Zopiclone and Zolpidem are Z-drugs used in the short-term treatment of insomnia that help fall asleep faster and have an undisturbed phase of sleep. While seemingly having the same function, they differ in their binding actions that impact sleep architecture and patterns of sleep.
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Zolpidem helps you fall asleep quickly, but Zopiclone helps you have an undisturbed phase of sleep. There are other characteristic features as well, and it is important to understand them to decide the one best for your insomnia requirements.
Overview of Zopiclone and Zolpidem
Zopiclone is a third-generation hypnotic belonging to the cyclopyrrolone class that is indicated for short-term treatment of insomnia. Studies have shown 7.5mg Zopiclone to be effective in people of all age groups dealing with varying intensities of sleep problems. It is licensed by the MHRA with a two to four-week recommended treatment.
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Zolpidem ( Ambien ) is a non-benzodiazepine hypnotic recommended for people who have trouble falling asleep or maintaining sleep. It is often used as an adjunct treatment option in improving sleep quality in people confronting chronic insomnia because of its muscle-relaxant properties. It is MHRA approved in the UK, available as Stilnoct or Stilnox in 5mg and 10 mg strengths.
Effectiveness for Different Types of Insomnia
A comparative study between Zopiclone and Zolpidem in the treatment of chronic primary insomnia has shown Zolpidem to be a comparatively better option in managing chronic primary insomnia.
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In a fourteen-day trial conducted on 479 chronic primary insomniacs, 67.9% in the Zolpidem group reported moderate improvements, whereas in the Zopiclone group, it was 61.6% with Zolpidem being at least as effective as Zopiclone.
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Sleep onset Latency ( time taken to fall asleep ) improved by 85.8% in Zolpidem users as compared to 77.5% in Zopiclone users. Significantly fewer Zolpidem users showed aggravated sleep onset ( difficulty in falling asleep ) and experienced fewer drug-induced adverse events.
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Most importantly, the bitter taste, a common problem with Zopiclone, was almost absent. To summarise, Zolpidem was better tolerated and was easier to discontinue in the end.
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Other trials comparing the residual effects of Zopiclone and Zolpidem ( lingering effects of the drug ) have observed drug-induced specific alterations. In the study conducted to observe the residual effects of Zopiclone and Zolpidem on driving performance and ocular saccades, Zolpidem did not have residual effects, whereas Zopiclone impaired driving performance, especially in the first part of the morning.
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Studies have even shown Zolpidem to be a safer option in elderly insomniacs and to prevent the risk of falls and accidents because of reduced grogginess.
Safety, Side Effects, and Risks
Z-drugs have been reported to be safer than sedatives and hypnotics and have fewer side effects. The incidence of sleep-driving related to sleep walking and impaired driving related to z-drugs is unknown.
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That said, problems can arise in the form of drowsiness, dizziness, and impaired cognition, especially in Zolpidem if used for a longer period, which are not limited to age, dose, or medical history of the patient.
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With Zopiclone, a bitter taste in the mouth is one of the primary problems, along with sedation and confusion. In some individuals, particularly children, it can result in hyperactivity problems.
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Continued administration can result in tolerance and dependence.
Cost and Availability
Zopiclone and Zolpidem are POMs ( Prescription Only Medications ) available under the NHS. They are free in Scotland, Wales, and Northern Ireland.
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Both medications are widely stocked in UK pharmacies, but you need a prescription to obtain them. Most NHS and private doctors will prescribe them for the short term because of the risk of dependence.
How to Choose Between Zopiclone and Zolpidem
Here’s a Quick Guide that will help you choose between the two
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Situation | Consider Zopiclone | Consider Zolpidem |
You struggle to fall asleep | Helps, but not as Good as Zolpidem | ✅ The Ideal Choice |
You often wake up during the night | ✅ The Ideal Choice | Less Effective than Zopiclone |
You don’t want to deal with morning grogginess | Not so effective | ✅ The Ideal Choice |
You have the habit of sleepwalking or talking in sleep | Varies in individuals | Not the ideal choice |
You are 65 or Older | Not as ideal as Zolpidem | The ideal choice. Better than Zopiclone |
Care About NHS Prescription Costs | Same cost as Zolpidem | Same Cost as Zopiclone |
Final Thoughts
Insomnia is a serious problem in the UK, affecting one in three people and impacting productivity to a significant extent. According to researchers, sleep deprivation increases the risk of mortality by 13% in addition to leading to the UK losing 200,000 working days yearly.
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Zopiclone and Zolpidem are potent benzodiazepines offering potential treatment solutions. That said, it is equally important to understand which one suits your requirements and use it under the guidance of a physician. Zopiclone helps you obtain an undisturbed sleep, but it may not be ideal for geriatric patients dealing with sleep problems. Zolpidem is an ideal choice for geriatrics, while having a slightly reduced efficacy than Zopiclone
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Because of their benzodiazepine nature, they come with the risk of side effects and dependence, and you should use them in lower strengths, taking care to taper the strengths before discontinuing them.