睡眠薬（マイスリー・ルネスタ・エスゾピクロン）の依存性

「睡眠薬（マイスリー・ルネスタ・エスゾピクロン）は依存するから、常用するのは良くないよ」と聞いたことはありますでしょうか？

睡眠薬に限らず、風邪薬やコーヒーなんかもそうですが、「それに依存してなくてはならないもの」となってしまうことは良くなく、
成分の効果が感じられなかったり、更に症状が悪化してしまったときには強い効き目のものにするか量を増やすかしか無くなってしまいます。
強いものといっても限界があるし、量を増やすとしても限界があり、副作用が出てしまう場合もあります。

睡眠薬（マイスリー・ルネスタ・エスゾピクロン）についてはまずはお医者さんの言うことを聞くのは大前提として、
どのくらい飲んだら副作用が出てくるのでしょうか？
依存性はどのくらいあるのでしょうか？

今日はそんな、睡眠薬（マイスリー・ルネスタ・エスゾピクロン）について詳しく見ていきます。

睡眠薬（マイスリー・ルネスタ・エスゾピクロン）を飲み始めたけど詳しいことが分からなくて不安だという人は
是非参考にしてみてください。

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睡眠薬（マイスリー）について

マイスリーは、非ベンゾジアゼピン系の睡眠薬で、ゾルピデム酒石酸塩が有効成分です。
マイスリーは、作用時間が短く、切れ味が良い睡眠薬で、寝つきが悪い方に処方される代表的な睡眠薬です。
マイスリーは、即効性が期待できる一方で、健忘の副作用に注意する必要があるとされています。

マイスリーの依存性は、従来のベンゾジアゼピン系の睡眠薬よりは抑えられていますが、長期間服用すると依存症になる可能性があります。
また、マイスリーは統合失調症や双極性障害（躁うつ病）の患者さんには処方されないことが多いです。

マイスリーの用法・用量は、通常、成人には1日1回就寝前に5mgを服用します。
必要に応じて10mgまで増量できますが、高齢者や肝機能障害のある方は5mgを限度とします。
マイスリーは空腹時に服用すると効果が高まりますが、食事の影響を受けにくいとも言われています。

マイスリーの剤形と薬価は、5mg錠と10mg錠の2種類があります。
先発品のマイスリー錠5mgは24.2円、10mgは40.2円です。
ジェネリック医薬品もありますが、価格はメーカーや販売店によって異なります。

 

マイスリーの依存性

睡眠薬（マイスリー）の依存性について、更に詳しく見ていきます。

マイスリーは、非ベンゾジアゼピン系の睡眠薬で、依存性は低いと考えられています。
しかし、長期間服用したり、量を増やしたり、アルコールと併用したりすると、依存症になる可能性があります。

依存症になると、睡眠薬がないと眠れなくなったり、不安やイライラが増したり、身体の不調が出たりします。
また、睡眠薬をやめようとすると、不眠が悪化したり、離脱症状が出たりします。

マイスリーの依存性は、服用期間や量によって異なります。
一般的には、4週間以上連続して服用すると依存の危険性が高まります。
また、1日10mg以上服用すると依存の危険性が高まります。

マイスリーの依存性を防ぐためには、以下のことに注意しましょう。

・主治医の指示通りに服用する
・必要最小限の量と期間で服用する
・アルコールと併用しない
・睡眠薬以外の睡眠改善法を試す

 

マイスリーは向精神薬になる？

マイスリーは、 非ベンゾジアゼピン系 の睡眠薬で、 GABA A 受容体 の ω1サブタイプ に作用することで、 催眠鎮静作用 を示します。
このような睡眠薬は、 脳の機能を低下させる ことで、眠気を促します。

向精神薬とは、 精神状態や感情に影響を与える薬のことで、 抗不安作用 や 抗うつ作用 などがあります。
マイスリーは、他のベンゾジアゼピン系睡眠薬と比較して ω1選択性が高く 、催眠鎮静作用に比べて、 抗不安作用 や 抗痙攣作用 や、
筋弛緩作用が弱い のが特徴とされます。

