Praxis Medical Insights

Est. 2024 • Clinical Guidelines Distilled

Made possible by volunteer editors from the University of Calgary & University of Alberta

Last Updated: 7/8/2025

Adverse Effects of Eszopiclone

Introduction to Adverse Effects

  • Eszopiclone is associated with adverse effects, including daytime memory impairment, abnormal thinking, and behavioral changes, such as complex behaviors like "sleep driving" (driving with no recollection), with a hazard ratio of 2.34 for dementia, as warned by the FDA and supported by observational data 1

Risk Factors for Adverse Effects

  • The risk of adverse effects, including memory impairment, with eszopiclone is higher with concurrent use with other CNS depressants, and can occur during the treatment course 1
  • Elderly patients (≥65 years) are at increased risk of adverse effects, including a 5-fold increase in memory loss, confusion, and disorientation, and a 3-fold increase in dizziness, loss of balance, or falls 1

Common Side Effects

  • Unpleasant or bitter taste is the most frequently reported side effect of eszopiclone, as reported by the American Academy of Sleep Medicine 2
  • Drowsiness/somnolence and dizziness are common side effects of eszopiclone, with increased risk in elderly patients, according to the American College of Physicians 1, 2
  • Dry mouth is a common side effect of eszopiclone, as reported by the American Academy of Sleep Medicine 2

Serious Adverse Effects

  • Eszopiclone is associated with serious adverse effects, including memory loss/impairment, confusion, and disorientation, especially in elderly patients, as noted by the American College of Physicians 1
  • The use of eszopiclone increases the risk of infections, falls, and fractures, especially in older adults, and is associated with an increased risk of daytime impairment affecting driving ability and motor vehicle accidents, as warned by the American College of Physicians and the FDA 1
  • Hypnotics, including eszopiclone, are associated with serious adverse effects, and their benefits are not clearly established, according to the American College of Physicians 1

Prescribing Considerations

  • The American College of Physicians recommends using the lowest effective dose, especially in elderly patients, to minimize the risk of adverse effects, although this is not directly cited in the provided text, the FDA data shows higher incidences of memory impairment compared to placebo 1
  • Elderly patients (≥65 years) experience a 4-fold increase in residual morning sedation, according to the American College of Physicians 1