Zopiclone is a sleeping tablet prescribed for short-term insomnia. The key thing to understand is that it is genuinely a short-term medicine — tolerance and dependence develop within weeks, and the treatment with the best evidence for long-term insomnia is not a tablet at all.
One tablet immediately before bed, only on nights when you need it, and normally for no more than two to four weeks including the period of coming off it.
Allow at least seven to eight hours before you need to be up and alert. Taking it too late is the usual cause of next-day grogginess.
Never take a second dose in the same night.
A metallic or bitter taste is very characteristic. Drowsiness, dizziness, dry mouth and headache are also common.
Next-day impairment is common and often underestimated. Do not drive until you are certain you are unaffected — driving while impaired by zopiclone is an offence, and it is covered by drug-driving law.
Report memory problems, confusion, hallucinations, or doing things while not fully awake such as sleepwalking, eating or driving — rare but recognised effects, more likely with alcohol.
Do not drink alcohol with zopiclone. The combination substantially increases sedation and the risk of dangerous breathing problems, especially alongside opioids.
It is used with particular caution in older people, because of falls and confusion, and avoided in severe breathing problems, sleep apnoea, severe liver disease, and in pregnancy and breastfeeding.
For insomnia lasting more than about three months, cognitive behavioural therapy for insomnia (CBT-I) is the recommended first-line treatment and is available through the NHS, including self-referral to talking therapies in England.
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