Difficulty falling or staying asleep is one of the most common reasons people seek medical help in the UK. When non-drug approaches fail, doctors may prescribe short-term hypnotics such as zopiclone or temazepam. Although both are used for insomnia, they differ significantly in pharmacology, safety profile, and long-term risk. This article provides a clear, evidence-based comparison of zopiclone vs temazepam, written for general readers. Drawing on UK clinical practice and regulatory guidance, it explains how these medications work, when they are prescribed, and what risks patients should understand before using them.
What are zopiclone and temazepam?
Zopiclone
Zopiclone is a non-benzodiazepine hypnotic commonly prescribed in the UK for short-term insomnia. It belongs to a group known as Z-drugs, which are designed to promote sleep with fewer muscle-relaxant and anxiolytic effects than benzodiazepines.
Clinicians often choose zopiclone when the primary complaint is difficulty falling asleep or frequent nighttime awakenings. It is typically prescribed for no longer than 2–4 weeks.
Temazepam
Temazepam is a benzodiazepine hypnotic that has been used for decades to treat severe insomnia. It enhances the effect of GABA, the brain’s main inhibitory neurotransmitter, producing sedation, muscle relaxation, and anxiolysis.
Because of its benzodiazepine classification, temazepam is more tightly controlled and generally reserved for cases where other treatments have failed.
How they work in the brain
Zopiclone acts selectively at the GABA-A receptor, primarily influencing sleep initiation and maintenance. Its targeted action explains why many patients describe it as a “sleep-only” medication rather than something that affects mood or daytime anxiety.
Temazepam also acts on GABA-A receptors but does so broadly across the central nervous system. This wider effect can improve sleep but also increases risks such as next-day sedation, impaired coordination, and dependence.
According to the NHS (https://www.nhs.uk/medicines/zopiclone/), both drugs should be used at the lowest effective dose for the shortest possible duration.
Effectiveness for insomnia
In real-world practice, both medications are effective at inducing sleep. However, subtle differences matter:
- Zopiclone is often preferred for sleep onset and middle-of-the-night awakenings.
- Temazepam may be more sedating overall, which can help some patients but impair others the next day.
Clinicians often observe that patients taking temazepam report heavier sedation, while those on zopiclone describe more “natural” sleep but sometimes complain of a bitter or metallic taste.
Side effects and tolerability
Common zopiclone side effects
- Bitter or metallic taste
- Dry mouth
- Drowsiness
- Headache
- Rarely, parasomnias (sleep-walking or sleep-eating)
Common temazepam side effects
- Daytime drowsiness
- Memory impairment
- Reduced coordination
- Dizziness
- Higher risk of tolerance and dependence
UK safety reviews by the MHRA (https://www.gov.uk/government/publications/benzodiazepines-and-z-drugs) highlight that benzodiazepines carry a higher long-term risk profile than Z-drugs when used beyond recommended durations.
Zopiclone vs Temazepam:Dependence and withdrawal risk
This is one of the most important differences between zopiclone and temazepam.
Temazepam has a well-documented risk of physical dependence. Withdrawal symptoms may include rebound insomnia, anxiety, tremor, and—in severe cases—seizures if stopped abruptly.
Zopiclone also carries dependence risk, but it is generally lower when used correctly. That said, UK guidance stresses that Z-drugs should not be viewed as “safe for long-term use.”
The NIH notes that all hypnotics affecting GABA pathways can lead to tolerance and withdrawal if misused (https://www.ncbi.nlm.nih.gov/books/NBK538131/).
UK legal and prescribing status
Both medications are prescription-only in the UK.
- Zopiclone is classified as a controlled drug under Schedule 4 (Part I) of the Misuse of Drugs Regulations.
- Temazepam is also Schedule 3/4 controlled, reflecting higher misuse potential.
Prescriptions are usually limited to short courses, and repeat prescribing is closely monitored.
Patient perspectives and online discussions
Many patients share experiences on forums and Reddit, often comparing how each drug feels in practice. While anecdotal reports can be useful, clinicians caution that online experiences vary widely and should not replace professional advice.
Some patients report preferring zopiclone because it feels less “heavy,” while others find temazepam more reliable for severe, acute insomnia.
Cost and availability
In the UK, both drugs are available as generics. Private prescriptions may vary in cost depending on dose and pharmacy.
Patients comparing options often look up Zopiclone price when considering private treatment or alternatives.
Alternatives and related medications
For patients who cannot tolerate either option, doctors may explore other short-acting hypnotics or non-drug strategies. Related medications sometimes discussed include Zolpidem and Zaleplon, as well as cognitive behavioural therapy for insomnia (CBT-I).
Brand-name versions of zopiclone such as Zopicon and Zopisign may also appear in treatment discussions, though their active ingredient is the same.
Comparison table
| Feature | Zopiclone | Temazepam |
|---|---|---|
| Drug class | Z-drug | Benzodiazepine |
| Main use | Short-term insomnia | Severe insomnia |
| Dependence risk | Moderate | High |
| Next-day sedation | Lower | Higher |
| Typical duration | ≤ 2–4 weeks | Very short-term |
| UK regulation | Controlled (Schedule 4) | Controlled (Schedule 3/4) |
Which is safer?
From a UK clinical perspective, zopiclone is generally considered safer for short-term insomnia due to its narrower action and lower dependence risk. Temazepam may still be appropriate in select cases but requires closer monitoring.
Ultimately, the “safer” choice depends on individual health factors, duration of use, and strict adherence to prescribing guidance.
Conclusion
Zopiclone and temazepam are both effective sleeping pills, but they are not interchangeable. Zopiclone is usually the first-line option in the UK for short-term insomnia, while temazepam is reserved for more severe cases due to its higher risk profile.
Understanding these differences helps patients make informed decisions and engage in better conversations with their healthcare providers.
Medical disclaimer
This article is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before starting, stopping, or changing any medication.