Hostname: page-component-78c5997874-t5tsf Total loading time: 0 Render date: 2024-11-11T07:52:10.546Z Has data issue: false hasContentIssue false
  • English
  • Français

Withdrawal from benzodiazepines by initially switching to zopiclone

Published online by Cambridge University Press:  16 April 2020

CM Shapiro ,
D Sherman  and
DF Peck
CM Shapiro
Affiliation:
Department of Psychiatry, Sleep Research Laboratory, The Toronto Hospital, Western Division, 399 Bathurst Street, TorontoM5T 2S8, Canada
D Sherman
Affiliation:
Department of Psychiatry, Sleep Research Laboratory, The Toronto Hospital, Western Division, 399 Bathurst Street, TorontoM5T 2S8, Canada
DF Peck
Affiliation:
Highland Health Board, Inverness, Scotland
Get access

Summary

Withdrawal from hypnotics can produce a variety of problems, especially sleep difficulties, some of which may arise from the multiple actions of most hypnotics, thus producing a range of rebound effects. This study examined whether switching patients to a hypnotic with a narrower range of action and of a different class would reduce these problems. One hundred and thirty-four patients participated; they were randomly allocated to one of three methods of switching from “previous hypnotic” to zopiclone (a cyclopyrrolone). The methods were gap (an interval between taking the two drugs); abuttal (taking zopiclone immediately on stopping previous drug); and overlap (gradually reducing previous drug after starting zopiclone). The main findings were that zopiclone was associated with better sleep and increased alertness; the abuttal method was the best method of switching; and no serious side effects from zopiclone were reported. It was concluded that zopiclone has a useful role in benzodiazepine withdrawal, and that immediate substitution is the best method.

Keywords

hypnotic withdrawllong-term outcomedrug substitutionzopiclone
Type
Research Article
Information
European Psychiatry , Volume 10 , Issue S3: Satellite Symposium to the AEP Congress , 1995 , pp. 145s - 151s
Copyright
Copyright © Elsevier, Paris 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adam, KOswald, IPossible mechanism for adverse reactions to triazolam. Lancet 1991; 338: 1157 (letter)CrossRefGoogle ScholarPubMed
Allain, HDelahayne, CLe Coz, FBlin, PDecombe, RMartinet, JPPostmarketing surveillance of zopiclone in insomnia: analysis of 20,513 cases. Sleep 1991; 14: 408–1310.1093/sleep/14.5.408CrossRefGoogle ScholarPubMed
Ashton, HBenzodiazepine withdrawal: outcome in 50 patients. Br J Addiction 1987; 82: 7–10CrossRefGoogle ScholarPubMed
Bianchi, MMusch, BZopiclone discontinuation: review of 25 studies assessing withdrawal and rebound phenomena. Intl J Clin Psycho-pharmacol 1990; 5(suppl 2):139–45Google ScholarPubMed
Golombok, SHiggitt, AFonagy, PDodds, SSaper, JLader, MA follow-up study of patients treated for benzodiazepine dependence. Br J Med Psychol 1987; 60: 141–9CrossRefGoogle ScholarPubMed
Greenblatt, DJHarmatz, JSZinny, MAShader, RIEffect of gradual withdrawal on the rebound sleep disorder after discontinuation of triazolam. N Engl J Med 1987; 12: 722–8CrossRefGoogle Scholar
Lemoine, PDelahaye, CMoreau, PBlin, PMicolle, JPStudy of two changeover methods from 0.25 mg triazolam to 7.5 mg zopiclone in general practice. Le Concours Medical 1991; 113: 1339–44Google Scholar
Baiter, MBUhlenhuth, EHInsomnia its treatment. Prevalence and correlates. Arch Gen Psychiat 1985; 42: 225–32Google Scholar
Murphy, SMTyrer, PA double-blind comparison of the effects of gradual withdrawal of lorazepam, diazepam and bromazepam in benzodiazepine dependence. Br J Psychiat 1991; 158: 511–516CrossRefGoogle ScholarPubMed
Oswald, IAdam, KA new look at short-acting hypnotics. In: Sauvanet, JP, et al. Imiduzopyridines in sleep disorders New York: Raven Press, 1988Google Scholar
Rickels, KCase, WGSchweizer, ESwenson, CFridman, RLow dose dependence in chronic benzodiazepine users: a preliminary report on 119 patients. Psychopharmacol Bull 1986; 22: 407–15Google ScholarPubMed
Risse, SCWhitters, ABurke, JChen, SScurfield, RMRaskind, MSevere withdrawal symptoms after discontinuation of alprazolan in eight patients with combat-induced posttraumatic stress disorder. J Clin Psychiatry 1990; 51: 206–9Google ScholarPubMed
Tham, TCKBrown, HMcTaggart, HTemazepam withdrawal in elderly hospitalized patients: a double blind randomised trial comparing abrupt versus gradual withdrawal. Irish J Med Sci 1989; 158: 194–6CrossRefGoogle ScholarPubMed
Van der Meij, NSleep and daytime fitness in elderly patients switched to zopiclone from other hypnotics. Sleep Res 1991;20A:402Google Scholar
World Health Organization Expert Committee on Drug Dependence (20th report) Technical Report Servies, No. 551 Geneva: WHO, 1974Google Scholar
Submit a response

Comments

No Comments have been published for this article.