pharmacology question: what does it mean that I reacted so very badly to a single dose of Lunesta (eszopiclone, 3 mg)?
posted by Corvid to health & fitness (4 answers total)
Last week, I tried a single dose of Lunesta for insomnia. (I usually take zolpidem, but lately it's a little less effective than it used to be.) How I wish I could un-take that nasty little pill.
First, it didn't work very well. After ~ 4 hours of lying awake, I finally fell asleep, and then slept long (too long) into the next day. (I had taken it on an empty stomach, as directed, with no recent high-fat meals.)
Worse, I got the famous bad taste, but in a really intense way. For me, the taste was more than just unpleasant and annoying -- it came with a strong and constant feeling of disgust. It tasted like the greasy, gaggy smell of a dead mouse decaying under the fridge -- like I had found that dead mouse and chewed on it for a while. I found it very hard to eat at all for a couple of days. My mouth still tastes like 3-day-old death. Anything that stimulates saliva flow, like eating, chewing gum or brushing my teeth, actually makes the taste worse for a while, so no amount of scrubbing or masking is helping at all. My appetite has suffered enough that I've lost a couple of pounds. (Is anyone thinking of using this as a weight loss drug? Sort of like Antabuse for food.)
I knew ahead of time that some people report an unpleasant taste while taking this drug, but apparently it's generally not this awful, because lots of people choose to take it anyway (and at great expense). People who like Lunesta like it a lot. I wasn't too concerned about the possibility of the taste, because I tend to like bitter flavors. I don't love the bitterness of aspirin, but it's no big deal. So this reaction really took me by surprise.
And worst of all, that one pill shoved me into a sharp, deep, foul depression, which is very unusual for me. It feels different than other times of sadness I've felt. It feels chemical. Fortunately, it's fading -- at the exact same rate that the foul taste is fading. I'm still aware of both, but each day feels a little closer to normal.
I understand that metabolites of Lunesta cause some people to experience this bad taste, to varying degrees. Depression is also listed as a possible side effect. I've experienced both of these with extreme intensity, from a single pill, and I'm still feeling them (at a greatly reduced level) a week later. I at least want to learn from the mistake I made when I ingested that little chunk of awfulness. So, questions:
1. How can it be that this little bit of drug is still affecting me? Supposedly, it has a half-life of 6 hours (9 hrs in people > 65; I'm 60), but that doesn't seem to be consistent with my experience.
2. Does this unusual reaction tell me anything useful about how my body processes drugs? (There have been other times when I've had paradoxical, or very strong, reactions to drugs. A single, small, experimental dose of thyroid medication made me extremely groggy. Most people get jittery and hyper if they take it but don't need it, but I could barely move).
3. Are there other drugs that are metabolized in a similar way that I might expect to react badly to, and should approach with extra caution?
[possibly relevant medical background: I have limited systemic scleroderma, with Sjogren's syndrome, autoimmune hepatitis, and chronic kidney disease, all "mild" enough to require only symptomatic treatment. I'm not taking any of the drugs that are listed as having potential interactions with Lunesta, and none of my conditions are listed as requiring any change in dosage.]