Temazepam
Temazepam is an intermediate-acting benzodiazepine licensed primarily as a hypnotic for short-term insomnia. Its relatively short duration reduces next-day hangover but does not remove the class-wide dependence, tolerance, and withdrawal liability.
01 Overview
Temazepam enhances GABA-A signalling and is used mainly to initiate and maintain sleep. It is metabolised largely by glucuronidation with no significant active metabolites, giving a cleaner pharmacokinetic profile than older hypnotics.
Even with short-term use, tolerance to the hypnotic effect and rebound insomnia can appear, and physical dependence develops with sustained dosing. Abrupt cessation after regular use can provoke withdrawal including seizures, and co-use with opioids or alcohol adds respiratory depression.
02 Mechanism
Positive allosteric modulator of the GABA-A receptor; enhances GABAergic inhibition to shorten sleep latency and reduce nocturnal awakenings.
03 Dosing
| Tier | Dose | Route | Notes |
|---|---|---|---|
| Light | 7.5–10 mg | Oral | Lower hypnotic dose, e.g. in elderly. |
| Common | 10–20 mg | Oral | Typical bedtime hypnotic dose. |
| Strong | 20–30 mg | Oral | Upper licensed range; higher sedation and hangover risk. |
04 Effects
| Effect | Magnitude | Evidence | |
|---|---|---|---|
| Sleep inductionShortens time to fall asleep and reduces awakenings. | Reduced sleep latency | Clinical | |
| AnxiolysisMild anxiolytic effect at bedtime. | Clinical | ||
| SedationIntended hypnotic sedation; residual daytime drowsiness possible. | Clinical |
05 Side effects
| Effect | Severity | Frequency | Evidence | Countermeasures |
|---|---|---|---|---|
| Dependence, tolerance and rebound insomniaTolerance to hypnotic effect, rebound insomnia and physical dependence; abrupt cessation can cause withdrawal including seizures. | Severe | Common with regular use | Clinical | |
| Respiratory depressionAdditive respiratory and CNS depression with opioids or alcohol. | Life-threatening | Uncommon alone, higher with CNS depressants | Clinical | |
| Next-day impairment and amnesiaResidual drowsiness, impaired psychomotor performance and memory the following day. | Moderate | Common | Clinical |