NationMaster - Encyclopedia: Temazepam

Temazepam (marketed under brand names Restoril®, Normison®, Planum®, Tenox® and Temaze®) is a benzodiazepine derivative with powerful hypnotic properties. It possesses strong anxiolytic, hypnotic, anticonvulsant, amnestic, sedative and skeletal muscle relaxant properties. Temazepam, an intermediate acting benzodiazepine, is generally prescribed for the treatment of short term severe insomnia in patients who have difficulty maintaining sleep or falling asleep. ^[1] In pharmacology and toxicology, a route of administration is the path by which a drug, fluid, poison or other substance is brought into contact with the body. ... Alprazolam 2mg tablets The benzodiazepines (pronounced , or benzos for short) are a class of psychoactive drugs considered as minor tranquilizers with varying hypnotic, sedative, anxiolytic, anticonvulsant, muscle relaxant and amnesic properties, which are brought on by slowing down the central nervous system. ... An anxiolytic is a drug prescribed for the treatment of symptoms of anxiety. ... Hypnotic drugs are a class of drugs that induce sleep, used in the treatment of severe insomnia. ... The anticonvulsants, sometimes also called antiepileptics, belong to a diverse group of pharmaceuticals used in prevention of the occurrence of epileptic seizures. ... Amnesia (or amnaesia in Commonwealth English) is a condition in which memory is disturbed. ... A sedative is a substance that depresses the central nervous system (CNS), resulting in calmness, relaxation, reduction of anxiety, sleepiness, and slowed breathing, as well as slurred speech, staggering gait, poor judgment, and slow, uncertain reflexes. ... In medicine, a muscle relaxant is a drug that causes skeletal muscle contraction to cease. ... This article is about the sleeping disorder. ...

History

Until recently temazepam was produced as a gel-filled capsule intended to be taken orally. However, it gained a certain notoriety in the United Kingdom, and especially Scotland, when it was discovered that if the capsules were melted and injected the effects were more potent and similar to alcohol. However, the liquid has a tendency to congeal in arteries and cause thrombosis and gangrene, in some cases requiring amputation. This article is about the country. ... This article does not cite any references or sources. ... Thrombosis is the formation of a clot or thrombus inside a blood vessel, obstructing the flow of blood through the circulatory system. ... Gangrene is the necrosis and subsequent decay of body tissues caused by infection or thrombosis. ... Partial hand amputation Amputation is the removal of a body extremity by trauma or surgery. ...

Pharmacology

Temazepam is an intermediate acting benzodiazepine and is lipophilic and is metabolised hepatically via oxidative pathways. The main pharmacological action of temazepam is the enhancement of the neurotransmitter, GABA at the GABA_A receptor.^[2] The half life of temazepam is 8-22 hours.^[3] This article or section does not cite its references or sources. ... Chemical structure of D-aspartic acid, a common amino acid neurotransmitter. ... Gaba may refer to: GabÃ¢ or gabaa (Philippines), the concept of negative karma of the Cebuano people GABA, the gamma-amino-butyric acid neurotransmitter GABA receptor, in biology, receptors with GABA as their endogenous ligand Gaba 1 to 1, an English conversational school in Japan Marianne Gaba, a US model...

Temazepam is an active benzodiazepine with powerful hypnotic properties. In sleep laboratory studies, temazepam dramatically decreased the number of nightly awakenings. Rebound insomnia was not observed after withdrawal of the drug. Temazepam decreased stage 3, and combined stage 3 and 4 sleep, accompanied by a compensatory increase in stage 2 sleep, but did not alter REM sleep. Alprazolam 2mg tablets The benzodiazepines (pronounced , or benzos for short) are a class of psychoactive drugs considered as minor tranquilizers with varying hypnotic, sedative, anxiolytic, anticonvulsant, muscle relaxant and amnesic properties, which are brought on by slowing down the central nervous system. ... Hypnotic drugs are a class of drugs that induce sleep, used in the treatment of severe insomnia. ... This article is about the sleeping disorder. ... For other uses, see Sleep (disambiguation). ...

Orally administered temazepam is well absorbed in humans. The onset of effects are rapid and are typically felt within 30 minutes. Temazepam has a half-life of about 8 to 10 hours in plasma (with considerable inter-individual variability). On multiple dosing, steady state is reached usually within 3 to 5 days with excretion of the drug mainly in the urine in the form of the inactive O-conjugate metabolite.

The elimination half life of temazepam increases in the elderly which may result in prolonged action.^[4]

Temazepam has been found to be dangerous in elderly patients due to a significant increased risk of falls.^[5] Temazepam shares cross tolerance with barbiturates and barbiturates can easily be subsituted for temazepam in those who are habituated to barbiturate sedative hypnotics.^[6] Barbiturates are drugs that acts as central nervous system (CNS) depressants, and by virtue of this they produce a wide spectrum of effects, from mild sedation to anesthesia. ...

Indications

Temazepam is often prescribed for severe insomnia for short periods of time (usually no more than 4 weeks) and other severe or disabling sleep disorders. Temazepam taken for longer than 2 - 4 weeks may result in a strong physical dependence with a resultant benzodiazepine withdrawal syndrome developing when dosage is decreased or the drug is stopped. Temazepam is considered to be one of the most addictive of the benzodiazepines and thus not suited for long-term treatment. This article is about the sleeping disorder. ... Physical dependence refers to a state resulting from habitual use of a drug, where negative physical withdrawal symptoms result from abrupt discontinuation. ... Benzodiazepine withdrawal syndrome, caused by withdrawal or dosage reduction of benzodiazepines, is the symptoms which appear when a patient who has taken the drug for a period of time stops taking the drug. ...

