Efficacy of temazepam in frequent users: a series of N-of-1 trials (original) (raw)
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Hypnotic efficacy of temazepam: A long-term sleep laboratory evaluation
British Journal of Clinical Pharmacology, 1979
Temazepam was evaluated in a strictly defined insomniac patient population under sleep laboratory conditions. Two protocols were used: a short-term (26-night) and a long-term (54-night) protocol evaluated the efficacy of the drug administered at night at 15 mg (short-term study) and 30 mg (long-term study), respectively. 2 Temazepam seemed to be both safe and effective at doses of 15 and 30 mg with up to 5 weeks of ingestion. 3 Suppression of slow wave sleep was observed at the high dose, but no suppression of REM sleep, found in studies with other benzodiazepines, was noted. 4 No evidence was found for development of tolerance or rebound effects.
Evaluation of temazepam as a hypnotic
Journal of Clinical Psychopharmacology, 1982
Temazepam is a 1,4-benzodiazepine, newly marketed in the United States for the symptomatic treatment of the complaint of insomnia. The manufacturer recommends a dose of 30 mg before bedtime for most adults and 15 mg for geriatric or debilitated patients. A dose of 30 mg usually produces peak plasma concentrations within 3 hours after oral ingestion and has a mean half-life of 10 to 15 hours. Thus, temazepam is absorbed more slowly and metabolized more quickly than flurazepam, the only other benzodiazepine marketed in the United States specifically for insomnia. Eight sleep laboratory and 21 clinical studies on temazepam indicate that temazepam reduces awakening during the night and increases sleep duration. However, there was no consistent evidence that temazepam reduces sleep latency--probably because temazepam, taken at bedtime, does not reach sufficiently high blood levels in time to affect sleep onset. One sleep laboratory study on 8 insomniac patients given 35 consecutive nightly doses of 30 mg found no evidence of tolerance or rebound insomnia. Studies on tolerance, metabolism and carry-over effects have shown that temazepam has no long-acting metabolites and does not affect waking function following use at bedtime. In patients for whom hypnotic medication is appropriate, temazepam should be an effective drug for reducing most symptoms of insomnia.
Temazepam's efficacy in patients with sleep onset insomnia
British Journal of Clinical Pharmacology, 1984
The hypnotic efficacy of temazepam capsules (30 mg) was studied in twelve patients who had objective polysomnographic evidence of sleep onset insomnia. Patients slept in the laboratory, retiring at their usual bedtime after taking placebo or temazepam 30 min earlier, and were monitored for 8 h using standard polysomnographic techniques. 2 Acute (nights 5-7) and chronic (nights 11-13) temazepam improved the sleep of these patients by reducing sleep latency and increasing sleep time compared to the placebo baseline (nights 2-4). 3 No detrimental effects on daytime function the following morning were observed using questionnaires and objective tests of performance. 4 No consistent evidence of disturbed sleep after discontinuation of treatment was obtained over three recovery nights.
Hypnotic residual effects of benzodiazepines with repeated administration
Sleep, 1986
Performance measures were compared to the multiple sleep latency test (MSLT) as indices to assess tolerance to the residual effects of benzodiazepine hypnotics during repeated nightly administration. Twelve healthy, normal sleepers received flurazepam 30 mg, temazepam 30 mg, and placebo for nine nights in a repeated measures, Latin-square design with 19 nights of recovery separating the treatments. As compared to placebo, both drugs altered sleep stage parameters in the early (nights 1-2) and late (nights 8-9) phases of the study. Hypnotic effects were found for both drugs in the early phase, but diminished for both in the late phase. The subjects' performance the next day was disrupted following treatment with flurazepam, but not with temazepam, during the early phase. Mean sleep latency on the MSLT was reduced by both drugs during the early phase. During the late phase, flurazepam did not disrupt performance but still affected the MSLT. Temazepam affected neither index the nex...
International Psychogeriatrics, 1992
Benzodiazepine hypnotic medications are widely prescribed for elderly patients, but there is a paucity of information available concerning the resudual cognitive and psychomotor (the morning-after) effects of these drugs. We compared two commonly used hypnotics—temazepam and triazolam—in a double-blind, placebo-controlled, single-dose study with community-dwelling healthy elderly with a DSM-III-R diagnosis of primary insomnia. Fortyfive subjects over the age of 65 (mean age 72.23, SD = 4.44) qualified for the study. Subjects were randomly assigned to one of five treatment groups (placebo, triazolam 0.125 mg., triazolam 0.25 mg., temazepam 15 mg., and temazepam 30 mg.). Neuropsychological testing was completed at baseline and 12–14 hours after the dosing.Patients were evaluated with a variety of tests that measured attention, concentration, motor speed, immediate memory, and learning of new information. Separate repeated measured analyses of variance were performed to assess the sign...
Residual effects of temazepam versus nitrazepam on memory and vigilance in the normal subject
Human Psychopharmacology: Clinical and Experimental, 1987
Eighteen normal volunteers with no sleep difficulties were given psychological tests and asked to fill out a self-evaluation questionnaire 11 h after administration of a hypnotic drug, nitrazepam 5 rng or temazepam 20 mg (in the form of soft gelatin capsules), which was compared to a placebo. Subjects received all three treatments at 1-week intervals, with the administration sequence determined by drawing lots. The tests used were the images test, the digitlsymbol substitution test (DSST), choice reaction time and critical fusion frequency. The two benzodiazepines proved to be efficient hypnotics, improving sleep induction and quality, but nitrazepam caused residual effects, as evidenced by difficult awakening and modified behaviour in the morning, as well as disturbed performance during DSST.