したがって、マイスリーは向精神薬としての効果はあまり期待できないと考えられます。

マイスリーの効果は主に睡眠に限定されており、 入眠障害 に有効です。
しかし、 依存性 や 健忘 などの副作用に注意する必要があります。
また、 統合失調症 や 双極性障害 に伴う不眠症には適応がありません。

マイスリーは医師の指示に従って正しく使用してください。

 

睡眠薬（ルネスタ）について

ルネスタは、非ベンゾジアゼピン系に分類される睡眠薬で、2012年に発売された比較的新しいお薬です。
アモバンのうち効果のある成分だけを取り出したもので、少ない量で同等の効果が発揮されるといわれています。

ルネスタの主な特徴は以下のとおりです。

・即効性があり、服用後15～20分くらいで眠気が出てきます。
・作用時間が短く、半減期は5時間です。入眠障害に有効で、中途覚醒にも多少の効果が期待できます。
・翌朝の眠気やふらつきなどの副作用が少ないです。睡眠だけに作用するように作られているため、筋弛緩作用や抗不安作用がわずかです。
・睡眠が深くなる作用があり、睡眠の質もよくなります。
・依存性が少ないです。ベンゾジアゼピン系睡眠薬と比較すると依存が形成されにくいことが報告されています。
・処方制限がありません。他の睡眠薬は30日までの処方制限がありますが、ルネスタはその制限がありません。

ルネスタの主な副作用は以下のとおりです。

・苦味があります。翌日にも口の中に苦い状態が続くことがあります。
・健忘があります。急激に覚醒レベルを落とすために、中途半端な覚醒状態になって記憶だけが抜け落ちてしまうことがあります。
・味覚異常、傾眠、頭痛、口渇、浮動性めまい、不眠症などがあります。

ルネスタの成分はエスゾピクロンという物質で、GABAという神経伝達物質の働きを強めて脳の活動を抑えることで睡眠をもたらします12。GABAはリラックスする物質として知られています。

ルネスタは1mg錠、2mg錠、3mg錠の3種類があります。
通常は2mgから開始し、必要に応じて増減します。

高齢者や肝機能障害・腎機能障害のある方は1mgから開始します。
最高用量は3mgです（高齢者は2mg）。

ルネスタは空腹時に服用する必要があります。
食事をとってしまうと効果が減弱してしまいます。
また、就寝直前に服用する必要があります。

健忘の副作用を避けるためにも、服用後はすぐにベッドに入るようにしてください。

ルネスタはアルコールと相互に作用を増強することがあります。
アルコールと一緒に服用すると、眠気やふらつきなどの副作用が強くなったり、呼吸抑制などの重篤な症状が起こる可能性があります。
ルネスタを服用する場合は、アルコールの摂取を控えるようにしてください。

 

ルネスタの依存性

睡眠薬（ルネスタ）の依存性について、更に詳しく見ていきます。

睡眠薬の依存性には、「精神的依存」と「身体的依存」の2つがあります。

・精神的依存とは、睡眠薬を飲まないと不安になったり、眠れないと思い込んだりすることです。
睡眠薬に心理的に依存してしまうと、必要以上に服用したり、服用をやめられなくなったりすることがあります。

・身体的依存とは、睡眠薬を飲むことで体が慣れてしまい、同じ量では効かなくなったり、服用をやめると離脱症状が出たりすることです。
睡眠薬に身体的に依存してしまうと、服用量を増やしたり、服用を中断すると不眠が悪化したり、
不安や動悸などの症状が出たりすることがあります。

ルネスタは非ベンゾジアゼピン系の睡眠薬で、ベンゾジアゼピン系の睡眠薬よりも依存性が低いとされています。
しかし、長期間服用した場合は、離脱症状が現れて、薬を中断すると数日から1週間程度眠れなくなることがあります。
また、耐性という観点では、入眠効果は長期間続くものの、薬の効果の持続時間が落ちてくるようです。

