WITHDRAWAL FROM BENZODIAZEPINES BY INITIALLY SWITCHING TO ZOPICLONE

Withdrawal from hypnotics can produce a variety of problems, especiall y sleep difficulties, some of which may arise from the multiple action s of most hypnotics, thus producing a range of rebound effects. This s tudy examined whether switching patients to a hypnotic with a narrower range of action and of a different class would reduce these problems. One hundred and thirty-four patients participated; they were randomly allocated to one of three methods of switching from ''previous hypnot ic'' to zopiclone (a cyclopyrrolone). The methods were gap (an interva l between taking the two drugs); abuttal (taking zopiclone immediately on stopping previous drug); and overlap (gradually reducing previous drug after starting zopiclone). The main findings were that zopiclone was associated with better sleep and increased alertness; the abuttal method was the best method of switching; and no serious side effects f rom zopiclone were reported. It was concluded that zopiclone has a use ful role in benzodiazepine withdrawal, and that immediate substitution is the best method.