Q: I am 58 years old and female. A few years ago, the doctor put me on
the sleeping pill, Imovane, and this helps me sleep quite well. The
problem is that every time I try to go off it, I cannot sleep, so that
eventually I have to start taking the medication again. Do you have any
suggestions as to how I can get off it?
A:Imovane, sometimes known as Zopiclone, is a short acting hypnotic
drug. It was touted by the manufacturer as a safe sleeping pill that
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was not supposed to be addictive. Unfortunately, that is not the case.
When you try to stop, you get a phenomenon known as rebound insomnia,
which means you will not be able to sleep for several days after
discontinuing the drug. It is best not to take any other sleeping
pills, as they will all give you the same problem. You will just have
to suffer for a while. It is almost as good to lie in bed and rest,
even if you are not actually asleep. The more you worry about not
sleeping, the more you will toss and turn.
Alcoholics and drug addicts should never be given this medication.
Actually, my practice is to only prescribe hypnotics in rare
circumstances, such as during a hospital admission or after a severe
shock such as a sudden bereavement. Even then, I only give the drug for
a period of two weeks at the most. Some doctors will also prescribe it
for short periods of time to establish a regular sleep pattern in
people who have difficulty sleeping. Antidepressants are alternatives.
Often insomnia is a result of a depressive illness that interferes with
sleep.
A word of caution for those over 65. As the efficiency of the liver and
kidneys tends to lessen with age, it becomes more difficult for the
body to eliminate drugs. They hang around so the effect can accumulate
over time, leading to confusion.
Clare Rowson is a medical doctor with a practice near Belleville, Ont.
Her columns are intended for general information only. Individuals are
encouraged to also seek the advice of their own doctor.
