Lunesta

Lunesta is the brand name for eszopiclone, a nonbenzodiazepine hypnotic in the cyclopyrrolone class used to treat insomnia in adults. It is a member of the Z-drug family and is typically prescribed for difficulty with sleep onset, sleep maintenance, or both. It is available only by prescription.

Eszopiclone acts as a positive allosteric modulator of the GABA-A receptor, enhancing the effects of the neurotransmitter GABA to produce sedative and sleep-promoting effects. It is not a benzodiazepine, but it shares a similar mechanism of action and sedative profile. The drug has a relatively longer duration of action than some other sleep aids, which can influence next-day alertness in some patients.

Indications and use: Lunesta is prescribed for adults with insomnia and is taken as a single nightly dose immediately before bedtime. The dose is individualized by a clinician and may vary based on age, liver function, and response to therapy. It is generally started at a low dose in older adults or those with hepatic impairment.

Safety and adverse effects: Common side effects include somnolence, dizziness, headache, dry mouth, and an unpleasant taste. Next-day impairment can occur, affecting performance the following day. Rare but serious events include complex sleep-related behaviors such as sleep-driving. Potential for dependence and withdrawal exists with long-term use. It should be avoided in individuals with hypersensitivity to eszopiclone, and caution is advised in pregnancy, breastfeeding, and concurrent use with alcohol or other central nervous system depressants.

Pharmacology and interactions: Eszopiclone is extensively metabolized in the liver, with potential interactions involving CYP enzymes, particularly CYP3A4. Strong inhibitors or inducers can alter drug levels. Alcohol and other sedatives can amplify sedative effects.