Talk:Eszopiclone

Neutrality Issue: Introduction Bias?
The last few sentences of the introduction seem a little biased/irrelevant. Specifically:

''All clinical trials of eszopiclone published so far are industry funded by the pharmaceutical manufacturer of eszopiclone, Sepracor. Eszopiclone (Lunesta) along with other "Z Drugs" including zolpidem (Ambien), zaleplon (Sonata) are the most commonly prescribed sedative hypnotics in the USA. There were 43 million prescriptions issued for insomnia medications during 2005 in the USA which generated a total of $2.7 billion for pharmaceutical companies.''

It's not that the information is not important: certainly 43 million prescriptions in 2005 is a noteworthy fact. However, the wording seems to imply that the drug companies are urging doctors doctors to prescribe hypnotics for a financial, rather than medical incentive. This part of the introduction does not seem to follow the general form of an introductory paragraph on Wikipedia. I do not dispute the well-cited facts. Rather I believe that because of the wording and the order the facts are displayed, the paragraph seems to imply: "All the research that doctors have at their disposal when prescribing one of these medicines is funded by the drug companies. Consequentially, 43 million scrips were issued in 2005 alone, perhaps because the drug companies published positive research. As a result, the drug companies earned $2.7 billion dollars."

If I were to reword this I would write:

The manufacturer of eszopiclone, Sepracor, has published all clinical trials of the drug so far (correcting the passive voice)''. Eszopiclone (Lunesta) is one of the most prescribed medicines for insomnia is the US. Doctors prescribed eszopiclone and the other "Z Drugs", namely zolpidem (Ambien) and zaleplon (Sonata), 43 million times in 2005 alone for a total of $2.7 billion of sales.''

I feel that wording is much more neutral. It is clear that the $2.7B went to the drug companies but clearly stating it along with the way the other facts are presented implies that the drug companies are only seeking profit. How about the fact that 43 million people, a sizable chunk of the US population, probably got a great deal of relief from insomnia because of the drug companies? I do not want to change the wording, however, without some imput from the Wikipedia community as I am a long-time reader, short-time contributor. Thanks in advance for your input!--Rotellam1 (talk) 03:10, 4 March 2010 (UTC)

Hi there. I understand your concern, however I feel your proposed wording does little to change the present intro and does not state the facts as well. (BTW, you should have added this at the bottom of this page.) Gandydancer (talk) 12:49, 28 March 2010 (UTC)

Why don't you people stop being pseudo-encyclopedic, and admit that this is an activist introduction?

I am a native English speaker, but I was trained as a German philosopher, so I write like one. I do agree that the less passive voice is formative and providing facts more clearly on this page, and preserving the practice across all Wiki projects, however I do not understand your characterization of 'neutral'. Please define or provide some criteria that cross references the original portion of the intro relative to your propose changes. AuQuebec (talk) 12:18, 29, April 2013 (UTC)

Elderly
This section does not seem unbiased. As a lay reader, I feel just a bit bullied. For example, Is there really call for the speculative remarks on melatonin agonists [sic] (should be melaonin RECEPTOR agonists)? It seems out of the blue and not really relevant unless you have some agenda.

Troponemia
This word is listed under the section about overdose, and possible symptoms of an overdose of this drug. I for one cannot seem to find the definition of this word through any searches that I've used, and only real mention I'm seeing to the word itself through google etc. is the second source that cites it (#19), which is a med. journal that I can't access without paying. Do you think we could put a short layman's description of the condition after the word? tonyb983 01:10, 15 October 2009 (UTC)

Abuse
I'd like to see some information about side effects, abuse, and effects in general.


