Archive 1995–2023

Insomnia is an important medical problem; its treatment requires both nonpharmacological methods (education and psychotherapy) and the use of hypnotic agents. The benzodiazepine derivatives may be used as hypnotic agents but their use is substantially limited. The alter­native treatment includes so-called z-drugs, which means nonbenzodiazepine hypnotic agents. Their mechanism of pharmacological action is a GABA-receptor agonism. In general, these drugs improve the quality of sleep (sleep latency, wake after sleep onset, number and duration of awakenings, total sleep time). Contrary to the benzo­diazepines they do not possess anti-anxiety, myorelaxant, and anti-seizure properties, and are better tolerated.

Eszopiclone for the treatment of insomnia was not available in Poland. It is not only effective in the treatment of insomnia in comparison to placebo but is also well tolerated. It may be used for a longer time than the benzodiazepines – not only a couple of weeks but per several months. Eszopiclone shortens the sleep latency, decreases the number of wakes after sleep onset and increases total sleep time. It improves the subjective evaluation of sleep by the patients, the quality of sleep and functioning during the day. Its efficacy in the treatment of insomnia in the elderly has also been proved. It is quite well-tolerated and the most frequent side-effect of eszopiclone in the unpleasant taste.