Lunesta (eszopiclone) withdrawal usually means a night or two of worse sleep after stopping, sometimes with anxiety, unusual dreams, nausea or an upset stomach. Most people who stop after short-term use at prescribed doses have mild, brief symptoms. People who have taken it for a long time, at high doses, or without a prescription can have stronger symptoms, including shakiness, sweating, cramps and, rarely, seizures, so Lunesta should be reduced with a prescriber's help rather than stopped suddenly.
What Lunesta is
Lunesta is the brand name for eszopiclone, a prescription sleep medicine in the hypnotic class. It works by slowing brain activity so a person can fall asleep and stay asleep. It is a Schedule IV controlled substance, which is why refills are limited.
According to the FDA label, the usual starting dose is 1 mg at bedtime, and the total dose should not exceed 3 mg once daily. Older or debilitated adults should not take more than 2 mg. People should only take it when they can stay in bed for 7 to 8 hours. MedlinePlus says sleep should improve within 7 to 10 days, and to call the doctor if it does not.
Lunesta sits in the same family as Ambien (zolpidem) and Sonata (zaleplon). For a broader comparison, see our guide to sleeping pill withdrawal and our overview of Lunesta and Sonata addiction.
Lunesta withdrawal symptoms
The FDA label warns that withdrawal can follow a rapid dose decrease or abrupt stop of any sedative-hypnotic. In Lunesta clinical trials, there was no evidence of a serious withdrawal syndrome. The events that did show up after people were switched to placebo were:
- Anxiety
- Abnormal or unusual dreams
- Nausea
- Upset stomach
MedlinePlus adds that stopping suddenly can also cause cramps, sweating and shakiness, and rarely seizures. Those stronger symptoms are more likely when someone has been taking more than prescribed or taking it for a long time.
Rebound insomnia
The most noticeable effect for many people is that sleep gets worse for a short time. The label describes rebound insomnia as a temporary, dose-dependent worsening of sleep. In studies, this effect was mild and looked like the original insomnia coming back. MedlinePlus notes that these sleep problems usually get better without treatment after one or two nights.
Lunesta withdrawal timeline
Eszopiclone has an elimination half-life of about 6 hours in adults and about 9 hours in people 65 and older, according to the label. That means most of the drug is cleared within a day or two, and withdrawal tends to start and peak early. There is no official day-by-day timeline, but the general pattern looks like this:
| Phase | What to expect | When to get help |
|---|---|---|
| First 1-2 nights | Trouble falling or staying asleep; possible anxiety and vivid dreams | Usually manageable; tell your prescriber if it is severe |
| First several days | Nausea, upset stomach, anxiety; sleep starting to settle after short-term use | Call your prescriber if symptoms are getting worse instead of better |
| After long-term or high-dose use | Longer stretch of poor sleep and anxiety; possible sweating, shakiness, cramps; rare seizures | Medical supervision is recommended; seizures need 911 |
The timeline stretches out when Lunesta has been combined with other sedatives or alcohol, or when it has been used for a long time. That is one reason a gradual reduction is safer than stopping all at once.
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Call 866-521-4950How to stop Lunesta safely
MedlinePlus is clear: do not stop taking eszopiclone without talking to your doctor, who will probably lower your dose gradually. The FDA label does not set a specific taper schedule, so your prescriber will tailor the plan to your dose, how long you have taken it, and your health. Do not change your dose or stop on your own.
A few things tend to make the process easier:
- Treat the insomnia, not just the pill. The American Academy of Sleep Medicine strongly recommends cognitive behavioral therapy for insomnia (CBT-I). It uses techniques such as stimulus control and sleep restriction, usually over four to eight sessions.
- Expect a rough night or two. Knowing that rebound insomnia is common and usually short-lived can keep it from turning into panic.
- Skip alcohol. MedlinePlus says not to drink while taking eszopiclone, and the label notes alcohol adds to its effect on coordination and thinking.
- Do not substitute other pills. Taking a different sleep aid, a leftover prescription or alcohol to get through withdrawal can be dangerous.
The approach is similar to the one described in our Ambien taper schedule guide, since prescribers handle the Z-drugs in much the same way.
Lunesta risks to know about
The FDA requires a boxed warning on Lunesta, Ambien and Sonata about complex sleep behaviors: sleepwalking, sleep-driving and other activities done while not fully awake. These have caused serious injuries and deaths, even at low doses and after a single dose. If this happens, stop the medicine and contact your prescriber right away. People who have had a complex sleep behavior should not be prescribed these drugs again.
Lunesta is a central nervous system depressant. Combining it with alcohol, opioids or other sedatives can cause dangerous sedation and slowed breathing. Mental health changes, including new or worsening depression, can also occur and should be reported to a doctor. If you have thoughts of suicide, call or text 988. For an emergency, call 911.
Is Lunesta addictive?
Lunesta can be misused, and the label notes that the risk of dependence rises with higher doses, longer use and use alongside other psychoactive drugs. People with a history of drug or alcohol problems are at higher risk. Our article Is Lunesta Addictive? explains the evidence, and signs of sleeping pill addiction lists warning signs to watch for.
Finding help
If tapering with your own doctor is not working, or the dose has climbed well past what was prescribed, professional treatment can help. Sleeping pill programs on this site are listed under Ambien and sleeping pill detox and sleeping pill rehab. You can also search by location, such as Texas, Houston or Phoenix, or browse every option on the states page.
Coming off Lunesta is usually very manageable with a plan. Talk to your prescriber, give your sleep a little time to reset, and reach out for more support if you need it.
Sources
- Lunesta (eszopiclone) Prescribing Information (U.S. Food and Drug Administration)
- Eszopiclone (MedlinePlus, National Library of Medicine)
- FDA Adds Boxed Warning for Risk of Serious Injuries Caused by Sleepwalking With Certain Prescription Insomnia Medicines (U.S. Food and Drug Administration)
- New Guideline Supports Behavioral, Psychological Treatments for Insomnia (American Academy of Sleep Medicine)
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