 * At first I thought I was the only one misspelling Lunesta as "Lunestra," but it seems I'm not. Is it within Wikipedia's rules to set up a redirect page from a misspelling? If so, uh, I don't know how to do it... McGehee 02:25, 8 January 2007 (UTC)

I have added a section on abuse of lunesta and I have expanded the side effects section.--Stilldoggy (talk) 01:39, 22 March 2008 (UTC)

Commercial spots
Is there gonna be any information about the commercials? Angie Y. 17:00, 1 October 2006 (UTC)
 * I cannot provide that information due to copyright violations. :-) Carlo Banez (talk) 17:13, 15 April 2008 (UTC)

Unpleasant Taste
I tried Lunesta once; when they say unpleasant taste, it truly is horrid, to the extreme. This being only a personal experience of mine, I didn’t like the taste (obviously); I know it may seem silly but I wanted to get my taste ‘corrected’ immediately, so I ate some food, checking to see if it was better, but I scarcely ‘touched’ my food at all as it was the worst 'food' I’ve ever tasted. Instead, I slept it off; Still had a little after taste in the morning but never took Lunesta again. Joey 08:39, 25 December 2006 (UTC)Joey


 * That's odd. I just swallow the pill and don't taste it at all. McGehee 02:27, 8 January 2007 (UTC)

- maybe it does just depend on the person.. for me, its extremely unpleasant. So bad that it distracts me from falling asleep, as I usually have to get something to wash my mouth out. But this still usually ends up unsuccessful and the taste is still there.. so those of us who already have a hard enough time falling asleep, now just have to do so with a rancid taste in their mouth. My taste buds would even be thrown off in the morning when I wake up and eat breakfast. Terrible side effect.

I can't believe the taste side-effect isn't mentioned in the article. That's bogus. That having been said, I personally just did my first night with Lunesta, and the morning-after taste isn't too bad (just barely noticeable for me). But then, it didn't put me sleep either, so.... --Skidoo 11:30, 4 April 2007 (UTC)

UPDATE to my previous comment (from 4 Apr): The taste is HORRIBLE. I had to switch. STRONG metallic taste after 2 nights. YUCK! Again, I can't believe it's not mentioned. |This is a common, well-documented side-effect.


 * I, too, experienced the horrible, HORRIBLE taste. The first time I tried it, I didn't notice anything unusual because I swallowed it right away.  But the second time, I put it on my tongue and then spent a few seconds looking for a drink to wash it down.  During that short time, the pill apparently partially dissolved and this unbelievably bad "chemical" taste overwhelmed my mouth, and I couldn't wash it out or do anything to get rid of it.  It was far and away the most powerfully bad taste I had ever experienced in my life.  "Unpleasant?"  Ha!  That doesn't even begin to describe it.  It was awful.  24.6.66.193 (talk) 23:30, 15 December 2007 (UTC)

Canker sores
I have been taking Lunesta for 6 months. I believe it is causing canker sores on my tongue. I get canker sores, sometimes several, about every week. Since this medication has such an acidic taste, I wonder if it is causing this. Has anyone else experienced this? —The preceding unsigned comment was added by 74.140.236.234 (talk) 01:04, 24 January 2007 (UTC).

Bad Mouth Taste
Take a look at the Wiki on Lunesta's sister drug, Imovane (Zopiclone). Imovane has a pronounced side effect in some people - bitter or metallic taste which can carry into the next day.

Personally, I tried both Zopliclone and Lunesta (separately) and experienced a moderate metallic taste with both drugs. In particular, I noticed a strong bitter taste when I cut a Lunesta tablet in half for a half dose. I think that is the reason why the 3 mg Lunesta dose is coated in a neutral shell - to keep the taste off the tongue. When I did not cut a pill in half there was still a moderate metallic morning mouth that slowly vanished.

BTW: If your prescriptions are not covered and you cannot afford Lunesta's high price, go to GetCanadianDrugs.com or elsewhere in Canada and try Zopliclone. Its not available in the USA. Lunesta's firm banned Zopliclone from the USA after it won a US patent for Lunesta. Zopliclone is available worldwide and is well understood. Its a fraction of the cost of Lunesta and is very likely just a effective.

Of course, TALK to your doctor, FIRST.

OBOE —The preceding unsigned comment was added by Oboist1 (talk • contribs) 23:15, 19 February 2007 (UTC).