Military Use

The United States Air Force uses temazepam under trade name Restoril as "no-go pills" to help pilots sleep after a mission (Cf. "go-pills"; dextroamphetamine, or recently modafinil, used as a stimulant for pilots). Another drug used for the same purpose is zolpidem. â€œThe U.S. Air Forceâ€ redirects here. ... Dextroamphetamine is a powerful psychostimulant which produces increased wakefulness, energy and self-confidence in association with decreased fatigue and appetite. ... Modafinil is a eugeroic drug generally prescribed to treat narcolepsy, made by the pharmaceutical company Cephalon Inc. ... Zolpidem is a prescription short-acting nonbenzodiazepine hypnotic that potentiates gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter, by binding to gamma-aminobutyric acid receptors. ...

Utilisation

Temazepam, despite being the most highly restricted benzodiazepine in Australia (along with flunitrazepam) is commonly prescribed for severe insomnia. Temazepam along with diazepam, nitrazepam and oxazepam represent 82% of the benzodiazepine market in Australia.^[7] Flunitrazepam (IPA: ; is marketed by Roche under the trade name Rohypnol. ...

Other Uses

Temazepam has also been used as a truth serum during interrogations because of its strong hypnotic properties. Given to the subject, temazepam weakens the resolve of the subject and makes him or her more compliant to pressure. As a truth serum, temazepam is rarely, if ever used. It was rarely utilized by the Soviet Union and East Germany in the 1970's during the Cold War. The preferred drugs used as truth serums were, and still are barbiturates, particularly sodium thiopental (Sodium Pentothal). Temazepam was also one of several drugs used in the research of mind control, brainwashing and mass-scale social engineering by Secret Intelligence agencies of several different federal governments. Other drugs used were, LSD and Barbiturates. ^[8] In former Soviet Union, temazepam was extensively used, along with other drugs like haloperidol (Haldol), thorazine, barbiturates, and morphine to keep political dissidents housed in psikhushkas (mental asylums and psychiatric hospitals) in a constant vegetative state. ^[9] ^[10] // A truth drug (or truth serum) is a drug used for the purposes of obtaining accurate information from an unwilling subject, most often by a police, intelligence, or military organization on a prisoner. ... // A truth drug (or truth serum) is a drug used for the purposes of obtaining accurate information from an unwilling subject, most often by a police, intelligence, or military organization on a prisoner. ... This article is about the state which existed from 1949 to 1990. ... For other uses, see Cold War (disambiguation). ... // A truth drug (or truth serum) is a drug used for the purposes of obtaining accurate information from an unwilling subject, most often by a police, intelligence, or military organization on a prisoner. ... Barbiturates are drugs that acts as central nervous system (CNS) depressants, and by virtue of this they produce a wide spectrum of effects, from mild sedation to anesthesia. ... Sodium thiopental, better known as Sodium Pentothal (a trademark of Abbott Laboratories), thiopental, thiopentone sodium, or trapanal, is a rapid-onset short-acting barbiturate general anaesthetic. ... Mind control (or thought control) has the premise that an outside source can control an individuals thinking, behavior or consciousness (either directly or more subtly). ... Brainwashing (also known as thought reform or re-education) consists of any systematic effort aimed at instilling certain attitudes and beliefs in a person against his/her will, usually beliefs in conflict with the persons prior beliefs and knowledge. ... Social engineering has several meanings: Social engineering (political science) Social engineering (computer security) This is a disambiguation page â€” a navigational aid which lists pages that might otherwise share the same title. ... Lysergic acid diethylamide, commonly called LSD, LSD-25, or acid. ... Barbiturates are drugs that acts as central nervous system (CNS) depressants, and by virtue of this they produce a wide spectrum of effects, from mild sedation to anesthesia. ... Haloperidol (sold under the tradenames Aloperidin, Bioperidolo, Brotopon, Dozic, Duraperidol (Germany), Einalon S, Eukystol, Haldol, Halosten, Keselan, Linton, Peluces, Serenace, Serenase, Sigaperidol) is a conventional, or typical, butyrophenone antipsychotic drug. ... Chlorpromazine was the first antipsychotic drug, used during the 1950s and 1960s. ... This article is about the drug. ... In the Soviet Union, psychiatry was used for punitive purposes. ...

Dosage

When used for treatment of insomnia, the usual dose is 7.5mg to 15mg taken at bedtime but can be used at doses up to 30mg. Image File history File links No higher resolution available. ...

In the United States, temazepam is available in 7.5mg, 15mg, 22.5mg and 30mg capsules.

It is available as 10 and 20mg tablets in Finland, but also in at least some countries in the rest of Europe.

In the United Kingdom Temazepam is currently available in doses of 10mg and 20mg tablets.

In Australia it is only available in 10mg tablets under the trade name "Normison" and the generic name "Temaze" and "Temtabs". 20mg tablets and Temazepam in capsule or gelcap form is no longer available in that country.

Usual UK doses (from BNF) are 10-20mg at bedtime, max 30-40mg in exceptional circumstances.

