Zopiclone.Doctor/Patient Consultation
Posted , 5 users are following.
I have been on Zopiclone 7.5mg for over 10 years and last week when I collected my repeat prescription which is usually for 1 month my doctor had prescribed 7 tablets x 3.75 and stated (take half per night then stop) My question is can my doctor do this without consulting with me to see how this might affect me.I would like to come off Zopiclone but feel this should be done gradually and not cutting dose to a quarter and then stopping.
Would appreciate any comments please.
0 likes, 9 replies
jaw444
Posted
Each individual is different and i agree with those doctors who believe in communicating with patients and coming to decisions about treatment together, with mutual respect. You may be a person who will not have too hard of a time going off the Zopiclone, you might be someone who has a harder time. If there are other health issues, you and the doctor should take them into account, imo.
One thing i might do in this position is to change doctors. Another possibility would be to ask this doctor for a referral to a specialist in helping people taper off medications, someone who has a lot of experience with it and with individual variability in that process. Such a doctor would work with you on the rate of tapering.
I would look at it that this doctor wants to help and sees that the medication is not good for the health, and wants to help you get off, he's making assumptions that you are too addicted and locked into it to make your own decisions, and he thinks he's doing what he's doing to help you in a way you can't help yourself.
Also (this is something i think about with my doctors), increasing information is mounting about associations between these medications and long term health issues, things like higher rates of cancer and heart disease among people who use them long term, not to mention traffic accidents and related risk of injury. So a prescribing doctor may well be thinking about how this looks if he keeps prescribing indefinitely without working with the patient on getting off or getting onto a different medication. I think that if they are thinking this way, about how their prescribing practices look in the eyes of other professionals, they may need to show that they are doing something to address the problem. So now your doctor is able to document in your record this measure he's taken to try to help you with the medication use rather than just continuing it without addressing it. Other doctors may do this in a different way, such as documenting in the chart conversations they have with you about it which shows that they aren't just prescribing unthinkingly. And a doctor can document your statements about how you're dealing with it and how you plan to deal with it. All of that can help them feel that they are being responsible or appearing responsible.
i recently started working with a therapist who i sought out to help me with the sleep problem and the medication dependence problem, using cognitive behavior therapy. As it turns out, he gave me a referral to an MD doctor (he is a PhD, psychologist) who works with people to help them get off of these medications. That's why i suggested you might ask your doctor for a referral for someone who has experience and expertise. You might tell him that you have considered cutting the medication in half and stopping in a week and you believe that it's too abrupt and you want to cut it down more gradually, taking into account your concerns and circumstances of your life, such as a job or other responsibilities or stresses. This conversation could give the doctor something he needs to document in your records that he is addressing the problem, trying to help you, and you are open to doing this and want to do it. It might help.
I have been taking both zopiclone 7.5mg snd zolpidem, a similar medication, i was taking the zopiclone for a year and a half, the zolpidem much longer. Starting in the first week of January, i started cutting the zopiclone by 1/4 tablet. Of course, i had the zolpidem to help me sleep but when i first started this, i was scared anyway, i was afraid my fragile precarious sleeping ability would go haywire if i changed anything. I was successful in cutting down that first 1/4. Then the first week of February, i cut down another 1/4 so that i was taking 1/2 per night, plus the Zolpidem. A couple of weeks later, gaining confidence i cut down another 1/4 tablet so i was taking 1/4,a nd a week later, i stopped the zopiclone. it all went smoothly, no real problems or withdrawal symptoms, but of course, still taking the zolpidem, it's impossible to judge. i am sure that i would have had sleep problems that i didn't have with the zolpidem.
Such as it is, i will say that this wasn't a hard transition. Now i'm cutting down the zolpidem by 1/4, just getting started on that. I'm starting at just under 30mg and i'm down to just under 25mg now. To succeed at this, i need to be more accepting of not always getting much sleep and i need to find other ways of helping myself get to sleep, which i'm looking into, including cognitive behavior therapy (which helps to change thoughts about sleep that are compounding the dependency), neurofeedback where a biofeedback device trains the brain to do what is needed to go into a state generating the brain waves that are conducive to sleep, and also, a electrical cranial stimulator, a device hooked up to the ear lobes at home which are supposed to get the brain into the alpha state, the alpha brain waves. These are just some ideas, People do this, they make the transition and they adapt. There are herbs, melatonin, various things. As long as i'm still on these medications, i am not trying any of these things because i don't think they can really work as long as i'm taking the medication.
Good luck to you, in communicating with your doctor, if possible, and with going off the meds--it's not that easy but people do it every day, it's doable and people tend to feel really happy about it.
RobertT
Posted
Possibly the biggest problem with doctors prescribing Zopiclone for more than 28 days is that they do it "off licence", i.e. the drug's licence only allows it to be prescribed for up to 28 days. To get an idea of the doctor's position prescribing off licence read the MRHA's web page: "Off-label or unlicensed use of medicines: prescribers’ responsibilities". (I think there's a problem posting links on this site.)
In the United States the derivative Eszopiclone (Lunesta) is licenced for long-term use – but I think they have in mind a few months rather than a few years and longer. In Bulgaria and Macedonia you can still buy Zopiclone across the counter, I believe, though no longer in Spain. (I don't know how much customs would consider "for personal use" – it's legal to "possess" Zopiclone in the UK but not to supply it, from what I read.)
In the few days this year and last year that I stopped taking Zopiclone I don't believe I had any side-effects and feel that I've a very good idea of whether I'm going to sleep without one or not, so don't find the tapering idea good or helpful. One doctor did tell me though that those that come of it most successfully do so by doing it gradually.
Your doctor may just be testing your reaction and checking what's in your best interest as in the article I referred to above. If you cannot manage as he suggests then I think you need to go back to him – he has to give his permission for you to change doctor or for you to see a specialist. (I myself would ask about seeing a psychiatrist specializing in sleep disorders.)
Read the NHS web page "GP services explained - The NHS in England - NHS Choices", contact your "Patient Advice and Liaison Service" (PALS).
steve_44408
Posted
Good luck and let us know how you get on.
daddybump
Posted
Your doctor is probably panicking, as the long term use of zopiclone will be the next major NHS scandal.
jaw444
Posted
dean725
Posted
they have since had me on allsorts of tablets including mirtazapine which doesnt help me sleep and now trazadone,which again doesnt help,all these tablets before give me zopiclone,which they put me on in the first place because i couldnt sleep after having some major surgery.
i'm going back to the doctors on friday to ask for some zopiclone,i run my own business and this whole insomnia lark is making me knackered,completely exhausted.
i recently bought a cranial stimulator and from today will be giving it the utmost attention,maybe i havnt been using it enough at approx one hour every night.
jaw444 dean725
Posted
RobertT
Posted
I probably have to agree though that Zopiclone loses its effect with use. To offset this I have taken Dothiepin/Dosulepin with it, but that might well have been damaging my heart; Trazadone, which, as is well documented, unless you actually have depression, tends to improve onset time of sleep and depth/quality of sleep but not duration; Mirtazapine, but that had highly undesirable effects on my blood sugar levels; and Fluvoxamine, which worked probably mostly because of its effect on melatonin. I now just take time-release melatonin with my Zopiclone.
The developed world has a big problem with sleep and the sooner insomnia is taken seriously, its cause not misdiagnosed and attributed to a past life as traffic wardens or the like the better.
thomas85511 Agakhan
Posted