 * yes this can be extremely unpleasant. It bothers me because its more than just a "taste", as even when you breathe in and out you can get a hint of that metallic just BLAH taste thats in your mouth. Anything I have for breakfast is completely tainted. The BEST way to combat this side effect that I have found is to gargle some PINEAPPLE and/or ORANGE juice. I do both in the morning and it helps a little, but the aftertaste is so strong that it even would be noticeable when I am eating lunch the next day! Although luckily it has never lasted for more than about the mid day of the next day you are taking it. —Preceding unsigned comment added by 24.136.126.165 (talk) 15:14, 9 November 2007 (UTC)

No Zopliclone was not even sent to the FDA it was not banned by lunesta in the us only Eszopiclone was — Preceding unsigned comment added by Qwh (talk • contribs) 21:29, 2 June 2013 (UTC)

Withdrawal Symptoms
How can "death by overdose (rare)" be a withdrawal symptom? If you are withdrawing, it doesn't seem possible to overdose. Should that be taken out? --BennyD 00:08, 9 November 2007 (UTC)

Well i suppose it is referring to a drug overdose in general, so even something like aspirin. But either way it should be taken out.. Nobody is going to kill themselves over this drug and if they do its because they can't deal with the horrid taste it gives you in your mouth. —Preceding unsigned comment added by 24.136.126.165 (talk) 03:31, 9 November 2007 (UTC)

It was vandalism, it didn't come from the citation. I removed it.--Stilldoggy (talk) 01:35, 22 March 2008 (UTC)

Taste
If you let the pill sit in your mouth without washing it down immediately, it is really bitter.


 * Yeah, I discovered that the hard way. (See my comments above, under "Unpleasant taste") 24.6.66.193 (talk) 23:40, 15 December 2007 (UTC)

There is also a morning aftertaste. For me, both have responded to fruit juice.


 * I tried fruit juice and the Lunesta taste just kicked its ass. 24.6.66.193 (talk) 23:40, 15 December 2007 (UTC)

I edited the IUPAC Name to the correct form of (5S)-6-(5-Chloro-2-pyridinyl)-7-oxo-6,7-dihydro-5H-pyrrolo[3,4-b]pyrazin-5-yl 4-methyl-1-piperazinecarboxylate--ChemSpiderMan (talk) 02:38, 17 December 2007 (UTC)

Carcinogenicity
Please refer to: http://en.wikipedia.org/wiki/Talk:Zolpidem#Carcinogenicity The same section has been included in this article. Paul Fisher (talk) 10:07, 16 May 2008 (UTC)

I changed the opening sentence to fit with the conclusions of the study, so that it is clear that it is not definitively proven. Reworded to may cause.-- Literature geek |  T@1k?  11:52, 16 May 2008 (UTC)

The extent of the carcinogenicity section seems way out of proportion to the available information indicating that the drug has this property. The information is not necessarily inaccurate but is presented in what seems to be excessive detail. Carcinogenicity for this drug as confirmed in rats (as mentioned in the article) was for doses of 100mg/kg - pardon if my math is off, but it seems to me that for a .5 kg rat, this is equivalent to a dose of 8110 mg for a 180 lb (81.1kg) individual, or ~2700 times higher than the prescribed dose. Perhaps this section should be toned down? Owlswater (talk) 00:40, 4 July 2008 (UTC)

Correction - quoting the relevant section re: blood plasma levels: "Plasma levels of eszopiclone at this dose are estimated to be 150 (females) and 70 (males) times those in humans receiving the MRHD. The mechanism for the increase in mammary adenocarcinomas is unknown. The increase in thyroid tumors is thought to be due to increased levels of TSH secondary to increased metabolism of circulating thyroid hormones, a mechanism that is not considered to be relevant to humans." Owlswater (talk) 00:41, 4 July 2008 (UTC)

Bias issue: Dependence section
In addition to the objections regarding bias raised w.r.t the introduction, I have a problem with the section on dependence. This section seems overblown. The entire discussion here is a bunch of hypotheticals related to the drug's purported similarity to benzodiazepines, whereas the only hard data actually supports the opposite conclusion, namely that "Eszopiclone was studied for up to 6 months in a group of patients which showed no signs of tolerance or dependence in a study funded and carried out by Sepracor."