Tolerance

Tolerance to temazepam's sleep promoting effects occurs rapidly. A study found that quality of sleep was increased after the first nights administration of either nitrazepam or temazepam but by day 7 quality of sleep was found to have returned to baseline suggesting the development of tolerance.^[11]

Dependence

Temazepam as with other benzodiazepine drugs can lead to physical dependence, addiction and what is known as the benzodiazepine withdrawal syndrome. Withdrawal from temazepam or other benzodiazepines after regular use often leads to withdrawal symptoms which are similar to those seen during alcohol and barbiturate withdrawal. The higher the dose and the longer the drug is taken for the greater the risk of experiencing unpleasant withdrawal symptoms. Withdrawal symptoms can however occur from standard dosages and also after short term use. Benzodiazepine treatment should be discontinued as soon as possible via a slow and gradual dose reduction regime.^[12] Dependence on temazepam and other benzodiazepine hypnotics eg nitrazepam often occurs due to discharging patients from hospital on benzodiazepines who were started on benzodiazepine hypnotics in hospital. It was recommended that hypnotics in hospital be limited to 5 nights use only to avoid the development of the benzodiazepine withdrawal syndrome eg withdrawal insomnia.^[13] Alprazolam 2mg tablets The benzodiazepines (pronounced , or benzos for short) are a class of psychoactive drugs considered as minor tranquilizers with varying hypnotic, sedative, anxiolytic, anticonvulsant, muscle relaxant and amnesic properties, which are brought on by slowing down the central nervous system. ... Physical dependence refers to a state resulting from habitual use of a drug, where negative physical withdrawal symptoms result from abrupt discontinuation. ... For other uses, see addicted. ... Benzodiazepine withdrawal syndrome, caused by withdrawal or dosage reduction of benzodiazepines, is the symptoms which appear when a patient who has taken the drug for a period of time stops taking the drug. ... Barbituric acid, the basic structure of all barbiturates Barbiturates are drugs that act as central nervous system depressants, and by virtue of this they produce a wide spectrum of effects, from mild sedation to anesthesia. ... Nitrazepam (marketed under the trade names MogadonÂ®, NitredonÂ®, NilandronÂ®) is a powerful hypnotic drug, which is a benzodiazepine derivative. ... Benzodiazepine withdrawal syndrome, caused by withdrawal or dosage reduction of benzodiazepines, is the symptoms which appear when a patient who has taken the drug for a period of time stops taking the drug. ...

The Committee on the Review of Medicines

The Committee on the Review of Medicines (UK) carried out a review into benzodiazepines due to significant concerns of tolerance, drug dependence and benzodiazepine withdrawal problems and other adverse effects. The committee found that benzodiazepines do not have any antidepressant or analgesic properties and are therefore unsuitable treatments for conditions such as depression, tension headaches and dysmenorrhoea. Benzodiazepines are also not beneficial in the treatment of psychosis due to a lack of efficacy. The committee also recommended against benzodiazepines being used in the treatment of anxiety or insomnia in children. The committee was in agreement with the Institute of Medicine (USA) and the conclusions of a study carried out by the White House Office of Drug Policy and the National Institute on Drug Abuse (USA) that there was little evidence that long term use of benzodiazepine hypnotics were benefitial in the treatment of insomnia due to the development of tolerance. Benzodiazepines tended to lose their sleep promoting properties within 3 - 14 days of continuous use and in the treatment of anxiety the committee found that there was little convincing evidence that benzodiazepines retained efficacy in the treatment of anxiety after 4 months continuous use due to the development of tolerance. The committee found that the regular use of benzodiazepines caused the development of dependence characterised by tolerance to the therapeutic effects of benzodiazepines and the development of the benzodiazepine withdrawal syndrome including symptoms such as anxiety, apprehension, tremor, insomnia, nausea, and vomiting upon cessation of benzodiazepine use. Withdrawal symptoms tended to develop within 24 hours on the cessation of a short acting benzodiazepine and within 3 - 10 days after the cessation of a more long acting benzodiazepine. Withdrawal effects could occur after treatment lasting only 2 weeks at therapeutic dose levels. However, withdrawal effects tended to occur with habitual use beyond 2 weeks and were more likely the higher the dose. The withdrawal symptoms may appear to be similar to the original condition. The committee recommended that all benzodiazepine treatment be withdrawn gradually and recommended that benzodiazepine treatment be used only in carefully selected patients and that therapy be limited to short term use only. It was also noted in the review that alcohol can potentiate the central nervous system depressant effects of benzodiazepines and should be avoided. The central nervous system depressant effects of benzodiazepines may make driving or operating machinery dangerous. The elderly are more prone to these adverse effects. In the neonate high single doses or repeated low doses have been reported to produce hypotonia, poor sucking, and hypothermia and irregularities in the fetal heart. Benzodiazepines should be avoided in lactation. Withdrawal from benzodiazepines should be gradual as abrupt withdrawal from high doses of benzodiazepines may cause confusion, toxic psychosis, convulsions, or a condition resembling delirium tremens. Abrupt withdrawal from lower doses may cause depression, nervousness, rebound insomnia, irritability, sweating, and diarrhoea. In the case of temazepam it was recommended that temazepam only be used for the short term treatment of severe insomnia.^[14] Drug addiction, or dependency is the compulsive use of drugs, to the point where the user has no effective choice but to continue use. ... Benzodiazepine withdrawal syndrome, caused by withdrawal or dosage reduction of benzodiazepines, is the symptoms which appear when a patient who has taken the drug for a period of time stops taking the drug. ... Prozac, a selective serotonin reuptake inhibitor (SSRI) Serotonin-norepinephrine reuptake inhibitor, Venlafaxine An antidepressant, is a psychiatric medication or other substance (nutrient or herb) used for alleviating depression or dysthymia (milder depression). ... An analgesic (colloquially known as a painkiller) is any member of the diverse group of drugs used to relieve pain (achieve analgesia). ... Tension headaches, which were recently renamed tension type headaches by the International Headache Society, are the most common type of headaches. ... Dysmenorrhea (or dysmenorrhoea), cramps or painful menstruation, involves menstrual periods that are accompanied by either sharp, intermittent pain or dull, aching pain, usually in the pelvis or lower abdomen. ... Psychosis is a generic psychiatric term for a mental state often described as involving a loss of contact with reality. Stedmans Medical Dictionary defines psychosis as a severe mental disorder, with or without organic damage, characterized by derangement of personality and loss of contact with reality and causing deterioration... what up?? Anxiety is a physiological state characterized by cognitive, somatic, emotional, and behavioral components (Seligman, Walker & Rosenhan, 2001). ... This article is about the sleeping disorder. ... The Institute of Medicine, a part of the National Academy of Sciences, is an American organization whose purpose is to provide national advice on issues relating to biomedical science, medicine, and health (National Academy of Sciences, n. ... Cover of a NIDA educational booklet. ... Benzodiazepine withdrawal syndrome, caused by withdrawal or dosage reduction of benzodiazepines, is the symptoms which appear when a patient who has taken the drug for a period of time stops taking the drug. ... what up?? Anxiety is a physiological state characterized by cognitive, somatic, emotional, and behavioral components (Seligman, Walker & Rosenhan, 2001). ... In psychology, apprehension (Lat. ... For the film see Tremors (film). ... This article is about the sleeping disorder. ... For other uses, see Nausea (disambiguation). ... Emesis redirects here. ... A diagram showing the CNS: 1. ... A human infant The word Infant derives from the Latin in-fans, meaning unable to speak. ... Hypotonia is a condition of abnormally low muscle tone (the amount of tension or resistance to movement in a muscle), often involving reduced muscle strength. ... Hypothermia is a condition in which an organisms temperature drops below that Required fOr normal metabolism and Bodily functionS. In warm-blooded animals, core [[body Temperature]] is maintained nEar a constant leVel through biologic [[homEostasis]]. But wheN the body iS exposed to cold Its internal mechanismS may be unable... Fetus at eight weeks A fetus (alternatively foetus or fœtus) is an embryo in later stages of development, from the third month of pregnancy until birth in humans. ... Kittens nursing Lactation describes the secretion of milk from the mammary glands, the process of providing that milk to the young, and the period of time that a mother lactates to feed her young. ... Look up Confusion in Wiktionary, the free dictionary Confusion can have the following meanings: Unclarity or puzzlement, e. ... Psychosis (not to be confused with psychopathy) is a generic psychiatric term for a mental state in which thought and perception are severely impaired. ... This article is about the medical condition. ... For the beer, see Delirium Tremens (beer). ... Anxiety is a complex combination of the feeling of fear, apprehension and worry often accompanied by physical sensations such as palpitations, chest pain and/or shortness of breath. ... The introduction to this article provides insufficient context for those unfamiliar with the subject matter. ... Irritability is an excessive response to stimuli. ... Perspiration (also called sweating or sometimes transpiration) is the production and evaporation of a fluid, consisting primarily of water as well as a smaller amount of sodium chloride (the main constituent of table salt), that is excreted by the sweat glands in the skin of mammals. ... Diarrhoea is the correct way to spell the word Diarrhoea. ...

