Lunesta (eszopiclone) can be addictive, though most people who take it as prescribed for a short time do not become addicted. It is a Schedule IV controlled substance, and its FDA label says the risk of abuse and dependence rises with higher doses, longer use, other drug use, and a history of alcohol, drug or psychiatric problems. People who take it nightly for a long time can also become physically dependent and should not stop abruptly without a doctor's help.
What Lunesta Is
Lunesta is a prescription sleep medicine that helps people fall asleep and stay asleep. Like Ambien and Sonata, it is a "Z-drug." It is chemically unrelated to benzodiazepines, but the label notes it shares some of their effects on the brain, and federal law places it in the same Schedule IV category as benzodiazepines, zolpidem and zaleplon.
MedlinePlus says to take Lunesta only at bedtime and only if you can stay in bed for at least 7 to 8 hours. Sleep usually improves within 7 to 10 days; if it does not, the person should talk to their doctor rather than take more.
What the FDA Label Says About Abuse
The Lunesta prescribing information is direct about the potential for misuse:
- Euphoria similar to diazepam: In a study of people with a history of benzodiazepine misuse, 6 mg and 12 mg doses of eszopiclone produced euphoria similar to 20 mg of diazepam (Valium). Both of those doses are above the usual maximum of 3 mg.
- Dose-related effects: At doses at least twice the maximum recommended, amnesia and hallucinations increased with the dose.
- Risk factors: The risk of abuse and dependence goes up with dose, length of treatment, and use of other mind-altering drugs.
- Who needs extra care: People with a history of alcohol or drug abuse, or a psychiatric disorder, should be monitored closely.
NIDA notes that Z-drugs were designed with the hope of fewer side effects and less dependence than benzodiazepines, but their misuse potential is less well studied and some indicators raise concern.
Tolerance and Dependence
One reassuring finding: in a six-month study, the label reports no development of tolerance on the sleep measures that were tracked. That suggests Lunesta may keep working at the same dose for many people, which lowers one common driver of dose escalation.
Physical dependence is a different matter. The label says rapid dose cuts or stopping abruptly have been linked to withdrawal signs like those seen with other sedative drugs. In clinical trials, mild symptoms in the first two days after stopping included anxiety, unusual dreams, nausea and upset stomach. MedlinePlus lists more serious symptoms after sudden stopping, including stomach and muscle cramps, vomiting, sweating, shakiness and, rarely, seizures.
| Physical dependence | Addiction | |
|---|---|---|
| What it means | Your body has adapted and reacts when the drug is stopped | Compulsive use, loss of control, continuing despite harm |
| Can it happen at prescribed doses? | Yes, especially with nightly long-term use | Less likely, but possible |
| Typical signs | Rebound insomnia, anxiety or nausea after stopping | Extra doses, daytime use, multiple prescribers, mixing with alcohol |
| What helps | A gradual taper set by your prescriber | A supervised taper plus therapy or a treatment program |
Who Is Most at Risk
- People with a current or past alcohol or drug problem
- People with depression, anxiety or other mental health conditions
- Anyone taking more than the prescribed dose or taking it more than once a night
- People who have used it nightly for months or years
- Those combining it with alcohol, opioids or other sedatives
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Call 866-521-4950Other Serious Risks
Complex sleep behaviors
Lunesta carries an FDA boxed warning, the agency's strongest, for complex sleep behaviors: sleepwalking, sleep driving and other activities while not fully awake. People usually do not remember them. The FDA says these events are rare but have led to serious injuries and deaths. If one happens, stop the drug and contact your doctor right away.
Next-day impairment
The label warns that Lunesta can impair driving and alertness the next day even at prescribed doses, and even when you feel fine. People on the 3 mg dose are advised not to drive or do other hazardous tasks the next day. Older adults face a higher risk of falls.
Alcohol and other sedatives
Alcohol adds to Lunesta's effects, and the label says not to take it on any evening you have been drinking. Mixing it with opioids, benzodiazepines or other sedatives can cause heavy sedation and slowed breathing. If someone is very hard to wake or breathing slowly, call 911.
Mood changes
Sleep medicines can worsen depression in some people. If you or someone you love has thoughts of suicide, call or text 988.
Signs Lunesta Use Has Become a Problem
- Taking more pills than prescribed or running out early
- Using it in the daytime or to calm down rather than to sleep
- Feeling unable to sleep at all without it
- Memory gaps or strange nighttime behavior you do not recall
- Drinking alcohol with it
- Seeing more than one prescriber or buying pills without a prescription
Our guide to signs of sleeping pill addiction covers these in more detail, and Lunesta and Sonata addiction explains treatment options.
How to Stop Lunesta Safely
If you have used Lunesta nightly for a long time or at high doses, do not stop suddenly. MedlinePlus says your doctor will usually lower the dose gradually. Expect that sleep may be worse for a night or two after stopping; the label and MedlinePlus both describe this rebound insomnia as usually short-lived.
Your prescriber sets the taper schedule and adjusts it based on how you feel. Do not change your dose on your own. For more on symptoms and timing, see Lunesta withdrawal and our overview of sleeping pill withdrawal.
Treatment and Better Sleep
The American Academy of Sleep Medicine strongly recommends cognitive behavioral therapy for insomnia (CBT-I) for adults with chronic insomnia, and suggests medicines mainly for people who cannot do CBT-I or need short-term added help. CBT-I is often the key to staying off sleeping pills.
For someone who has developed an addiction, NIDA advises against quitting alone. A medically supervised taper in sleeping pill detox, followed by counseling, is the safer path, especially when alcohol or other sedatives are involved.
Finding Help
Our sleeping pill rehab directory lists programs that treat Lunesta, Ambien and Sonata dependence. Browse a state such as New Jersey or a city like Newark or detox in San Diego. Our insurance guides explain how to check your coverage. If Ambien is also in the picture, read Is Ambien addictive?
Sources
- Lunesta (eszopiclone) Prescribing Information (U.S. Food and Drug Administration)
- Certain Prescription Insomnia Medicines: New Boxed Warning (U.S. Food and Drug Administration)
- Eszopiclone (MedlinePlus, National Library of Medicine)
- What Classes of Prescription Drugs Are Commonly Misused? (National Institute on Drug Abuse)
- How Can Prescription Drug Addiction Be Treated? (National Institute on Drug Abuse)
- New Guideline Supports Behavioral, Psychological Treatments for Insomnia (American Academy of Sleep Medicine)
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Call 866-521-4950Related guides
- Ambien Addiction: Signs, Risks and Treatment Options
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- Sleeping Pill Withdrawal: Symptoms, Risks and Timeline
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