The most common is the sensation of “bitter taste in the mouth” referred by patients. The following adverse effects have been reported: General: headache, muscle weakness. Central nervous system: residual daytime sleepiness, decreased alertness, vertigo, anterograde amnesia, confusion, asthenia and, exceptionally, ataxia, diplopia, libido modification.
Dependency and rebound of insomnia after discontinuation of treatment. Gastrointestinal: nonspecific discomfort. In some patients, often elderly, paradoxical reactions consisting of irritability, vertigo, aggressiveness, agitation, hallucinations and depersonalization may occur (see Warnings). Skin reactions and pruritus have been described.
The development of drug dependence cannot be excluded. Various factors seem to favor its production: duration of treatment, dose, association with other medications (anxiolytics, antipsychotics, hypnotics, etc.) and a history of other drug dependencies, including alcohol. It is not advisable to extend the treatment beyond 4 weeks, a progressive decrease in the dose is beneficial.
Anterograde amnesia is possible, particularly when sleep is interrupted (waking up early due to an external event) or there is a delay in going to bed after taking the tablet. To prevent this eventual phenomenon, zopiclone should be administered at bedtime.
It has been reported in patients undergoing treatment with non-benzodiazepine hypnotics the appearance of alterations of thought or behavior. Some of these changes may be characterized by decreased inhibition (eg aggressiveness, outgoing behavior) similar to those evoked by alcohol consumption and other CNS depressants (see Drug Interactions).
Other reported behavioral disturbances included bizarre behavior, agitation, hallucinations and depersonalization. Because some of the adverse effects of these drugs are dose dependent, it is important to remember that the daily dose should not exceed the recommended maximum and that it should always be the minimum necessary to achieve the desired therapeutic effects, especially in the elderly.
In patients with primary depression treated with both benzodiazepine and non-benzodiazepine hypnotics, cases of worsening symptoms have been reported, even leading to suicidal ideation. Rarely can it be determined with precision whether any of the aforementioned behavioral alterations were caused by the drug, spontaneously, or as a result of an underlying psychiatric or medical illness.
Best time to take this medicine
Due to the rapid onset of its pharmacological action after oral administration, this medication should be taken just before bedtime. Patients should be advised not to perform tasks that require total attention and / or precise motor coordination, such as the operation of dangerous machinery or driving vehicles, after taking this medication.
Major Side Effects
Tolerance: The therapeutic effect of benzodiazepines and related drugs may decrease with repeated use for several weeks. Even though it has not yet been reported with zopiclone, the tolerance phenomenon must be taken into account, strictly respecting the maximum treatment time including the progressive discontinuation period. After four weeks of treatment, the specialist must reassess the need to continue or not the administration of the hypnotic.
Dependence: In patients treated for a long time and, especially with doses higher than those recommended, signs and symptoms compatible with withdrawal symptoms have been described. It is recommended to progressively withdraw treatment with zopiclone in order to minimize the risk of withdrawal syndrome and alert the patient to the possibility of it, notifying the doctor if manifestations such as headache, insomnia, muscle aches, anxiety, agitation occur , confusion, irritation and in severe cases seizures.