Cognitive Behavioural Therapy

Temazepam, nitrazepam and zopiclone are the most frequently prescribed hypnotics in the United Kingdom. Hypnotic drugs are of poor value for the management of chronic insomnia. It is widely accepted that hypnotic drug usage beyond 4 weeks is undesirable for all age groups of patients. Many continuous sedative hypnotic users exhibit disturbed sleep as a consequence of tolerance but experience worsening rebound or withdrawal insomnia when the dose is reduced too quickly which compounds the problem of chronic hypnotic drug use. Chronic hypnotic drug consumption has been shown to reduce work performance increase absenteeism increase road traffic accidents, increased morbidity, increased mortality and is associated with increased deliberate self harm. In the elderly increases in falls and fractures associated with sedative hypnotic drug use has been found. CBT have been found to be more effective for the long term management of insomnia than sedative hypnotic drugs. No formal withdrawal programs for benzodiazepines exists with local providers. A meta-analysis of published data on psychological treatments for insomnia show a success rate between 70 and 80%. A large scale trial utilising cognitive behavioural therapy in chronic users of sedative hypnotics including nitrazepam, temazepam and zopiclone found that CBT to be a more effective long term treatment for chronic insomnia. Persisting improvements in sleep quality, sleep latency, increased total sleep, improvements in sleep efficiency, significant improvements in vitality, physical and mental health at 3, 6 and 12 month follow up was found in those receiving cognitive behavioural therapy. A marked reduction in total sedative hypnotic drug use was found in those receiving CBT, with 33% reporting zero hypnotic drug use. Age has been found not to be a barrier to successful outcome of CBT. It was concluded that CBT for the management of chronic insomnia was flexible, practical and cost effective treatment for the treatment of insomnia and that CBT leads to a reduction of benzodiazepine drug intake in significant number of patients.^[15] Nitrazepam (marketed under the trade names MogadonÂ®, NitredonÂ®, NilandronÂ®) is a powerful hypnotic drug, which is a benzodiazepine derivative. ... Zopiclone (trade names: Imovaneâ„¢ and Zimovaneâ„¢) is a novel hypnotic agent used in the treatment of insomnia. ... In medicine, epidemiology and actuarial science, the term morbidity can refer to the state of being diseased (from Latin morbidus: sick, unhealthy), the degree or severity of a disease, the prevalence of a disease: the total number of cases in a particular population at a particular point in time, the... Cognitive therapy or cognitive behavior therapy is a kind of psychotherapy used to treat depression, anxiety disorders, phobias, and other forms of psychological disorder. ... CBT can mean: Cognitive behavioral therapy, a kind of psychotherapy Classic BattleTech, a science-fiction universe Cincinnati Bell Telephone, the dominant telephone company for Cincinnati, Ohio, and its nearby suburbs in Ohio, Indiana and Kentucky Cock and ball torture, a sexual activity involving torture of the male genitals. ...

