A Guide To Temazepam: Prescribed Uses, Addiction, and Treatment

Another class of prescription drugs commonly abused is sleeping aids or pills that are designed to promote restful sleep during the night. While these drugs (benzodiazepines) are legally prescribed by medical practitioners to patients who are diagnosed to have sleeping problems, they have shown to be the subject of misuse or abuse.

One such drug is temazepam, which has been found to have the potential for developing tolerance and abuse among those who take it. Those who are prescribed such drugs should be aware of its medical uses, guidelines for proper usage, side effects, and potential dangers of abuse.

What is Temazepam?

Temazepam is a type of benzodiazepine, which is a category of psychoactive drugs. This particular compound is known by popular brand names Restoril and Normision. Temazepam is medically approved for the short-term (i.e. not more than ten days) treatment of people who suffer from insomnia, a condition that is characterized by symptoms that include difficulty in falling asleep or staying asleep, frequent waking during the night, and early morning awakening.

It also acts as an anti-anxiety and skeletal muscle relaxant. Like other benzodiazepines, temazepam acts by enhancing the effects of the gamma-aminobutyric acid (GABA) in the brain. GABA is a neurotransmitter that inhibits brain activities. The inhibition becomes necessary because excessive brain activity causes anxiety and other psychiatric disorders.

History of Temazepam

The brand name Restoril was first used in 1969 and its ability to treat insomnia was discovered. It was approved by the U.S. Food and Drug Administration (FDA) in 1981. Generic temazepam was later manufactured by other pharmaceutical laboratories.

By the late 1980s, temazepam became one of the most commonly prescribed anti-anxiety medication in the market. However, its potential for abuse was soon discovered and thereafter, caution has been observed in the prescription and use of temazepam.

Contraindications of Temazepam

The use of temazepam should be avoided in individuals who have the following conditions:

  • Gross lack of coordination of muscle movements (ataxia)
  • Severe hypoventilation
  • Acute narrow-angle glaucoma
  • Hepatitis and liver cirrhosis
  • Renal deficiencies
  • Sleep apnea
  • Depression accompanied by suicidal tendencies
  • Severe personality disorders such as borderline personality disorder
  • History of alcohol, narcotics, or substance dependence
  • Myasthenia gravis
  • Hypersensitivity to any benzodiazepine (e.g. alprazolam, Xanax, valium)
  • Pregnancy
  • Below 18 years of age


The drug can be dangerous for women who are pregnant because it can cause birth defects or life-threatening withdrawal symptoms in the newborn. Babies who are born with dependence on habit-forming medicines may need medical treatment for several weeks.

Women who are currently taking temazepam should also take birth control pills to prevent pregnancy.

Lactating or breastfeeding mothers should avoid taking temazepam. The drug can pass into the breast milk and cause harm to the nursing baby.

Before taking temazepam, a person should advise his physician if he has any of the following conditions:

  • Asthma, chronic obstructive pulmonary disease (COPD), or breathing disorder
  • Kidney or liver disease
  • A history of depression, suicidal thoughts, or behavior
  • A history of drug or alcohol dependence
  • Personal or family history of sleepwalking

Adverse Side Effects of Temazepam Use

Temazepam may cause some side effects, some which are common and will go away in time. Other effects, however, are more severe and need medical attention.

The common side effects include the following:

  • Drowsiness or “hangover” feeling during the day
  • Headache
  • Dizziness or difficulty with coordination
  • Nausea
  • Vomiting
  • Nervousness
  • Fatigue
  • Lethargy
  • Minimal impairment of memory
  • Longer reaction time
  • Decreased physical performance
  • Reduced alertness
  • Muscle weakness

In some cases, the drug produces less common or serious side effects. Among these are the following:

  • Confusion
  • Agitation
  • Hostility or aggressive behavior
  • Hallucinations
  • Depressed mood
  • Memory problems
  • Suicidal thoughts
  • Worsening anxiety
  • Rash
  • Hives
  • Swelling of the face, throat, tongue, lips, or eyes
  • Hoarse voice
  • Difficulty of breathing or swallowing
  • Hyperhydrosis
  • Hypotension
  • Burning eyes
  • Increased appetite
  • Changes in libido
  • Gastrointestinal disturbances
  • Palpitations

In case any of the severe side effects are observed, the physician must be advised immediately. The dosage may have to be lowered or the use of temazepam may have to be stopped.

Other rare side effects have been reported by some who have taken the drug. If any of the following signs are observed, the physician’s advice should also be sought immediately:

  • Difficulty in breathing
  • Wheezing
  • Fast, irregular, pounding heartbeat or pulse
  • Loss of appetite
  • Weight loss
  • Loss of memory
  • Nightmares
  • Shakiness and unsteady walk
  • Shortness of breath
  • Tightness in the chest
  • Uncontrolled eye movements
  • Unsteadiness, trembling, or other problems with muscle control or coordination
  • Unusual excitement, nervousness, restlessness, or irritability

Special Precautions When Using Temazepam

When using temazepam, special precautions should be taken when engaging in activities such as driving or operating heavy machinery or equipment because the drug can slow down motor and cognitive skills. The ability to do these activities effectively and safely may be impaired.

In rare cases, it was reported that patients were observed performing activities such as eating, making phone calls, and driving but they later had no recollection of the same. Others have sleepwalked and even engaged in sexual activities while not yet fully awake. In case this occurs, the doctor should be advised immediately so another medication may be prescribed in the place on temazepam.

