Drug: Zopiclone (Imovane)
Zopiclone (Imovane) should NOT be used:
For Stroke victims
For old people
For long term for anyone (max 7 – 10 days)
Below are the Wikipedia descriptions of Zopiclone. They strongly indicate the risks of Zopiclone and also the withdrawal effects.
Download the information here:
Zopiclone – Wikipedia, the free encyclopedia
Benzodiazepine withdrawal syndrome – Wikipedia, the free encyclopedia
Dave Madison of the United States talked to a doctor in Stockholm who was clear that Imovane was not to be used for Stroke victims. She double checked with her superiors and she also referred to guidelines in the UK saying the same.
Calle has received information from several doctors and experts as well. A couple of them are Niklas Fröst at Remonthagen Stroke Rehab Center in Östersund as well as Kjell Söder at Reacting Stroke Rehab Center also in Östersund:
Imovane has devastating effects that destroy any possibilities for a Stroke victim to recover since rehabilitation is made impossible. Effects from Imovane are among other loss of memory, confusion, anxiety, sleepiness, effects on the motoric system being unable to move or do things. This also leads to frustration and further anxiety. All of these are of course the worst you can expose someone to that has been injured by a Stroke. Imovane does also have side effects like hallucinations and more, which clearly also are devastating for anyone.
Yngve Gustafson, Professor in Geriatrics in Umeå, has apart from the obvious reasons above added that Imovane is life threatening for a Stroke victim and should never be used due to risk of dying in the sleep. 3 out of 4 stroke victims suffer from Sleep Apnea. For those Imovane is directly life threatening.
These and others have pointed out that:
Imovane should not be used for Stroke victims
Imovane should not be used for old people
Imovane increases the risk for Alzheimers
Even for people that are not Stroke victims or old Imovane (Zopiclone) is a very serious drug. It should be used with caution and only for very short time. This is much stricter than what shows on the website today saying nothing about restrictions for Stroke victims, old people, short term usage, etc…
The people Calle has talked to refer to guidelines and research:
1. FASS
FASS (The Swedish medication database):
http://www.fass.se/LIF/product?userType=2&nplId=19910816000041
Använd inte Imovane
Om du är allergisk mot zopiklon eller något annat innehållsämne i detta läkemedel (anges i avsnitt 6).
Om du lider av någon av följande sjukdomar:
o en allvarlig leversjukdom
o sömnapné (sömnstörning med tillfälliga andningsuppehåll under sömnen)
o myastenia gravis (en allvarlig muskelsjukdom)
o andningssvikt (allvarliga besvär med andningen)
http://www.fass.se/LIF/product?userType=2&nplId=20010420000157
Ta inte Zopiclone Actavis
om du är allergisk motzopiklon eller något annat innehållsämne i detta läkemedel (anges i avsnitt 6).
om du har allvarlig leversjukdom
om du har svår muskelsvaghet (myastenia gravis)
om du har andningsproblem (respiratorisk insufficiens)
om du har svåra andningsstillestånd under sömnen (sömnapné)
Försiktighet bör iakttas vid nedsatt leverfunktion, respiratorisk insufficiens, missbrukare samt vid behandling av äldre och patienter med nedsatt allmäntillstånd.
2. Clinical Handbook – Akademiska Sjukhiset
Klinisk Handbok 2012
Akademiska Sjukhuset
Bensodiazepinbesläktade preparat
Zolpidem ( Stilnoct )
Zopiklon ( Imovane )
Zaleplon ( Sonata )
Verkningsmekanismen är väsentligen lika som för BDZ och ganska snart står det klart
att dessa också kan ge beroende varför det är narkotikarecept som gäller idag.
Neuropsykologiska effekter av Bensodiazepiner
Exekutiva funktioner, planering påverkas negativt
Svårt för förändringar, rigiditet
Uppmärksamhet och motorisk uthållighet nedsättes
Kognitiva svårigheter påminner mycket om skador man förvärvar efter längre tids
Alkoholbruk.
Om BDZ anses indicerat skall behandlingstiden vara så kort som möjligt.
3. Not to be used by Stroke victims
http://www.medsafe.govt.nz/consumers/cmi/i/imovane.pdf
Do not take Imovane if you have:
had a stroke
https://media.healthdirect.org.au/medicines/GuildLink_Information/165934/CMI/swcimova10620.pdf
Do not take Imovane if you have:
sleep apnoea (a condition where you temporarily stop breathing while you sleep)
had a stroke
http://www.emedical.com.au/default.asp?pageID=56&itemID=11194&purchaseTypeID=4
When you must not take it
Do not take Imovane if you :
have difficulty in breathing
Do not take Imovane if you:
have had a stroke
have severe muscle weakness
have breathing problems during the day or the night
have severe liver problems.
4. Short term use
http://psychology.wikia.com/wiki/Zopiclone
Zopiclone (Imovane) is a drug with the potential for misuse with the potential for causing dosage escalation, drug abuse and drug dependence. Zopiclone is well known amongst drug addicts as a drug of abuse and commonly seek it from their doctors with over 5% of drug addicts at treatment centers reporting a zopiclone addiction. It is abused orally and sometimes intravenously and often combined with alcohol to achieve a combined sedative hypnotic – alcohol euphoria. Patients who do abuse the drug are also at risk of dependence. Withdrawal symptoms are frequent after long term use of normal doses even after a gradual reduction regime. The Compendium of Pharmaceuticals and Specialties recommends that zopiclone prescriptions do not exceed 7 – 10 days due to concerns of addiction, drug tolerance and physical dependence.
Zopiclone may be more addictive than benzodiazepines.
http://products.sanofi.ca/en/imovane.pdf
Prescriptions for IMOVANE should be written for short-term use (7-10 days) and it should not be prescribed in quantities exceeding a 1-month supply.
Zopiclone belongs to the class of medications called sedative-hypnotics. It is used for the short-term and symptomatic relief of sleep disturbances. Zopiclone can help with difficulty falling asleep, frequent wake-ups during the night, or early morning awakenings. Zopiclone should usually not be taken for more than 7 to 10 consecutive days. It should be used only by people for whom disturbed sleep results in problems functioning during the day.
5. Similar drugs
http://www.internetmedicin.se/page.aspx?id=1304
As further example that this isn’t just a few doctors that Calle has talked to, the Australian gov’t (amongst others) also agrees that Zopiclone/imovane should not be given to stroke patients:
And furthermore, as Calle notes, not to the elderly and certainly not for that long.
Please also see this page: Guidance from United Healthcare.