Abuse and misuse

Unprescribed temazepam is often detected in urine samples of drug misusers which suggests a high misuse potential of temazepam.^[16] Studies suggest that temazepam is a particularily euphoric benzodiazepine, and along with other hypnotic benzodiazepines, particularily, flunitrazepam, nitrazepam, and nimetazepam, it is considered to have the highest abuse potential of all benzodiazepines. In the UK, temazepam has superseded diazepam, nitrazepam and flurazepam as the most commonly abused benzodiazepine, in line with the increase in temazepam prescriptions and possibly (until recently) because of the availability of easily injectable forms of temazepam from capsules, 'jellies', 'eggs' (Stark et al. 1987). Benzodiazepines have been injected but at present temazepam is mainly involved. Strang et al. (1994) conducted a questionnaire survey of subjects attending drug clinics in seven British cities. Of 208 subjects returning the questionnaire, 186 had used benzodiazepines and 103 had injected them intravenously. Temazepam was the most commonly used and had been injected from preparations of capsules, tablets and syrup.[1] Alprazolam 2mg tablets The benzodiazepines (pronounced , or benzos for short) are a class of psychoactive drugs considered as minor tranquilizers with varying hypnotic, sedative, anxiolytic, anticonvulsant, muscle relaxant and amnesic properties, which are brought on by slowing down the central nervous system. ... Hypnotic drugs are a class of drugs that induce sleep, used in the treatment of severe insomnia. ... Flunitrazepam (IPA: ; is marketed by Roche under the trade name Rohypnol. ... Nitrazepam (marketed under the trade names MogadonÂ®, NitredonÂ®, NilandronÂ®) is a powerful hypnotic drug, which is a benzodiazepine derivative. ... Nimetazepam (marketed under brand name EriminÂ®) is a drug which is a benzodiazepine derivative. ... Diazepam (IPA: ), first marketed as Valium by Hoffmann-La Roche, is a drug which is a benzodiazepine derivative. ... Nitrazepam (marketed under the trade names MogadonÂ®, NitredonÂ®, NilandronÂ®) is a powerful hypnotic drug, which is a benzodiazepine derivative. ... Flurazepam (marketed under the brand names Dalmane and Dalmadorm) is a drug which is a benzodiazepine derivative. ...

Temazepam (whether obtained from capsules, tablets or elixir), is extremely irritating and likely to cause tissue damage. When arm veins become occluded due to local irritation, users may proceed to injecting in the groin, where inadvertent intra-arterial injection has led to amputation. The severity of the addiction which can develop to temazepam is illustrated by the case of a temazepam injector who needed his leg amputated but was later admitted for a second amputation since he had continued injecting into his remaining leg (Parrott 1995). A second subject, following a leg amputation, injected temazepam gel into his eye, resulting in bilateral blindness. [2]

In Northern Ireland in cases where drugs were found in tests on impaired drivers who had low alcohol readings but were suspected of driving under the influence of drugs benzodiazepines were found to be present in 87% of cases, with temazepam accounting for the vast majority of cases.^[17] Northern Ireland (Irish: ) is a part of the United Kingdom lying in the northeast of the island of Ireland, covering 5,459 square miles (14,139 kmÂ², about a sixth of the islands total area). ...

Side effects

Rare side effects include: Somnolence (or drowsiness) is a state of near-sleep, a strong desire for sleep, or sleeping for unusually long periods. ... Look up euphoria, euphoric in Wiktionary, the free dictionary. ... // Pre-syncope is a sensation of feeling faint. ... Anterograde amnesia is a form of amnesia, or memory loss, in which new events are not transferred from short-term memory to long-term memory. ... In medicine, hypoventilation exists when ventilation is inadequate to perform gas exchange. ... For other uses, see Concentration (disambiguation). ...

Before taking temazepam, one should ensure that at least 8 hours are available to dedicate to sleep. Failing to do so can increase the side effects of the drug.

Long-term use of temazepam can result in psychological and physical dependence and the appearance of benzodiazepine withdrawal symptoms when the drug is discontinued or the dose reduced. Temazepam impairs cognitive and psychomotor functions, affecting reaction time and driving skill. The use of this drug in combination with alcohol potentiates these side effects, and can lead to toxicity and death. Benzodiazepine withdrawal syndrome, caused by withdrawal or dosage reduction of benzodiazepines, is the symptoms which appear when a patient who has taken the drug for a period of time stops taking the drug. ... Cognitive The scientific study of how people obtain, retrieve, store and manipulate information. ... // Toxic and Intoxicated redirect here â€“ toxic has other uses, which can be found at Toxicity (disambiguation); for the state of being intoxicated by alcohol see Drunkenness. ... For other uses, see Death (disambiguation). ...

Residual 'hangover' effects after nighttime administration of temazepam such as sleepiness, impaired psychomotor and cognitive functions may persist into the next day which may impair the ability of users to drive safely or may increase the risks of falls and hip fractures.^[19] Cognitive The scientific study of how people obtain, retrieve, store and manipulate information. ... A hip fracture is a fracture in the proximal end of the femur (the long bone running through the thigh), near the hip joint. ...

Interactions

See Diazepam#Interactions. Diazepam (IPA: ), first marketed as Valium by Hoffmann-La Roche, is a drug which is a benzodiazepine derivative. ...