Alcohol consumption should be avoided when taking temazepam. This may increase the impact of the side effects, particularly drowsiness, dizziness, and sedation.

In addition, the drug is habit-forming and as such, it should only be used by the person it was prescribed for. It should not be shared with another person, especially one who has a history of drug or alcohol abuse.

Drug Interactions

Some drugs may interfere with the action of temazepam and can either affect the efficacy of the drug or increase the impact of its side effects.

One product that has been found to interact with temazepam is sodium oxybate (Xyrem), a drug that is prescribed for excessive daytime sleepiness. The interaction between the two substances can result in serious side effects including shallow breathing, decreased blood pressure, and severe drowsiness.

The physician should be alerted if the patient is currently taking any other sleeping aids or anti-anxiety medications such as alprazolam, diazepam, lorazepam, muscle relaxants, or narcotic pain relievers such as codeine. Some allergy, cough, and cold medications may also contain ingredients that can cause drowsiness. These may also interact with the effects of temazepam.

The doctor should likewise be advised if any of the following drugs is being taken:

  • Fluvoxamine
  • Itraconazole
  • Ketoconazole
  • Nefazodone
  • Vitamins
  • Minerals
  • Herbal products
  • Recreational or illegal drugs

Using temazepam with ethanol or alcoholic beverages can increase the side effects on the nervous system. The interaction can result in increased dizziness, drowsiness, impaired concentration, and impaired judgment.

To be on the safer side, those who are currently taking other medications, supplements, or vitamins should advise their doctor prior to starting the use of temazepam. It is also recommended that when purchasing prescription and non-prescription drugs, the product labels are consulted to verify if there are any ingredients that would interact with other drugs such as temazepam.

Tolerance and Addiction

Chronic or excessive use of temazepam may lead to drug tolerance. As such, this drug is not recommended for long-term use.

In one study conducted by the National Institute on Drug Abuse and the Institute of Medicine back in 1979, it was found that most benzodiazepines lose their sleep-inducing properties after about 3 to 14 days. When drugs such as temazepam are used for longer than 14 days, tolerance will rapidly develop and will result in loss of effectiveness.

In other studies, it was observed that tolerance to temazepam’s sleep-inducing and thermoregulatory effects can develop in as little as one week’s use.

Therefore, medical practitioners have been advised against the long-term use of temazepam. Ideally, the prescription should be limited to less than two weeks. Benzodiazepines, in general, should not be used for months or years.

Temazepam Overdose

Because tolerance can develop rapidly, patients who use temazepam for prolonged periods are at a risk of developing drug overdose. Some of the symptoms of overdose include the following:

  • Blurred vision
  • Change in consciousness
  • Mental confusion
  • Impaired or absent reflexes
  • Impaired balance
  • Difficulty or trouble breathing
  • Dizziness, faintness, lightheadedness
  • Sedation
  • Irregular, fast, slow, or shallow breathing
  • Loss of consciousness
  • Pale or blue lips, fingernails, or skin
  • Shortness of breath
  • Sleepiness or unusual drowsiness
  • Fatigue
  • Hypotension
  • Coma
  • Death

If symptoms of overdose are observed, the patient should be brought to an emergency room as soon as possible to receive the proper treatment. Drug overdose is considered a medical emergency. It is a potentially life-threatening situation and any delay can cause irreversible damages.


Studies on Temazepam Dangers

Here are some previous studies on temazepam and the accompanying health risks in drug abuse and overdose:

  • A 1985 study revealed that temazepam has the highest rate of intoxication and overdose among other benzodiazepines. 
  • A 1993 study conducted in the U.K. found temazepam to generate the most number of fatalities per million prescriptions among prescription drugs in the 1980s.
  • In 1995, a study by Australian researchers revealed that temazepam overdose is more likely to result in coma compared to other benzodiazepines.
  • According to a 2012 study published in the British Medical Journal, people who take any kind of sleeping pill are 5 times more likely to die within 2 years compared to those who don’t. This does not necessarily conclude that sleeping pills lead to death directly, but it indicates that those with sleeping problems are at an increased risk of developing serious medical conditions. The study further showed that taking as few as 18 sleeping pills a year places a person at an increased risk of developing cancer and other serious health problems. [source]
  • In 2012, a study involving more than a thousand adults found that those who took benzodiazepines such as Restoril had increased chances of developing dementia by 50 percent.

Treatment for Temazepam Addiction

Those who become addicted to temazepam or other benzodiazepines are strongly recommended to undergo in-patient treatment at a residential treatment facility where they can receive the appropriate care and therapy for several months on a 24/7 basis.

Typical treatments include detoxification, withdrawal management, and behavioral therapy. Patients are typically taught how to avoid relapses, coping mechanisms, self-growth, and proper nutrition and exercise. They are also made to attend individual, group support, and family counselling sessions.

An aftercare program, such as attendance at 12-step meetings, is also advised.

Conclusion

Daily stress and life challenges can cause insomnia or sleeplessness that can tempt a person to resort to taking sleeping aids or drugs. One tablet can lead to a pattern of addiction that produces serious consequences. Those who may be facing difficult pressures in the workplace or the home should seek the advice of qualified therapists who can equip them with stress-coping and relaxation techniques rather than just resort to taking sleeping pills for immediate relief.

Helpful Links and Resources

http://www.everydayhealth.com/drugs/temazepam

https://en.wikipedia.org/wiki/Temazepam

https://www.drugs.com/temazepam.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1601049/

 

https://www.theguardian.com/science/2012/feb/27/sleeping-pills-increase-risk-death-study



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