Temazepam, known by brand names like Restoril, is a medication belonging to the benzodiazepine class. It is primarily used for the short-term management of severe or debilitating insomnia. This medication can also be prescribed to help reduce anxiety, particularly before medical or dental procedures, acting as a pre-medication.
How Temazepam Works
Temazepam exerts its effects by interacting with the central nervous system, specifically by enhancing the activity of a neurotransmitter called gamma-aminobutyric acid, or GABA. GABA is the brain’s primary inhibitory neurotransmitter, meaning it helps to calm down excessive brain activity.
When temazepam binds to specific sites on GABA-A receptors, it increases GABA’s ability to bind. This makes it harder for neurons to fire, reducing overall brain activity and producing sedative, hypnotic, and anxiety-reducing effects.
Important Considerations for Prescribing
Temazepam is prescribed for short-term use, typically 7 to 10 days, or up to four weeks. This is due to the risk of dependence and withdrawal symptoms, which increase with longer use or higher doses.
Dosages for adults range from 7.5 mg to 30 mg, taken once daily at bedtime. A lower starting dose, such as 7.5 mg, may be used for transient insomnia or in elderly patients due to increased side effect risk. The medication is available in capsules of 7.5 mg, 15 mg, 22.5 mg, and 30 mg, which should be swallowed whole.
If sleep problems do not improve after 7 to 10 nights, or if behavioral changes occur, consult a healthcare provider. Medical supervision is required to monitor effects and manage risks.
Potential Side Effects and Warnings
Common side effects of temazepam include drowsiness, dizziness, headache, and a “hangover” feeling the day after taking a dose. Other reported effects can include fatigue, unsteadiness, impaired memory and learning, and slurred speech.
Abrupt discontinuation or rapid dose reduction after continued use can lead to severe and potentially life-threatening withdrawal symptoms. These may include rebound insomnia, heightened anxiety, restlessness, irritability, muscle cramps, vomiting, sweating, headaches, tremors, confusion, and seizures.
The medication carries a boxed warning about dangerous effects when combined with central nervous system depressants, such as alcohol or opioids. Concurrent use can result in profound sedation, severe respiratory depression, coma, and even death. Patients should avoid alcohol and discuss all other medications, including over-the-counter drugs, with their doctor to prevent adverse interactions.
Other warnings include memory problems and complex sleep behaviors like “sleep-driving,” where a person performs activities without memory of them. Temazepam may also increase the risk of suicidal thinking and behavior, particularly in children, adolescents, and young adults, especially during the initial months of treatment. Patients and their families should monitor for behavioral changes or worsening depression.