high dose zopiclone

Understanding zopiclone and its potential to be misused, is an important part of learning more about this powerful z-drug. 

Since Zopiclone is commonly used to treat short-term insomnia – usually 10 days or less [1].

It is not uncommon for some patients to experience addiction or withdrawal if they do not stick to their short-term treatment.  

In this article we will try to outline (where evidence is available) the possible concerns surrounding Zopiclone addiction and withdrawal, using real world examples from the literature.

 

Important Note:

Zopiclone is usually taken in a dose range of:

3.75mg to 7.5mg

for

2 – 4 weeks only.[2]

 

Please understand that you should only use Zopiclone as indicated by a healthcare professional.

 

Below you’ll find some relevant information that will help in clarifying zopiclone and its relationship to addiction and withdrawal, however, let us re-cap on Zopiclone Side effects.  

Physical Effects 

  • Heavy feeling in the arms 
  • Loss of coordination 
  • Metallic taste in the mouth (within an hour of administration)

Psychological Effects

  • Inability to think clearly and rationally 
  • Become overly-confident 
  • Aggressive and/or violent behaviour

To make sure you’re fully aware of Zopiclone’s potential to cause dependency, from withdrawal, here are a few case studies that indicate such withdrawal/dependency problems.

CASE 1: Increasing the Dose

zopiclone case

7.5mg Zopiclone was given to a 29 year old man suffering from pneumothorax. 

This individual then increased the dose to 22.5mg, which was further supplemented with tablets from other sources [3]. 

 

Mixing Zopiclone with other drugs is definitely something which should always be avoided.

 

Results

Eight months passed before the man realised he was misusing zopiclone.

Coming off zopiclone, symptoms of his withdrawal included, severe anxiety, tremors, sweating, and rebound insomnia.

To stop these withdrawal symptoms, the man was given a 25mg dose of amitriptyline, over several weeks. 

Thankfully, he made a full recovery.

Discussion

What is important to take note of, if considering taking zopiclone, is that Zopiclone is not without certain rebound, withdrawal or dependency phenomena [3]. 

Given that this individual was mixing various supplements with zopiclone, and taking such a high zopiclone dose, the body is simply not prepared for this. 

Moreover, jumping from the usual dose of 7.5mg to a larger, 22.5mg dose, poses dangers to the body and also brain. Increasing ones risk of addiction and withdrawal. 

CASE 2: 30mg Zopiclone Daily

case 1

A 7.5mg Zopiclone dose was given to a 26-year old man to treat his insomnia.

His 7.5mg dose (taken daily) was increased to four times daily (a hefty increase).

Usually, a 7.5mg dose is the standard Zopiclone dose, however, a larger dose increase would significantly change the body’s way of dealing with such a large amount.

Results

The man stopped taking his 4x daily zopiclone dose and experienced withdrawal symptoms, including anxiety, tremors, sweating, hot flushes and palpitations [3]. 

To remove these common withdrawal symptoms, the man’s zopiclone dose was decreased to 7.5mg, nightly, and 3.75mg, daily.

He was monitored closely.

Discussion

This individual also reported a strong craving for zopiclone, most probably due to the unusually high dose of zopiclone.

In this regard, addiction to zopiclone is possible, if large doses of the z-drug are taken. 

CASE 3: Switching Doctors

case 2

A woman suffering from bipolar affective disorder was prescribed a 7.5mg zopiclone dose for her insomnia [3].

A year later, after the first treatment, she was self-administering 7.5mg zopiclone 4x daily.

The woman managed to obtain the required dose by frequently changing doctors [3]. 

Results

A reduction in her 4x daily zopiclone dose meant that she experienced sweating, palpitations, tremors, and anxiety.

Again, these withdrawal symptoms are indications that an individual is developing an addiction to zopiclone.

Her zopiclone dose was subsequently reduced, and she was monitored during this period.

Discussion

As we can see, the main reason why these patients grew a dependence and associated withdrawal is because they each increased their prescribed dose. 

The higher the dose of zopiclone that is taken, the greater the risk of overdose and possible death.

Always consult with your doctor before making any changes to dose.

Conclusion: Follow The Dosage Guidlines

opiclone guidelines

As we can see, the main reason why these above mentioned patients grew a dependence and associated withdrawal is because each increased their prescribed dose.

