Zopiclone.Doctor/Patient Consultation

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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

9 Replies

  • Posted

    personally, i think this is a kind of doctor i would never want to have, i would not be able to work honestly with this doctor, there would be no trust, and i would need to find a different doctor. There is a lot of variability among doctors about their knowledge of these medications and their respectfulness toward patients. This has nothing to do with them being "nice." Or not much. I need a doctor who works collaboratively with me. I don't know for sure how hard it would be to come off zopiclone 7.5mg by cutting it in half and stopping in 7 days, it might not be too bad, people differ a lot with these things, for some it's reportedly pretty hard. There's another thread about zopiclone here ("Down the rabbit hole" ) where people talk together about their experiences in tapering off zopiclone, but they are all tapering gradually with their doctors' cooperation.

    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.

  • Posted

    I've been taking Zopiclone 7.5 mg nightly since August 2005 except for about 6 weeks last year when I found I could manage without them and a few days this year when I forgot to request a prescription (in the turmoil of having double-glazing fitted).

    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).

  • Posted

    I had a similar problem to you just recently. A new doctor at my surgery without even meeting me decided to reduce my prescription of Zop and basically expected me to come off them in a month (I have been on them for 15 years) He told me that there is an increased risk of dementia when taking the drug long term! (This I believe was a LIE). After a lot of stress and worry I wrote to one of the other doctors ahead of seeing her in person and got everything straightened out with my repeat prescription restored.

    Good luck and let us know how you get on.

  • Posted

    Your doctor should not have done this. Zopiclone is similar in its effects to benzodiazepines, but is much more difficult to come off. There is a lot of useful info on the website benzo.org.uk, including information on how to wean yourself off zopiclone by crossing over to diazepam and tapering off over several months. This does work. Your doctor's method is dangerous and idiotic and will inevitably cause you a great deal of suffering. Study the above and challenge your doctor - or see another one.

    Your doctor is probably panicking, as the long term use of zopiclone will be the next major NHS scandal.

  • Posted

    if i understand right (not sure that i do), the difficulty in stopping Z drugs such as zopiclone, is the relatively short half life of these medications--only about 5 or 6 hours for zopiclone compared to something like 30 days for diazepam. Because of the short half life, the z drugs are being eliminated from your circulation fast, and in 6 hours, there is half of the last dose, and in 12 hours, half of that, and so on. I've read where people using these meds say that during the day, they become anxious and agitated or otherwise symptomatic of withdrawal, which is said to be from this short half life and rapid metabolism. I believe that is why the method of cross over to diazepam is sometimes recommended. One of the people who posts on this thread recently did this, about a month ago i think, and was pleased with the success, it was not a months long process but only less than a month, because of the relatively low dosage involved, of Zop and of diazepam. i don't know that he's reported back since he said he thought he would be on diazepam about another week and would then be free of meds. I've read that tapering often gets harder as the dose gets lower. However, not everyone is the same, and while tapering works best for many, it's not the best method for everyone. We have some people who have posted on this thread who stopped cold turkey and were happy with the results. i went cold turkey off of about 30mg a night diazepam 20 years ago, i never heard of tapering then, and it went fine, the withdrawal symptoms only lasted about 4 days, they continued after that but were going away, nothing after a couple of weeks. That's just me, many people say they they tried this and it was disastrous for them. i will add that the one thing that continued after stopping the diazepam was inconsistent sleep, but that's why i started taking it in the first place so i would not say stopping the diazepam cold turkey resulted in not being able to sleep as well as "normal people" in my case.
  • Posted

    I have mentioned this in the 'down the rabbit hole thread',about 6 or 7 years my doctor abruptly stopped me having zopiclone,entirely out of the blue he told me i had been on them too long.For two weeks i was in a right state,no sleep whatsoever,after going to the docor for the third time they started me on amytripalene,it took 150mg of this to get me to sleep,the downside being that i felt rotten the day after,very slow at everything i did and a mouth drier than a salt dish.

    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.

    • Posted

      Dean - i'm always interestedin your experience of the neuro cranial stimulator because i' just finished paying off the installment payments on mine, totally about $795 and still haven't taken it out of  the shrink wrapped wrapper, thinking that until i'm off the zolpidem, it will be too hard to judge how it's going to work.  I dont remember the last time we talked.  In late february i took my last quarter pill of zopiclone so i've been off that for a couple of months, still taking a higher than prescribed about of zolpidem, determined to get off, not looking forward do it, so curious about using the alpha stim
  • Posted

    This is it, antidepressants can be prescribed (the ones I know about anyway) time over within their licence and there are medical people or biological scientists ready to go on record saying that most insomnia results from depression.

    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.

  • Posted

    Dr's can do what they want and reduce as they see fit. I think this is a bad practice, as it could lead to withdrawal and cravings. I had mine stopped all togather after becoming addicted and taking too many. I started buying them on the internet and got in to a terrible state. Now free of them, but still now and again get cravings.

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