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Lunesta vs Restoril
Introduction
For patients struggling with insomnia, certain drugs that affect the chemicals in the brain that may be unbalanced in people with sleep problems can help induce and maintain sleep. Lunesta and Restoril are two such medications commonly prescribed for insomnia. They each impact different aspects of the sleep-wake cycle but both have sedative effects to promote restful sleep.
Lunesta (eszopiclone) is classified as a nonbenzodiazepine hypnotic agent, which works by slowing down activity in the brain allowing for a calming effect and maintaining long periods of undisturbed sleep. On the other hand, Restoril (temazepam) falls under benzodiazepines class which increases GABA effects leading to decreased anxiety and promotion of sleep primarily by reducing time to fall asleep.
Lunesta vs Restoril Side By Side
Attribute | Lunesta | Restoril |
---|---|---|
Brand Name | Lunesta | Restoril |
Contraindications | Should not be taken with alcohol; may worsen insomnia or cause unusual mood changes or thoughts. Inform doctor about all current medications due to potential interactions. | Should not be taken with alcohol; may worsen insomnia or cause unusual mood changes or thoughts. Inform doctor about all current medications due to potential interactions. |
Cost | For brand name: around $340 for 30 tablets (2 mg). For generic (eszopiclone): starts from as low as $0.60/day ($18/month). | For brand name: about $230 for 30 capsules (30 mg). For generic (temazepam): starts at around $0.20 - $0.80 per day. |
Generic Name | Eszopiclone | Temazepam |
Most Serious Side Effect | Allergic reactions, unusual thoughts or behavior, new or worsening depression, anxiety leading to self-harm thoughts, memory problems, impaired vision. | Signs of an allergic reaction, aggressive behavior or other behavior changes, anxiety, hallucinations or confusion, depression and suicidal thoughts, memory problems. |
Severe Drug Interactions | Antifungal agents (ketoconazole), macrolide antibiotics (erythromycin), protease inhibitors for HIV treatment (ritonavir). | Similar to Lunesta, including but not limited to antifungal agents, macrolide antibiotics, and protease inhibitors for HIV treatment. |
Typical Dose | 1–3 mg/night, with 2 mg/night being adequate for most adults. | 15 mg/day, taken by mouth immediately before bedtime, can be increased to 30 mg/day if needed. |
What is Lunesta?
Eszopiclone (the generic name for Lunesta) is a new-generation hypnotic drug, and it has significantly improved the treatment of insomnia compared to older drugs such as benzodiazepines. Eszopiclone was first approved by the FDA in 2004. It works by modifying the GABA receptors in the brain to induce sleepiness, thus helping individuals fall asleep more quickly and stay asleep longer. It's typically prescribed for people with chronic or severe forms of insomnia.
On the other hand, Temazepam (Restoril), an older medicine from the class of benzodiazepines, also enhances activity at GABA receptors but with less selectivity than eszopiclone. Restoril can be used on an as-needed basis due to its shorter half-life but may have more pronounced side effects like daytime drowsiness and dependency risk compared to Lunesta which exhibits fewer such effects because of its selective action on specific subtypes of GABA receptors.
What conditions is Lunesta approved to treat?
Lunesta is approved for the treatment of insomnia, specifically:
- Difficulty falling asleep (onset insomnia)
- Difficulty staying asleep through the night (maintenance insomnia)
Restoril, on the other hand, is also approved to treat insomnia but is typically used when difficulty falling asleep initially is the main issue. It's worth noting that both drugs should only be taken under medical supervision due to potential risks and side effects associated with sleep medications.
How does Lunesta help with these illnesses?
