Latest research on Eszopiclone

Eszopiclone, marketed by Sepracor under the brand-name Lunesta, is a nonbenzodiazepine hypnotic agent (viz., a sedative) used as a treatment for insomnia. Eszopiclone is the active stereoisomer of zopiclone, and belongs to the class of drugs known as cyclopyrrones. Its main selling point is that it is approved by the U.S. Food and Drug Administration for long-term use, unlike almost all other hypnotic sedatives, which are approved only for the relief of short-term (6-8 weeks) insomnia.

Eszopiclone dosage

Sex differences in their pharmacokinetics and side effect profiles, including increased risk of cognitive impairment in the morning and motor vehicle accidents, led the US Food and Drug Administration to require the manufacturers of Ambien and Lunesta to lower recommended starting doses in women. [source, 2015]
The recommended starting dose of Eszopiclone for women was lowered from 2 to 1 mg. [source, 2015]
After that meta-analysis, the FDA lowered the recommended doses for Zolpidem and Eszopiclone, but as with suvorexant, there are few controlled-trial results for the new lower recommended dosages. [source, 2015]
We do not know if the benefits of low-dose Zolpidem and Eszopiclone are as minimal as those of suvorexant. [source, 2015]
For example, the now-recommended 1 mg dosage of Eszopiclone was ineffective in many PSG contrasts [source, 2015]
Note that Zopiclone 7.5 mg contains about 3.75 mg EsZopiclone, and patients and their physicians approaching such doses must be cautious of potential driving impairment. [source, 2015]
Eszopiclone and Zolpidem also dose-dependently disrupted sleep-stage─specific electroencephalography (EEG) spectral profiles in rats, even at low doses that do not induce sleep. [source, 2014]
The present study compared sleep induced by the standard of care, Eszopiclone (a non-benzodiazepine GABAA receptor modulator) and by two distinct DORAs, DORA-12 and DORA-22, using polysomnography (PSG) and quantitative electroencephalography (qEEG) spectral analysis following dose administration during the active phase across several species and following REM deprivation in rats. [source, 2014]
Representative doses for each species were chosen based on prior dose response studies inducing salient, active-wake reduction approximating that seen in rats, the highest dose tested (DORA-22 in rhesus monkeys), or a qEEG effect magnitude similar to that in other species (Eszopiclone in mice, dogs). [source, 2014]
The use of different doses for nonelderly (2 mg or 3 mg) and elderly patients (1 mg or 2 mg) was based on the pharmacokinetic profile of Eszopiclone in studies of healthy subjects and on the findings of previous clinical studies. [source, 2012]