This is why we continue to stress the importance of coordinating your Zopiclone treatment with a qualified healthcare professional.

The vast majority of problems surrounding Zopiclone, lie with the patients inability to correctly follow guidelines properly.

So stick to the plan and always talk to your doctor before any changes are made.

The higher the dose you use, the greater the risk of overdose and death.

Zopiclone Withdrawal Effects

zopiclone withdrawal effects

Withdrawal, also known as detox, is defined as:

 

cutting back or stopping altogether the consumption of any drug or medication. 

 

Experiencing withdrawal can have physical and psychological effects on the body.

Also, symptoms of withdrawal, depending on the drug, can affect people differently [14].

Withdrawal from benzos, for example, may lead to an increased level of irritability along with a short period of benzo-induced depression [15].

These withdrawal effects from benzos gradually improve after the acute withdrawal stage, which is the ‘first stage’ of withdrawal that lasts a few weeks [16]. 

Zopiclone vs Benzodiazepines - Withdrawal

zopiclone vs benzodiazepines

One study tested the effects of replacing Flunitrazepam (FLU) with zopiclone among chronic benzo users, and how this might ease withdrawal symptoms. 

In addition, this research aimed to assess whether discontinuation of zopiclone was associated with greater or fewer sleep problem (such as rebound insomnia) [4]. 

Results from this work showed that:

 

withdrawal from zopiclone, compared with Flunitrazepam was milder

 

Moreover, the researchers reported that:

 

zopiclone could play a beneficial role in coming off chronic benzo use [4]. 

 

However, this work still needs more validation, since it cannot be fully concluded that zopiclone should replace another sleeping pill if someone is suffering withdrawal symptoms. 

Interestingly, Benzos can produce something called ‘paradoxical reactions’, which refers to a range of negative effects such as aggression, irritability, rage and even suicide [15]. 

Although violence is rare in benzo abuse, it can still occur.

CASE STUDY: Rebound Insomnia

case 5

A middle-aged woman was prescribed 7.5mg zopiclone for her insomnia.

The woman subsequently increased her dose to 15mg, and then further to 22.5mg [3]. 

Result

When the woman tried stopping her 22.5mg zopiclone dose, she experienced severe rebound insomnia and anxiety

Discussion

Her dependency meant that she was hesitant to reduce the dose, and this is a classic sign of withdrawal symptoms.

 

It is always recommended to follow the dosage guidelines of a professional. 

Rebound Insomnia Zopiclone

rebound insomnia

Rebound insomnia is described as:

 

the worsening of initiating or maintaining sleep after someone has abruptly stopped taking sleeping pills [5].

 

Furthermore, rebound insomnia occurs as the body may be dependent on a drug to fall asleep, which means that their insomnia will return or ‘rebound’ [6]. 

Rebound insomnia can last from a few days to a few weeks.

 

“Rebound insomnia is like having a double dose of insomnia. The body — which couldn’t sleep in the first place — adapts to needing a sleeping pill to sleep; and when it is then taken away, the insomnia is compounded.”

– Dr. Cosmo Hallström, Royal College of Psychiatrists 

Medications that cause rebound insomnia can include anything from neurotransmitters, such as serotonin to tryptophan and melatonin.

With zopiclone, rebound insomnia has been reported as being:

 

rare at the moderate dose of 7.5mg [7]. 

Zopiclone Addiction UK

zopiclone addiction uk

A UK woman was prescribed zopiclone by her GP for pain related to shoulder surgery.

The woman took the pills every night for six months, and found it difficult giving up zopiclone after some time [8]. 

Moreover, the woman felt depressed and found decision making hard.

What’s important to note is that this woman also experienced withdrawal symptoms based on ‘rebound insomnia’ – see above section rebound insomnia zopiclone to learn more. 

Another woman, also from the UK, revealed addiction to zopiclone and alcohol [9].

Addiction to the z-drug lasted for four years, before she entered rehab.

In rehab, it took three intensive weeks to overcome zopiclone addiction.

Severe Dependence

To demonstrate a more severe case of chronic zopiclone use, a 31-year old British woman was admitted for a ten-day alcohol detoxification [10]. 

This individual was taking zopiclone at a dose of 30mg, daily, which would be considered high. 

