The role of eszopiclone in the treatment of insomnia.
BACKGROUND
Insomnia is a common and underdiagnosed condition that can result in significant economic and clinical consequences. Despite numerous behavioral and pharmacotherapeutic treatment options available for insomnia, few receive adequate treatment, and sleep maintenance (staying asleep) remains a significant problem. To date, available sedative-hypnotic agents have limitations that have lead to inadequate treatment of insomnia. This review provides an overview of eszopiclone and its role in the treatment of insomnia.


METHODS
Electronic databases (MEDLINE, EMBASE, International Pharmaceutical Abstracts) were searched for applicable primary literature and review articles.


RESULTS
Mechanisms of action at the gamma-amino butyric acid (GABA) receptor sites and pharmacologic and pharmacokinetic characteristics are presented. Eszopiclone, a nonbenzodiazepine S-enantiomer of racemic zopiclone, is highlighted as the first sedative-hypnotic agent to be approved by the United States Food and Drug Administration for the treatment of sleep onset latency and sleep maintenance insomnia with no short-term restrictions. Recently, the European Medicines Agency recommended marketing authorization of eszopiclone.


CONCLUSIONS
Eszopiclone has been shown to be an efficacious and cost-effective option for the treatment of transient and chronic insomnia in adults.
Morin
Anna K
AK
Massachusetts College of Pharmacy and Health Sciences, Department of Pharmacy Practice, 19 Foster Street, Worcester, Massachusetts 01608, USA. anna.morin@mcphs.edu
Willett
Kristine
K
D000208:Acute Disease; D000328:Adult; D000368:Aged; D053961:Azabicyclo Compounds / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use*; D002908:Chronic Disease; D015897:Comorbidity; D003362:Cost-Benefit Analysis; D004347:Drug Interactions; D000069582:Eszopiclone; D058785:GABA-A Receptor Agonists; D006801:Humans; D006993:Hypnotics and Sedatives / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use*; D010879:Piperazines / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use*; D044094:Receptors, Melatonin / Q000819:agonists; D012449:Safety; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy*; D016896:Treatment Outcome; D014481:United States; D014486:United States Food and Drug Administration
D053961:Azabicyclo Compounds; D058785:GABA-A Receptor Agonists; D006993:Hypnotics and Sedatives; D010879:Piperazines; D044094:Receptors, Melatonin; D000069582:Eszopiclone