27 June 2017 07:00
Photo : iStockphoto
The McGill university health Centre (MUHC) has discovered that many patients receive the sleeping pill zopiclone (Imovane) over long periods of time or in too high doses, and this, despite the warnings of the manufacturer and Health Canada.
The survey was conducted among the patients of the MUHC, of which 1 049 patients who received the drug between 1 April 2015 and 31 march 2016.
In the aftermath of a car accident fatal occurred in Quebec, and the cause of which was the use of a sleeping aid, the College of physicians had circulated to its members the recommendations made by the coroner in 2016, on the prescribing of zopiclone. The recommendations of the coroner reflected those already issued by Health Canada (2014): limit the initial dose to the smallest that are effective, and do not exceed use for 7 to 10 days. A dose maximum should be established for older patients, or those with renal or hepatic impairment.
The investigation of the MUHC, has revealed that several prescriptions were non-compliant to these recommendations, and to that of the manufacturer (Sanofi in the case of the Imovane). In fact, 75 % of patients who have been prescribed zopiclone and have received a minimum dose initial too strong. Meanwhile, the maximum recommended dose was exceeded for 64 % of the patients older than 65 years, compared with 3.7% for patients under 65 years of age. Of 607 patients admitted to the MUHC for more than 10 days, 39% received the drug for more than 10 days.
In the study published in English, researchers place the zopiclone under the term Z-Drugs, which includes several other medicines of the same type. They recall that the use of Z-Drugs has risen alarmingly in the United States. From 1993 to 2007, the number of prescriptions has increased five times faster than the number of insomnia diagnosed. In Quebec, the phenomenon is less accentuated, because these drugs are not covered by the public system, said the study. But several private insurers the cover, they add.
However, these drugs are anything but benign, say the researchers. Studies have shown that there is a link between over-treatment and disorder of dementia or an increased risk of falls with injury. They should not, according to the article at the MUHC, be prescribed for short periods of time.