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An evaluation of the efficacy and safety of eszopiclone over 12 months in patients with chronic primary insomnia
Abstract
Background and purpose A double-blind placebo-controlled study of eszopiclone found significant, sustained improvement in sleep and daytime function. The 6-month open-label extension phase is described herein.Patients and methods Adults (21-64) with primary insomnia who reported sleep duration <6.5 h/night or sleep latency >30 min/night were included. Patient-reported endpoints included sleep and daytime function. Safety and compliance were assessed at monthly clinic visits. The final double-blind month was used as the baseline for efficacy analyses of the open-label period.Results Patients who were initially randomized to double-blind placebo and then switched to open-label eszopiclone (n=111) significantly reported the following: (1) decreased sleep latency, wake time after sleep onset, and number of awakenings; (2) increased total sleep time and sleep quality; and (3) improved ratings of daytime ability to function, alertness and sense of physical well-being compared to baseline (P<or=0.0001 all monthly endpoints). There was no evidence of tolerance on any measure in either group. These subjects (n=360) sustained the double-blind treatment gains for all sleep and daytime parameters, with further significant improvement in a number of measures. Eszopiclone was well tolerated in both groups; unpleasant taste was the only undesirable effect reported by >5% of patients.Conclusions The significant improvements in sleep and daytime function were evident in those switched from double-blind placebo to 6 months of open-label eszopiclone therapy and were sustained during the 6 months of open-label treatment for those receiving prior double-blind eszopiclone. During 12 months of nightly treatment, eszopiclone 3mg was well tolerated; tolerance was not observed.
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“Nevertheless, current evidence 33 34 35 36 37 does not support the development of tolerance or rebound insomnia following eszopiclone discontinuation in primary insomnia patients.”
From Z-drug abuse and dependence: Clinical guideline of the Brazilian Academy of Neurology for diagnosis and management (2025) · cites this paper as [35]
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“In clinical practice, hypnotic medications are often used over durations of one to twelve months without dosage escalation, 52-55”
From Clinical Guideline for the Evaluation and Management of Chronic Insomnia in Adults (2008) · cites this paper as [53]
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Metadata
- Authors
- ROTH, T., WALSH, J., KRYSTAL, A., WESSEL, T., & ROEHRS, T.
- Affiliations
- Henry Ford Hospital (US)
- Duke University (US)
- Sunovion (United States) (US)
- Corresponding author
- ROTH, T
- Venue
- Sleep Medicine
- Publisher
- Elsevier BV
- Published
- 2005-11
- Volume
- 6
- Issue
- 6
- Pages
- 487-495
- ISSN
- 1389-9457 (ISSN-L)
- OpenAlex
- W2066580767
- Cited by
- 230
- References
- 23
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 7 · 2023: 10 · 2022: 5 · 2021: 6 · 2020: 4 · 2019: 4 · 2018: 9 · 2017: 9 · 2016: 12 · 2015: 10 · 2014: 19 · 2013: 7 · 2012: 13
- FWCI
- 27.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Sleep Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Physiology (medical) › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Keywords
- eszopiclone, chronic primary insomnia, long-term efficacy, sustained treatment effects, daytime functioning, sleep latency, sleep quality, wake after sleep onset, awakening, drug safety, tolerability, open-label extension
- MeSH terms
- Adult, Aged, Drug Administration Schedule, Female, Follow-Up Studies, Humans, Hypnotics and Sedatives, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Piperazines, Treatment Outcome, Cross-Over Studies, Azabicyclo Compounds
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