Contraindications

Use of temazepam should be avoided, when possible, in individuals with the following conditions:

For other uses, see Ataxia (disambiguation). ... In medicine, hypoventilation (also known as respiratory depression) occurs when ventilation is inadequate (hypo means below) to perform needed gas exchange. ... The liver is an organ in vertebrates including humans. ... Hepatitis (plural hepatitides) implies injury to liver characterised by presence of inflammatory cells in the liver tissue. ... Cirrhosis is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrotic scar tissue as well as regenerative nodules, leading to progressive loss of liver function. ... Kidneys viewed from behind with spine removed The kidneys are bean-shaped excretory organs in vertebrates. ... In medicine, dialysis is a type of renal replacement therapy which is used to provide an artificial replacement for lost kidney function due to renal failure. ... Sleep apnea, sleep apnoea or sleep apnÅ“a is a sleep disorder characterized by pauses in breathing during sleep. ... On the Threshold of Eternity. ... Myasthenia gravis (sometimes abbreviated MG; from the Greek myastheneia, lit. ... Alprazolam 2mg tablets The benzodiazepines (pronounced , or benzos for short) are a class of psychoactive drugs considered as minor tranquilizers with varying hypnotic, sedative, anxiolytic, anticonvulsant, muscle relaxant and amnesic properties, which are brought on by slowing down the central nervous system. ...

Special caution needed

Pregnancy

Temazepam belongs to the Pregnancy Category X of the FDA, and as such it is known to cause serious birth defects and fetal abnormalities.

Patients at a high risk for abuse and dependence

Temazepam can lead to physiological tolerance, and psychological and/or physical dependence. At a particularly high risk for temazepam misuse, abuse, and dependence are: In physiology, tolerance occurs when an organism builds up a resistance to the effects of a substance after repeated exposure. ...

Patients from the aforementioned groups should be monitored very closely during therapy for signs of abuse and development of dependence. Discontinue therapy if any of these signs are noted. Long-term therapy in these patients is not recommended. Borderline Personality Disorder (DSM-IV Personality Disorders 301. ...

Overdose

Manifestations of acute overdosage of temazepam can be expected to reflect the increasing CNS effects of the drug and include:

Temazepam overdose is considered a serious medical emergency and generally requires the immediate attention of medical personnel. The antidote for an overdose of temazepam (or any other benzodiazepine) is flumazenil (Anexate®). Somnolence (or drowsiness) is a state of near-sleep, a strong desire for sleep, or sleeping for unusually long periods. ... In physiology and medicine, hypotension refers to an abnormally low blood pressure. ... In medicine, a coma (from the Greek koma, meaning deep sleep) is a profound state of unconsciousness. ... For other uses, see Death (disambiguation). ... Flumazenil (flumazepil, AnexateÂ®, LanexatÂ®, MaziconÂ®, RomaziconÂ®) is a benzodiazepine antagonist, used as an antidote in the treatment of benzodiazepine overdose. ...

If the patient is conscious, vomiting should be induced mechanically or with emetics (e.g., syrup of ipecac 20 to 30 mL). Gastric lavage should be employed as soon as possible, utilizing concurrently a cuffed endotracheal tube if the patient is unconscious, in order to prevent aspiration and pulmonary complications. Maintenance of adequate pulmonary ventilation is essential and fluids should be administered IV to encourage diuresis. The use of pressor agents IV, may be necessary to combat hypotension but only if considered essential. The value of dialysis in emergency therapy for benzodiazepine overdosage has not been determined. If excitation occurs, barbiturates should not be used. It should be borne in mind that multiple agents may have been ingested. In physiology and medicine, hypotension refers to an abnormally low blood pressure. ...

The oral LD₅₀ of temazepam was 1963 mg/kg in mice, 1833 mg/kg in rats, and >2400 mg/kg in rabbits. An LD50 test being administered In toxicology, the LD50 or colloquially semilethal dose of a particular substance is a measure of how much constitutes a lethal dose. ...

Temazepam is a drug which is very frequently involved in drug intoxication, including overdose.^[20] Overdose of temazepam may result in excessive sedation, impairment of balance and speech. This may progress in severe overdoses to respiratory depression or coma and possibly death. The risk of overdose is increased if temazepam is taken in combination with alcohol, opiates or other CNS depressants. Temazepam overdose responds to the benzodiazepine receptor antagonist flumazenil. Flumazenil (flumazepil, AnexateÂ®, LanexatÂ®, MaziconÂ®, RomaziconÂ®) is a benzodiazepine antagonist, used as an antidote in the treatment of benzodiazepine overdose. ...

Benzodiazepines were implicated in 39% of suicides by drug poisoning in Sweden, with temazepam, nitrazepam and flunitrazepam accounting for 90% of benzodiazepine implicated suicides, in the elderly over a period of 2 decades. In three quarters of cases death was due to drowning, typically in the bath. Benzodiazepines were the predominant drug class used in suicides in this review of Swedish death certificates with 72% of benzodiazepine overdoses showing that benzodiazepines were the sole drug used in deaths by overdose. Benzodiazepines and in particular temazepam, nitrazepam and flunitrazepam should therefore be prescribed with caution in the elderly.^[21] Nitrazepam, and especially temazepam were the benzodiazepines most commonly detected in overdose related drug deaths in an Australian study of drug deaths. Benzodiazepines were found to be the sole cause of death in one third of cases.^[22] Anna Augusta Kershaw (1841-1931) death certificate Death Certificate is also an album by Ice Cube A death certificate is a document issued by a government official such as a registrar of vital statistics that declares the date, location and cause of a persons death. ... Nitrazepam (marketed under the trade names MogadonÂ®, NitredonÂ®, NilandronÂ®) is a powerful hypnotic drug, which is a benzodiazepine derivative. ...

