Non-Benzodiazepine Hypnotics ("Z-drugs")

Non-Benzodiazepine Hypnotics (“Z-drugs”) include eszopiclone, zolpidem, and zopiclone.

  • Treatment with Z-drugs usually should not exceed 7 to 10 consecutive days.
  • If there is use for more than 2 to 3 consecutive weeks, the clinician should do a complete re-evaluation of the patient and reassess any underlying medical or psychiatric disorders.
  • Bind to GABA receptors that are distinct from those affected by benzodiazepines
  • Compared to benzodiazepines, there is minimal anticonvulsant, respiratory depressant, and muscle relaxant effects
  • These drugs still have addictive potential
  • Some studies suggest that withdrawal and tolerance can occur after a longer period of use (2 to 3 months) relative to benzodiazepines (4 weeks)
  • “Z drugs” may cause non-REM parasomnias (e.g. - sleep walking) and should be avoided in patients who have parasomnias.
  • Anecdotally, patients may report more restful sleep than benzodiazepines