True, the available studies are by the drug company itself (like most such studies are). But unless the listed hypotheticals can be supported by citations relevant to this particular drug, they should be removed. Wikipedia should not be in the business of inventing hypotheticals.

The following sentences on general causes of insomnia are irrelevant in this section and I am removing them: "Insomnia itself can result from dependence or substance withdrawal symptoms. Causes of insomnia include chronic anxiety, depression, alcohol or substance abuse or withdrawal, adverse or withdrawal effects from medication, or age-related changes in sleep."

Inaccuracy and bias: Withdrawal section
A bunch of withdrawal symptoms is listed, but where do these come from? They are certainly not from the citation given (which say nothing of withdrawal symptoms).

The insert claims only the following: "The clinical trial experience with LUNESTA (eszopiclone) revealed no evidence of a serious withdrawal syndrome. Nevertheless, the following adverse events included in DSM-IV criteria for uncomplicated sedative/hypnotic withdrawal were reported during clinical trials following placebo substitution occurring within 48 hours following the last LUNESTA (eszopiclone) treatment: anxiety, abnormal dreams, nausea, and upset stomach."

Given the only hard data available: "Eszopiclone was studied for up to 6 months in a group of patients which showed no signs of tolerance or dependence", I find the wording on abrupt discontinuation hard to swallow. Where does it come from that the drug cannot be abruptly discontinued? It is inaccurate and should be removed unless it can be supported by citations relevant to this particular drug (and not benzodiazepines as a class).

Cost in the USA
For the USA users of Eszopiclone

I just would like you to notice that the equivalent drug known as "Zopiclone" is available in Israel for just about 3.8 $ (US Dollars) per 20 tablets, it comes to (about) 19 cents per 1 Zopiclone tablet of 7.5 mg = (about) 3.75 mg of Eszopiclone. This is less then 1/10 of its price in the US.

The only difference between Zopiclone and Eszopiclone is that Zopiclone contains Eszopiclone + the other (pharmacologically non-active) isomer of that drug.

Please read the chapter "Availability in Europe" in this Wikipedia article to see that the EMA (the European Union's equivalent to the US FDA) stated it would not be granting Eszopiclone 'new active substance' status, as it was essentially pharmacologically and therapeutically too similar to Zopiclone.

written for you by a Zopiclone user in Israel. — Preceding unsigned comment added by 109.186.126.105 (talk) 14:09, 30 October 2011 (UTC) Zopiclone is ilegal in the united state but you can get generic eszopiclone for 1 dollar per 30 tablets — Preceding unsigned comment added by Qwh (talk • contribs) 10:09, 6 June 2013 (UTC)

BMJ from 2012
Systematic review says "Although the drug effect and the placebo response were rather small and of questionable clinical importance"

User:Dfdemt appears to be calling the BMJ here a "sketchy source"?

Doc James (talk · contribs · email) 00:35, 24 December 2017 (UTC)

--Dfdemt (talk) 11:39, 18 May 2019 (UTC)I am not calling the BMJ a "sketchy source". I have been practicing medicine since 1998 and get alot of nice info from the BMJ. However, the statement I deleted, "It is slightly effective for this purpose" is not a fact, it is an opinion. Effectiveness varies from patient to patient, no matter what a medical journal might state. Thank you.

Yes, Dfdemt, I think we agree completely that when properly introduced with gravitas and providential hope, even tictacs can have marvelous effects. That's exactly why measuring against placebo is important. Active placebo isn't used often enough -- i.e. if a compound is known to make folk flush, use niacin as the placebo to maintain blinding. Mention of the small effect size of the drug on average is important and accurate. If you have published evidence that tends to refute the unbiased claim by the folk in BMJ, I'd rather you put that side by side for consideration rather than censoring the section. — Preceding unsigned comment added by 2601:18A:C500:30E0:E1C9:D758:8688:CF8B (talk) 19:24, 16 January 2022 (UTC)

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