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Hypnotics and falls risk — GPhC CRA MCQ

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HardCNS TherapeuticsHypnotics and falls riskGPhC CRA

A 79-year-old man started zopiclone 3.75 mg nightly ten days ago after bereavement. He now reports morning confusion and a nocturnal fall. He has no fracture and asks for a stronger dose because sleep remains poor. What is the best response?

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Correct answer: C — Review zopiclone now and plan withdrawal with insomnia management

Zopiclone can cause residual sedation, confusion and falls, particularly in older people. New confusion and a fall soon after initiation require treatment review rather than dose escalation or substitution with another sedative. Withdrawal and non-drug insomnia management should be discussed through shared decision making.

Reference: NICE NG249, Falls—assessment and prevention: https://www.nice.org.uk/guidance/ng249/chapter/Recommendations