Lunesta works to manage insomnia by enhancing the action of gamma-aminobutyric acid (GABA), a neurotransmitter in the brain that has inhibitory effects. It does this by binding to and activating GABA receptors, which increases the influx of chloride ions into neurons, making them less likely to fire off impulses. This results in a general slowdown of activity in the central nervous system, including calming overactive wake-promoting brain regions. GABA plays an essential role in reducing neuronal excitability throughout our nervous system and is directly responsible for muscle relaxation, sleep induction, anxiety reduction amongst other things. Individuals with insomnia often have an imbalance or deficiency in their GABA production or function. Therefore, by enhancing the action of GABA using Lunesta can help limit negative symptoms associated with insomnia like trouble falling asleep or staying asleep through night.
What is Restoril?
Restoril, the brand name for temazepam, is a benzodiazepine medication primarily used in the treatment of insomnia. Restoril works by enhancing the activity of certain neurotransmitters in the brain to induce sedation and sleepiness. It was first approved by the FDA in 1981.
As Restoril belongs to the class of benzodiazepines, it has a different mechanism and side-effect profile compared to non-benzodiazepine hypnotic drugs like Lunesta (eszopiclone). While both medications are effective at initiating sleep, Restoril may have an advantage with longer duration sleep due to its extended half-life.
Common side effects include drowsiness during daytime hours and feeling hungover. Its long-term use can lead to dependency or addiction; hence caution is advised when using this medication over an extended period.
What conditions is Restoril approved to treat?
Restoril, also known as temazepam, is approved by the FDA for short-term treatment of insomnia. The key conditions that Restoril can effectively treat include:
- Short-term sleeping problems (insomnia)
- Reducing difficulty in falling asleep
- Minimizing the frequency of awakening during night time
How does Restoril help with these illnesses?
Restoril, like Lunesta, is a medication used to treat insomnia and other sleep disorders. It works by enhancing the action of gamma-aminobutyric acid (GABA), a neurotransmitter that inhibits activity in the brain. This results in a reduction of anxiety and an increase in feelings of calmness, promoting sleep. Restoril's effects on GABA also help improve both the duration and quality of sleep for many patients. Its efficacy can be seen as comparable to Lunesta; however, it has been around longer which gives it an extensive track record concerning safety profiles and side effects. Given these attributes, Restoril may sometimes be prescribed when a patient does not respond well to newer medications such as Lunesta or may be coupled with other treatment modalities for comprehensive management of sleep disorders.
How effective are both Lunesta and Restoril?
Both eszopiclone (Lunesta) and temazepam (Restoril) have established histories of success in treating insomnia, with Lunesta being approved by the FDA a couple of decades after Restoril. They act on GABA receptors, but their specific action varies slightly due to differences in their chemical structure. The effectiveness of Lunesta and Restoril was directly compared in several clinical trials; they showcased similar efficacy in managing symptoms of insomnia as well as comparable safety profiles.
A 2008 review showed that both drugs are effective at promoting sleep onset from the first night of treatment, and their side effect profile is considered favorable among other hypnotic medications. Both are also well-tolerated even within elderly populations - a group highly prone to issues with sleep health.
However, some studies suggest that individuals taking Lunesta may experience longer total sleep time than those on Restoril. This could be attributed to its unique pharmacokinetics which permit sustained drug levels throughout the night.
Nonetheless, like all hypnotics, these medications should ideally be used for short-term management of acute episodes rather than long-term chronic therapy because there's potential risk for dependency or tolerance over time. Further research is needed to confirm standalone long term safety and efficacy data for these two medications. Ultimately choosing between them will depend on individual patient factors such as how quickly they need to fall asleep versus staying asleep through the night without waking up prematurely.
At what dose is Lunesta typically prescribed?
Oral dosages of Lunesta range from 1–3 mg/night, but studies have indicated that 2 mg/night is adequate for most adults experiencing insomnia. The elderly or those with liver disease may be started on a lower dosage of 1 mg/night. In either population, the dosage can be increased if there is no response after a few days to a week. However, the maximum dosage that should not be exceeded in any case is 3 mg per night. Restoril, on the other hand, typically has an adult dosage range between 7.5-30mg at bedtime for treating insomnia due to anxiety or transient situational stress; however, it's important to remember these doses are only guidelines and individual needs vary greatly based on factors such as age and overall health status.