ルネスタの依存性に関する具体的な期間や量については、個人差があるため一概に言えません。
しかし、一般的には以下のような目安があります。

・精神的依存は、1～2週間程度で発生する可能性があります。睡眠薬を飲まないと不安になるような気持ちが強くなってきたら注意が必要です。
・身体的依存は、1～2ヶ月程度で発生する可能性があります。同じ量では効かなくなったり、
服用をやめると不眠や不安などの症状が出たら注意が必要です。

ルネスタの依存性を防ぐためには、以下のようなことに気をつけることが大切です。

・ルネスタは医師の指示通りに服用しましょう。自己判断で服用量を増やしたり減らしたりしないでください。
・ルネスタは空腹時に就寝直前に服用しましょう。食事やアルコールと一緒に服用すると効果が減弱したり増強したりします。
・ルネスタは必要最小限の期間だけ服用しましょう。長期間服用する必要がある場合は医師と相談してください。
・ルネスタを中止する場合は医師の指示通りに徐々に減量しましょう。急に中止すると離脱症状が出る可能性があります。
・ルネスタの服用と同時に、睡眠環境や生活習慣を改善することも大切です。睡眠の質を高めるために、寝室を暗く静かにし、
快適な温度に保ちましょう。また、日中に適度な運動をしたり、カフェインや刺激物の摂取を控えたりしましょう。

 

ルネスタは向精神薬になる？

ルネスタは、 非ベンゾジアゼピン系 の睡眠薬で、 GABA A 受容体 の ω1サブタイプ に作用することで、 催眠鎮静作用 を示します。
このような睡眠薬は、 脳の機能を低下させる ことで、眠気を促します。

向精神薬とは、 精神状態や感情に影響を与える 薬のことで、 抗不安作用 や 抗うつ作用 などがあります。
ルネスタは、他のベンゾジアゼピン系睡眠薬と比較して ω1選択性が高く 、催眠鎮静作用に比べて、 抗不安作用 や 抗痙攣作用 や、
筋弛緩作用が弱い のが特徴とされます。

したがって、ルネスタは向精神薬としての効果はあまり期待できないと考えられます。

ルネスタの効果は主に睡眠に限定されており、 入眠障害 に有効です。
しかし、 依存性 や 健忘 などの副作用に注意する必要があります。
また、ルネスタは向精神薬ではないため、 処方日数制限がなく 、長期服用が可能です。

ルネスタは医師の指示に従って正しく使用してください。

 

睡眠薬（エスゾピクロン）について

エスゾピクロン（商品名：ルネスタ）は、睡眠薬の中でも 非ベンゾジアゼピン系 に分類されるお薬です。
非ベンゾジアゼピン系の睡眠薬は、 脳の機能を低下させることで睡眠を促す 作用があります。
エスゾピクロンは、 睡眠にしぼって作用する ため、筋弛緩作用や依存性が低いとされています。

エスゾピクロンの強さは、 作用時間が短い ことが特徴です。
血中濃度が最高になるまでに 約1時間 かかり、半分になるまでに 約5時間 かかります。
このため、 入眠障害 に効果的で、翌朝の眠気やふらつきが少ないと言われています。

ただし、 中途覚醒や早朝覚醒 には効果が乏しいこともあります。

エスゾピクロンの成分は、 ゾピクロン（商品名：アモバン）を改良して作られたもの です。
ゾピクロンの成分のうち、睡眠薬としての効果の大部分を持つ部分だけを取り出したものがエスゾピクロンです。
これによって、 苦味の副作用が軽減 されています。

エスゾピクロンはどんな人向けの薬なのでしょうか。
一般的には、 寝つきが悪くて熟睡できない方 に処方されることが多いです。
しかし、エスゾピクロンにも副作用や注意点があります。

主な副作用としては、 傾眠、頭痛、浮動性めまい、注意力障害、うつ病、神経過敏、記憶障害 などがあります。
重大な副作用としては、 ショック、アナフィラキシー、蕁麻疹、血管浮腫、薬物依存、不安、異常な夢 などがあります。
また、 アルコールや他の中枢抑制剤との併用は危険 です。

