Could discontinuation of Imovane (zopiclone) cause withdrawal symptoms?/nA 35-year-old man with psy

Fråga: Could discontinuation of Imovane (zopiclone) cause withdrawal symptoms? A 35-year-old man with psychotic disorders has been taking Imovane (zopiclone) 7.5 mg x3 for three months. When his tablets were finished he developed anxiety and sweating.

Sammanfattning: Several cases of withdrawal symptoms including anxiety and sweating have been reported associated with discontinuation of relatively large doses of zopiclone.

Svar: One Drugline-question has documented a few cases of zopiclone dependence and withdrawal symptoms (1). In summary, one subject took zopiclone 7.5 mg x 5-6 per day after he stopped consuming a large amount of alcohol. When he tried to discontinue the intake of zopiclone, he had anxiety attacks. Another similar case described a 36-year-old man who took zopiclone 60-90 mg/day. When he abruptly discontinued to take the drug he got cramps. This patient was also consuming alcohol and taking trimipramine and promazine at the same time. In addition, rebound effects with deteriorated sleeping quality have been seen when zopiclone was discontinued in studies of sleeping disorders (see reference 1), although the absence of rebound insomnia has also been reported in the literature (2).

Three cases of dependence and four cases of abstinence problems associated with zopiclone have been reported to SADRAC (Swedish Adverse Drug Reactions Advisory Committee). The symptoms of the patients included palpitation, sweating, dizziness, hypertension, short episodes of confusion, anxiety, diarrhea and tremulous. Association between the symptoms and zopiclone usage was judged probable or possible in all of these cases.

We suggest that the present case be reported to SADRAC.