In a retrospective study of deaths, when benzodiazepines were implicated in the deaths, the benzodiazepines flunitrazepam, temazepam and nitrazepam were the most common benzodiazepines involved. Benzodiazepines were a factor in all deaths caused by drug addiction in the study. Temazepam, nitrazepam and flunitrazepam were significantly more commonly implicated in suicide related deaths than natural deaths. In four of the cases benzodiazepines alone were the only cause of death. It was concluded that flunitrazepam and temazepam were significantly more toxic than other benzodiazepines.^[23] Flunitrazepam (IPA: ; is marketed by Roche under the trade name Rohypnol. ... Nitrazepam (marketed under the trade names MogadonÂ®, NitredonÂ®, NilandronÂ®) is a powerful hypnotic drug, which is a benzodiazepine derivative. ... Nitrazepam (marketed under the trade names MogadonÂ®, NitredonÂ®, NilandronÂ®) is a powerful hypnotic drug, which is a benzodiazepine derivative. ... Flunitrazepam (IPA: ; is marketed by Roche under the trade name Rohypnol. ...

From a research perspective, there are some data suggesting that temazepam may be more frequently involved in drug-related deaths (worldwide) than are some other benzodiazepines. Temazepam produced more sedation than did other benzodiazepines, in overdose situations. Thus, there is some reason to think that temazepam (once taken in overdose) may have greater toxicity than other benzodiazepines. ^[24]

Legal Status

In the United Kingdom, the drug is available only by private prescription. Temazepam is a Class B drug in the United Kingdom and possession is illegal without a prescription. Additionally, all manufacturers in the UK have replaced the gel-capsules with solid tablets. The Misuse of Drugs Act 1971 is an Act of Parliament, by which the United Kingdom aims to control the possession and supply of numerous drugs and drug-like substances, as listed under the Act, and to enable international co-operation against illegal drug trafficking. ... A medical prescription ) is an order (often in written form) by a qualified health care professional to a pharmacist or other therapist for a treatment to be provided to their patient. ...

In the US, temazepam is a Schedule IV drug and is only available by prescription. Temazepam is the only benzodiazepine which requires specially coded prescriptions in certain States. The Controlled Substances Act (CSA), Title II of the Comprehensive Drug Abuse Prevention and Control Act of 1970, is the legal foundation of the United States governments fight against the abuse of drugs and other substances. ...

Internationally, temazepam is a Schedule IV drug under the Convention on Psychotropic Substances[3]. Convention on Psychotropic Substances Opened for signature February 21, 1971 in Vienna Entered into force August 16, 1976 Conditions for entry into force 40 ratifications Parties 175 The Convention on Psychotropic Substances is a United Nations treaty designed to control psychoactive drugs such as amphetamines, barbiturates, and psychedelics. ...

In Canada Temazepam is a Schedule III controlled substance requiring a doctors prescription.

In Australia, prescription is restricted as a Schedule 8 medicine. As a Schedule 8 controlled substance, it is illegal to have this drug in possession without an authority prescription from a registered doctor.

In Hong Kong, Temazepam is regulated under Schedule 1 of Hong Kong's Chapter 134 Dangerous Drugs Ordinance. It can only be used legally by health professionals and for university research purporses. The substance can be given by pharmacists under a prescription. Anyone who supplies the substance without prescription can be fined $10000 (HKD). The penalty for trafficking or manufacturing the substance is a $5,000,000 (HKD) fine and life imprisonment. Possession of the substance for consumption without license from the Department of Health is illegal with a $1,000,000 (HKD) fine and/or 7 years of jail time. More information can be found: [4] ISO 4217 Code HKD User(s) Hong Kong Inflation 2. ...

Temazepam in Popular Culture

Temazepam tablets are called Jellies, Tams, Terms, Temazzies, Eggs, Green Eggs, Norries, and Rugby balls.

The recreational effects of the drug were documented on the Black Grape album, It's Great When You're Straight... Yeah. The track 'Tramazi Parti' contains the lyric: I got my boots on the back of my head / It's full of jellies in the good old bed / And no one knows what no one said. Although there is no medical research confirming this behaviour, it is not inconsistent with the known side effects of the drug. Black Grape were a rock and roll band from England, formed in 1993 by former members of Happy Mondays, Shaun Ryder and Bez. ... Its Great When Youre Straight. ...

On the BBC radio series The Archers, Jolyon Gibson's Christmas present to Kate was a bottle of temazepam capsules. Feeling depressed on New Year's Eve 1995, Kate took whisky and the "jellies" together and ended up in hospital.[5] The Archers is a British radio soap opera broadcast on the BBCs main spoken-word channel, Radio 4. ...