エスゾピクロンの用法・用量は、成人では1回2mgを就寝前に服用し、高齢者では1回1mgを服用します。
必要に応じて増減することもありますが、成人では1回3mgを超えないようにします。
また、食事後に服用すると効果が減少するため、空腹時に服用する必要があります。

以上がエスゾピクロン（ルネスタ）についての詳しい説明です。

エスゾピクロンは、 非ベンゾジアゼピン系の睡眠薬で、作用時間が短く、入眠障害に効果的 ですが、 副作用や依存性に注意 が必要です。
エスゾピクロンを服用する場合は、医師の指示に従って正しく使用してください。

 

エスゾピクロンの依存性

睡眠薬（エスゾピクロン）の依存性について、更に詳しく見ていきます。
エスゾピクロンは、 非ベンゾジアゼピン系 の睡眠薬で、 ベンゾジアゼピン系 よりも 依存性が低い とされています。
しかし、 長期間 や 高用量 で服用すると、 耐性 や 依存性 が形成される可能性があります。

耐性とは、同じ量の薬を服用しても効果が弱まることです。
依存性とは、薬をやめると不快な症状が出ることです。
睡眠薬の場合、依存性の症状としては、 反跳性不眠 が代表的です。

反跳性不眠とは、睡眠薬を中止すると一時的に不眠症が悪化することです。
寝つきが悪くなったり、何度も起きたりすることがあります。

エスゾピクロンの依存性を防ぐためには、以下の点に注意する必要があります。

・睡眠薬は短期間で使用し、必要に応じて減量や中止を行う
・睡眠薬を服用する前に医師や薬剤師に相談し、用法・用量を守る
・睡眠薬を服用する際には、睡眠環境や生活習慣の改善も行う
・睡眠薬を服用する際には、アルコールや他の中枢抑制剤との併用を避ける
・睡眠薬を服用する際には、自動車運転や危険な作業を行わない

エスゾピクロンの依存性についての詳しい説明でした。
エスゾピクロンは非ベンゾジアゼピン系の睡眠薬で、依存性が低いですが、
長期間や高用量で服用すると依存性が形成される可能性があります。

睡眠薬を服用する場合は、医師の指示に従って正しく使用してください。

 

エスゾピクロンは向精神薬になる？

エスゾピクロンは、 ルネスタ の一般名（成分名）です。
したがって、ルネスタと同じく、向精神薬としての効果はあまり期待できないと考えられます 。

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「睡眠薬（マイスリー・ルネスタ・エスゾピクロン）の依存性」についてのまとめ

睡眠薬（マイスリー・ルネスタ・エスゾピクロン）についてまとめると以下のようになります。

 

睡眠薬 成分 どんな人向けなのか 依存性
マイスリー ゾルピデム酒石酸塩 入眠障害に有効。効果が早く出て切れ味がよい。翌朝の眠気が少ない。統合失調症や双極性障害には適応外。 非ベンゾジアゼピン系で依存性は低いが、長期服用は避けるべき。健忘の副作用に注意。
ルネスタ エスゾピクロン 入眠障害に有効。効果が長く持続する。中途覚醒や早朝覚醒にも効果があることがある。 非ベンゾジアゼピン系で依存性は低いが、長期服用は避けるべき。味覚異常や傾眠の副作用に注意。
エスゾピクロン エスゾピクロン ルネスタの一般名（成分名）。ルネスタと同じく入眠障害に有効。 ルネスタと同じく非ベンゾジアゼピン系で依存性は低いが、長期服用は避けるべき。味覚異常や傾眠の副作用に注意。

 

いずれの睡眠薬にも副作用があり、長期服用は避けるべきです。
睡眠薬を使用しながら、生活リズム、食事などの基礎的な改善を図り、
少しでも早く質の良い睡眠を取れるようになるといいですね。

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