Comparison of lorazepam and zopiclone for insomnia in patients with stroke and brain injury: a randomized, crossover, double-blinded trial.
OBJECTIVE
To determine if lorazepam or zopiclone is more effective in providing a restful night of sleep and to assess the effects of these medications on cognition.


METHODS
A randomized, double-blinded, crossover trial was performed at a tertiary care rehabilitation inpatient unit in a teaching hospital. A total of 18 brain-injured and stroke patients, aged 20-78 yrs, were administered lorazepam, 0.5-1.0 mg, orally at bedtime as needed for 7 days and zopiclone, 3.75-7.5 mg, orally at bedtime as needed for 7 days. Total sleep time and characteristics of sleep were measured. Effects on cognition were also measured using the Folstein Mini Mental Status Exam.


RESULTS
There was no difference in average sleep duration or in subjective measures of sleep. Cognition as assessed by the Mini Mental Status Exam revealed no difference in the zopiclone arm compared with the lorazepam arm.


CONCLUSIONS
Zopiclone is equally effective as lorazepam in the treatment of insomnia in stroke and brain-injured patients.
Li Pi Shan
Rodney S
RS
Department of Physical Medicine and Rehabilitation, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Ashworth
Nigel L
NL
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D053961:Azabicyclo Compounds; D001930:Brain Injuries / Q000150:complications* / Q000534:rehabilitation; D003071:Cognition / Q000187:drug effects; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000494:pharmacology / Q000627:therapeutic use*; D008140:Lorazepam / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D010879:Piperazines / Q000494:pharmacology / Q000627:therapeutic use*; D017286:Polysomnography; D012525:Saskatchewan; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000523:psychology; D020521:Stroke / Q000150:complications*; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
D053961:Azabicyclo Compounds; D006993:Hypnotics and Sedatives; D010879:Piperazines; C515050:zopiclone; D008140:Lorazepam