Zopiclone, Zaleplon and Zolpidem

Harm Reduction

The fact that they are more selective in the receptors on which they work seems to make little difference to the outcome in most cases if the drug is taken every night. Many patients who experience difficulties are transferred back to a benzodiazepine, typically valium.

There is a wide variation in the half-life and response to these drugs (such as the degree of sedation) between different individuals (for example, the elderly and people with hepatic impairment).

Hypnotics may be as likely to cause depression as to help it. Some studies suggest that long term users of sedative hypnotic drugs have a markedly raised suicide risk as well as an overall increased mortality risk. The evidence specifically on ‘Z drugs’ is limited.

‘Z drugs’, despite the earliest claims of manufacturers, are not free from the risk of  ‘rebound effect’; the emergence or re-emergence of symptoms that were either absent or controlled while taking a medication, but appear when that same medication is discontinued, or reduced in dosage.
 
It is not recommended to take this group of hypnotics for more than a couple of weeks. It is not wise to drive under the influence of this group of drugs and some people have experienced events of which they have little actual recall. In extreme cases this can leave you very vulnerable. If you start to feel very weak and sleepy make sure you are in a safe, contained environment.

There is a considerable risk in mixing ‘Z drugs’ with alcohol or other CNS depressants, such as the opioids.

Taking ‘Z drugs’ as a ‘downer’ to counteract the effects of  stimulants is not just a simple antidote, but puts more strain on your body, particularly the heart and liver if you repeat the pattern.