 

Prior to this high zopiclone dose, the woman was taking up to 90mg of zopiclone for 13 years [10]. 

 

After her detoxification treatment from alcohol and zopiclone, the woman was prescribed Diazepam, which she did not find effective [10]. 

Misuse of Zopiclone

zopiclone misuse

Prescription medications have, and always will be, misused.

 

It is up to the consumer to understand exactly what they intend to ingest.

 

Individuals who choose to ignore their doctors and missus drugs, tend to either have no information, or badly written information from the web.

There also seems to be an underestimation of the misuse of zopiclone, when compared to benzos [11].

The UK’s Advisory Council on the Misuse of Drugs noted:

 

it is important that all z-drugs are properly monitored and controlled [11].

 

It’s important to restate this crucial point, long-term use of zopiclone, and with other z-drugs, can lead to tolerance and dependency [11]. 

These particular cases of zopiclone dependency are premised on an abnormally high dose regime.

In order to identify and understand zopiclone misuse, you must understand the signs and how to spot an addict suffering withdrawal symptoms.

Please read on below.

Zopiclone Addiction Symptoms

zopiclone addiction symptoms

To understand the symptomatology of Zopiclone, a few warning signs might suggest you, or someone you know is addicted.

Look out for:

  •   Taking more zopiclone than prescribed by your doctor.
  •   Having to purchase more zopiclone tablets through your doctor or street dealers.
  •   Using (and mixing) zopiclone with other substances such as alcohol, other illicit drugs.
  •   Continuing with self-administration of zopiclone regardless of its health impacts.
  •   Becoming increasingly isolated from the people around you.

In addition, accompanying withdrawal symptoms are usually expressed in the following manner:

  • Anxiety (mild and severe)
  • Shaking and tremors
  • Insomnia 
  • Fast-beating heart and palpitations.

Moreover, if someone stops taking zopiclone or reduces their intake, seizures and delirium can also occur [12]. 

So be sure to inform a healthcare professional immediately if you suspect addiction and withdrawal. 

Zopiclone Detox

zopiclone detox

If an individual is considering detoxifying from zopiclone, ensure that they are in a medically-assisted environment [12]. 

This environment should be well-maintained until the individual can adjust to normal functioning without zopiclone. 

 

Those detoxing from zopiclone should always avoid other, more common drugs, such as alcohol [13].

 

How to avoid addiction of Zopiclone?

  • Always speak to your medical professional regarding dosing with zopiclone.
  • Don’t assume that a high dose will be the best approach.
  • It is best to ensure your zopiclone dose is prescribed according to your GPs recommendations. 
  • For more information on zopiclone dosing, take a look at our dosage article

References

  1. https://www.healthnavigator.org.nz/medicines/z/zopiclone/
  2.  https://www.ncbi.nlm.nih.gov/pubmed/18077750
  3. https://www.bmj.com/content/316/7125/117
  4. https://www.researchgate.net/publication/13399727/
  5. https://www.verywellhealth.com/rebound-insomnia-how-long-sleep-worsens-after-stopping-pills-3014747
  6. https://www.addictioncenter.com/sleeping-pills/withdrawal-detox/
  7. https://academic.oup.com/ijnp/article/8/2/309/755465
  8. https://www.dailymail.co.uk/health/article-1311782/The-nightmare-giving-sleeping-pills-One-woman-reveals-addiction-battle.html
  9. https://www.thesun.co.uk/archives/bizarre/286125/sarah-harding-my-secret-addiction-to-sleeping-pills/
  10. https://jmedicalcasereports.biomedcentral.com/articles/10.1186/1752-1947-4-403
  11. https://academic.oup.com/ijnp/article/22/4/270/5306970
  12. https://www.priorygroup.com/blog/zopiclone-addiction-signs-support-and-recovery
  13. http://www.addictioneducation.co.uk/z-drugs-leaf09.pdf
  14. https://adf.org.au/reducing-risk/withdrawal/
  15. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5852433/
  16. https://www.addictionsandrecovery.org/post-acute-withdrawal.htm
  • UPDATED

    4th May 2020 – date of the last edit to this article.

  • AUTHOR
  • SCIENCE

    This article uses only evidence based information.

  • MORE

the complex relationship between sleep and mood can also translate into depression over time.

NHS UK

Related

More