieved from Drugs.com: https://www.drugs.com/mmx/zopiclone.html
- Cooper, J. S. (2015, December 29). Sedative-Hypnotic Toxicity Treatment & Management. Retrieved from Medscape: http://emedicine.medscape.com/article/818430
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