At what dose is Restoril typically prescribed?
Treatment with Restoril typically begins at a dosage of 15 mg/day, taken by mouth immediately before bedtime. The dose can then be increased to 30 mg/day if clinically indicated and there is no significant impairment of daytime functioning. It should not be used for an extended period; usually, it's recommended for short-term treatment durations of 1-2 weeks or less. If insomnia persists after a reasonable period of treatment, one might need to reevaluate the situation as this may indicate the presence of an underlying disorder. As always, consultation with a healthcare provider is essential when adjusting medication dosages.
What are the most common side effects for Lunesta?
Common side effects experienced by those taking Lunesta compared to Restoril include:
- Drowsiness, sleepiness or somnolence (particularly the next day)
- Unpleasant taste in mouth
- Dry mouth
- Headache
- Dizziness
- Nausea
- Anxiety or nervousness
- Cough and throat irritation
- Painful menstruation (cramps)
-Unusual dreams or nightmares
-Increased sweating
-Decreased libido (sex drive)
-Tremors (unintentional trembling or shaking) -Stomach discomfort, indigestion/dyspepsia
Should you experience any of these symptoms to a severe degree, it's recommended that you seek medical attention.
Are there any potential serious side effects for Lunesta?
While both Lunesta and Restoril are sleep aids, they can have different side effects. For Lunesta, some of the more serious potential side effects include:
- Allergic reactions: hives; difficulty breathing; swelling of your face, lips, tongue or throat
- Unusual thoughts or behavior: aggression, hallucinations, confusion or agitation
- New onset depression or worsening of your depression
- Anxiety leading to self-harm thoughts
- Memory problems
- Daytime drowsiness
- Impaired vision
For Restoril on the other hand:
- Signs of an allergic reaction such as itching; hives; trouble breathing; chest tightness and/or swelling in hands/feet/lips/tongue/throat.
- Confusion and disorientation which might lead to aggressive behavior.
- Major shifts in mood or mental health including depressed mood with suicidal ideation. -Nervous system abnormalities: muscle stiffness and tremors. -Low sodium levels - headache, slurred speech, severe weakness.
In case you experience any such symptoms while taking either drug, it's essential that you seek immediate medical attention.
What are the most common side effects for Restoril?
While taking Restoril, you might experience these common side effects:
- Dizziness or drowsiness
- Nausea or upset stomach
- Headache
- Daytime drowsiness (after a night's dose)
- Feeling nervous, excited, or irritable
- Dry mouth and unusual thirst
- Decreased libido In rare cases, Restoril can cause confusion or memory loss. It is also important to note that long-term use of this medication may lead to dependency. Always consult with your healthcare provider about the potential risks and benefits before starting any new medication regimen.
Are there any potential serious side effects for Restoril?
While Restoril is generally effective in treating insomnia, it's also important to be aware of potential side effects that could ensue. If you experience any of the following, seek medical attention immediately:
- Signs of an allergic reaction such as hives; difficulty breathing; swelling of your face, lips, tongue, or throat
- Aggressive behavior or other behavior changes
- Anxiety, hallucinations or confusion
- Depression and suicidal thoughts
- Memory problems (amnesia), especially if taken for extended period
- Unusual risk-taking behavior and increased energy
- Difficulty with coordination/balance or feeling light-headed
Remember that not everyone will experience these reactions but being aware gives you a chance to act promptly should they occur.
Contraindications for Lunesta and Restoril?
Both Lunesta and Restoril, similar to other sleep medications, may worsen insomnia or cause unusual mood changes or thoughts in some people. If you notice your insomnia worsening, experience strange dreams or nightmares, find yourself acting out dreams while asleep (sleepwalking), experiencing memory loss, confusion or hallucinations please seek immediate medical attention.