Cited references

^ Rickels K. (1986). "The clinical use of hypnotics: indications for use and the need for a variety of hypnotics.". Acta Psychiatr Scand Suppl. 332: 132-41. PMID 2883820.
^ Oelschläger H. (4). "[Chemical and pharmacologic aspects of benzodiazepines]". Schweiz Rundsch Med Prax. 78 (27-28): 766-72. PMID 2570451.
^ Professor heather Ashton (April 2007). BENZODIAZEPINE EQUIVALENCY TABLE. Retrieved on Sept 23, 2007.
^ Vozeh S. (21). "[Pharmacokinetic of benzodiazepines in old age]". Schweiz Med Wochenschr. 111 (47): 1789-93. PMID 6118950.
^ Shats V; Kozacov S. (1). "[Falls in the geriatric department: responsibility of the care-giver and the hospital]". Harefuah 128 (11): 690-3. PMID 7557666.
^ Rooke KC. (1976). "The use of flurazepam (dalmane) as a substitute for barbiturates and methaqualone/diphenhydramine (mandrax) in general practice.". J Int Med Res. 4 (5): 355-9. PMID 18375.
^ Mant A; Whicker SD, McManus P, Birkett DJ, Edmonds D, Dumbrell D. (Dec 1993). "Benzodiazepine utilisation in Australia: report from a new pharmacoepidemiological database.". Aust J Public Health. 17 (4): 345-9. PMID 7911332.
^ O'Neal, Maryadele J. Merck Index: An Encyclopedia of Chemicals, Drugs, and Biologicals. Merck. October 18, 2006.
^ Yevgenia Albats and Catherine A. Fitzpatrick. The State Within a State: The KGB and Its Hold on Russia - Past, Present, and Future. 1994.
^ See: Sidney Bloch and Peter Reddaway (1984). Soviet Psychiatric Abuse: The Shadow over World Psychiatry. Victor Gollancz, London.
^ Cook PJ; Huggett A, Graham-Pole R, Savage IT, James IM. (8). "Hypnotic accumulation and hangover in elderly inpatients: a controlled double-blind study of temazepam and nitrazepam." (pdf). Br Med J (Clin Res Ed). 286 (6359): 100-2.. PMID 6129914.
^ MacKinnon GL; Parker WA. (1982). "Benzodiazepine withdrawal syndrome: a literature review and evaluation.". The American journal of drug and alcohol abuse. 9 (1): 19-33. PMID 6133446.
^ Hecker R; Burr M, Newbury G. (1992). "Risk of benzodiazepine dependence resulting from hospital admission.". Drug Alcohol Rev. 11 (2): 131-5. PMID 16840267.
^ Committee on the Review of Medicines (29). "Systematic review of the benzodiazepines. Guidelines for data sheets on diazepam, chlordiazepoxide, medazepam, clorazepate, lorazepam, oxazepam, temazepam, triazolam, nitrazepam, and flurazepam. Committee on the Review of Medicines." (pdf). Br Med J. 280 (6218): 910-2. PMID 7388368.
^ Morgan K; Dixon S, Mathers N, Thompson J, Tomeny M. (Feb 2004). "Psychological treatment for insomnia in the regulation of long-term hypnotic drug use." (PDF). Health Technol Assess. 8 (8): 1-68. National Institute for Health Research. PMID 14960254.
^ Garretty DJ; Wolff K, Hay AW, Raistrick D. (Jan 1997). "Benzodiazepine misuse by drug addicts.". Annals of clinical biochemistry. 34 (Pt 1): 68-73. PMID 9022890.
^ Cosbey SH. (Dec 1986). "Drugs and the impaired driver in Northern Ireland: an analytical survey.". Forensic Sci Int. 32 (4): 245-58. PMID 3804143.
^ ^a ^b Liljequist R; Mattila MJ. (May 1979). "Acute effects of temazepam and nitrazepam on psychomotor skills and memory.". Acta Pharmacol Toxicol (Copenh). 44 (5): 364-9. PMID 38627.
^ Vermeeren A. (2004). "Residual effects of hypnotics: epidemiology and clinical implications.". CNS Drugs. 18 (5): 297-328. PMID 15089115.
^ Zevzikovas A; Kiliuviene G, Ivanauskas L, Dirse V. (2002). "[Analysis of benzodiazepine derivative mixture by gas-liquid chromatography]". Medicina (Kaunas). 38 (3): 316-20. PMID 12474705.
^ Carlsten, A; Waern M, Holmgren P, Allebeck P. (2003). "The role of benzodiazepines in elderly suicides.". Scand J Public Health. 31 (3): 224-8. PMID 12850977.
^ Drummer OH; Ranson DL. (Dec 1996). "Sudden death and benzodiazepines.". Am J Forensic Med Pathol. 17 (4): 336-42. PMID 8947361.
^ Ericsson HR; Holmgren P, Jakobsson SW, Lafolie P, De Rees B. (10). "[Benzodiazepine findings in autopsy material. A study shows interacting factors in fatal cases]". Läkartidningen. 90 (45): 3954-7. PMID 8231567.
^ http://www.a1b2c3.com/drugs/benz12.htm

External links

Categories: Anticonvulsants | Anxiolytics | Benzodiazepines | Hypnotics | Muscle relaxants | Sedatives There are several sulphonamide-based groups of drugs. ... Acetazolamide, sold under the trade name DiamoxÂ®, is a carbonic anhydrase inhibitor that is used to treat glaucoma, epileptic seizures, benign intracranial hypertension and altitude sickness. ... Ethoxzolamide (6-ethoxybenzothiazole-2-sulfonamide, alternatively known as Ethoxyzolamide) is a sulfonamide medication that functions as a carbonic anhydrase inhibitor. ... Sultiame (rINN, also known as sulthiame) is a sulfonamide and inhibitor of the enzyme carbonic anhydrase. ... Zonisamide (brand name ZonegranÂ®) is an anticonvulsant used as an adjunctive therapy in adults with partial-onset seizures. ... The propionate (also propanoate) ion is C2H5COOâˆ’ (propionic acid minus one hydrogen ion). ... Beclamide (marketed as Chloracon, Hibicon, Posedrine, Nydrane, Seclar, and other names) is a propionate and was used as a sedative and as an anticonvulsant. ... An aldehyde. ... Paraldehyde is the cyclic form of three acetaldehyde molecules (a trimer). ... A bromide is a phrase, or person who uses phrases, which have been used and repeated so many times as to become either insincere in their meaning, or seem like an attempt at trying to explain the obvious. ... Potassium bromide (KBr) is a salt, used as an anticonvulsant and a sedative in the 1800s. ... Sodium bromide is the chemical compound with the formula NaBr. ...

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