I have been Rx'd all of the Z-Drugs. I prefer Lunesta (Eszopiclone) 3mg. The Z-Drugs at their highest dosage option are all basically equal. Ambien 10mg, Sonata 10mg, and Lunesta 3mg are considered equal. Obviously, Lunesta is stronger mg vs mg but the FDA only allows 30qty per month at their strongest dosage option.
I believe Lunesta 6mg equals Valium 20mg related to achieving euphoria. The difference is Lunesta 6mg will 100% induce a deep sleep. Lunesta 3mg for someone sedative/hypnotic naive has a stronger chance of overdose than Valium, especially if it is mixed with alcohol, opiates/opioids, and other types of sedative/hypnotic drugs. High doses of Lunesta has more bradycardia effects than high doses of Valium.
The Z-Drugs are suggested for short-term use (30-45 days) and at that point said patient should be rotated to a different type of sleep medication. I find this to be true with Ambien and Sonata but not with Lunesta. I have had two long-term treatment periods with Lunesta and the last 2 years I have been on Lunesta 3mg. It still works decently.
Though I do take other Rx drugs at night for pain/sleep related issues. They are Clonidine HCl 0.6mg, Vistaril PAM 100mg, Ativan 1mg, Roxicodone 30mg, and Methadone 10mg. I add anti-histamines too.
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{{ This is off-topic from OP's thread topic but maybe considered useful information to anxiety, sleep, pain, and mental discomfort patients }}
I find anti-histamines helpful for sleep/anxiety ranked in this order of strength & effectiveness :
-- Promethazine
-- Vistaril PAM
-- Clorpheniramine Maleate
-- Diphenhydramine HCl
-- Doxylamine Succinate
I have found the best safe tag-along drug is Clonidine HCl. From opiate/opioid to anti-histamine, Clondine HCl makes a world of difference. Clonidine is used to tag-along opioids for cancer patients in severe pain and need better results. As well as epidural shots. Pain management uses it for non-cancer pain as well to minimize the amount of opioids needed for pain relief. This is a great tool for pain patients constantly going in and out of surgeries because it allows "room to grow" for acute pain treatment.
Another safe effective combo is Gabapentin 1000mg and Vistaril PAM 200mg. I have high sedative, opioid, and anti-histamine scoring and this combo is amazing. The Vistaril PAM is the main effecting factor. There are two forms of Hydroxyzine HCl -- Vistaril PAM (Hydroxyzine Pamoate) and Hydroxyzine HCl & Vistaril PAM is the one you want. Last week I dosed this listed combo and I was extremely relaxed & stress/anxiety free for close to 8 hrs without feeling a decline in effects.