Neither Lunesta nor Restoril should be taken if you are consuming alcohol as it can increase the sedative effects of the drugs and potentially be dangerous. Always inform your doctor about all medications you're currently taking; these include prescription drugs, over-the-counter medicines/supplements and herbal products. Certain medications like antifungal agents (ketoconazole), macrolide antibiotics (erythromycin), protease inhibitors for HIV treatment (ritonavir) among others may interact with these sleeping aids altering their effectiveness and could lead to serious side effects.
How much do Lunesta and Restoril cost?
For the brand name versions of these drugs:
- The price for 30 tablets of Lunesta (2 mg) averages around $340, which works out to approximately $11/day.
- The price for 30 capsules of Restoril (30 mg) is about $230, equating to roughly $8/day.
Thus, if you are on a typical dosage range for Lunesta (i.e., 1–3 mg per day), then brand-name Restoril is less expensive on a per-day treatment basis. Please note that cost should not be a primary consideration in determining which of these drugs is right for you.
For the generic versions of Lunesta (eszopiclone) and Restoril (temazepam), costs are significantly lower:
- Eszopiclone comes in packs ranging from 7 up to 90 tablets with approximate costs starting from as low as $0.60/day ($18/month).
- Temazepam also comes in varying pack sizes with costs starting at around $0.20 - $0.80 per day depending on your dose and where the medication is purchased.
Please take into account other factors such as potential side effects, effectiveness and your personal medical history when deciding between these medications.
Popularity of Lunesta and Restoril
Eszopiclone, available under the brand name Lunesta, was estimated to have been prescribed to about 2.7 million people in the US in 2020. Eszopiclone accounted for just over 11% of hypnotic prescriptions (medications used to induce sleep) in the US. It is a "Z-drug" and has a unique mechanism of action that distinguishes it from other classes of sleep aids such as benzodiazepines or barbiturates.
Temazepam, including brand versions like Restoril, was prescribed to approximately 3 million people in the USA during the same year. In terms of hypnotics use in America, temazepam accounts for around 13% of total prescriptions made by doctors. As a member of the benzodiazepine class, temazepam has been popular since its introduction decades ago but has seen a slight decline recently due to concerns over potential risks with long-term usage.
Conclusion
Both Lunesta (eszopiclone) and Restoril (temazepam) have been used for many years in the treatment of insomnia, with numerous clinical studies backing their efficacy over placebo treatments. In some cases, these drugs may be combined with other treatments but this is always under the careful consideration of a physician as they can also interact negatively with certain medications. Due to their different mechanisms of action - Lunesta affects GABA receptors while Restoril primarily acts on benzodiazepine receptors - they are often prescribed under different circumstances.
Generic forms of both drugs are available which offers significant cost savings especially for patients paying out-of-pocket. Both Lunesta and Restoril may require an adjustment period; therefore immediate effects might not be noticeable.
The side effect profiles are similar between these two medications, both being generally well-tolerated; however, Lunesta carries less risk for dependency than Restoril, which is a characteristic feature of benzodiazepines like temazepam. For both drugs, it's important that patients closely monitor their sleep patterns when starting treatment and immediately seek medical help if they notice worsening insomnia or develop any unusual behavioral changes.
Refrences
- Pechnick, R. N., Lacayo, L. M., Manalo, C. M., Bholat, Y., & Spivak, I. (2011, July). Eszopiclone stimulates the hypothalamo-pituitary-adrenal axis in the rat. European Journal of Pharmacology. Elsevier BV.http://doi.org/10.1016/j.ejphar.2011.04.016
- Hair, P. I., McCormack, P. L., & Curran, M. P. (2008). Eszopiclone. Drugs. Springer Science and Business Media LLC.http://doi.org/10.2165/00003495-200868100-00005
- Najib, J. (2006, April). Eszopiclone, a Nonbenzodiazepine Sedative-Hypnotic Agent for the Treatment of Transient and Chronic Insomnia. Clinical Therapeutics. Elsevier BV.http://doi.org/10.1016/j.clinthera.2006.04.014