Quazepam and temazepam: Effects of short‐ and intermediate‐term use and withdrawal

  title={Quazepam and temazepam: Effects of short‐ and intermediate‐term use and withdrawal},
  author={Anthony Kales and Edward O. Bixler and Constantin R. Soldatos and Antonio Vela‐bueno and Judith A. Jacoby and Joyce D. Kales},
  journal={Clinical Pharmacology \& Therapeutics},
Two benzodiazepine hypnotics, one with an intermediate elimination t½ (temazepam, 15 mg) and the other with a long t½ (quazepam, 15 mg), were evaluated in 22‐ night sleep laboratory studies. The effectiveness and side effects of these benzodiazepines were assessed during short‐ and intermediate term use. Subjects were also assessed for the presence of rebound insomnia after abrupt withdrawal. Quazepam, 15 mg, was significantly effective in improving sleep both with short‐ and intermediate‐term… 
Comparison of short and long half‐life benzodiazepine hypnotics: Triazolam and quazepam
The 0.25 mg dose of triazolam, which is being prescribed increasingly, has a profile of side effects that is similar to that of the 0.5 mg dose, and is associated with sleep and mood disturbances whereas quazepam exerted carryover effectiveness.
Quazepam: Hypnotic Efficacy and Side Effects
  • A. Kales
  • Medicine, Psychology
  • 1990
Quazepam is a benzodiazepine hypnotic that can be useful in the adjunctive pharmacologic treatment of insomnia and is more effective with short‐term use, and with continued use it maintains its efficacy in contrast to both of these drugs which show rapid development of tolerance.
Rebound insomnia after only brief and intermittent use of rapidly eliminated benzodiazepines
It is indicated that even under conditions of brief, intermittent use and withdrawal, triazolam and, to a lesser degree, temazepam produce rebound insomnia after abrupt withdrawal, thereby predisposing to drug‐taking behavior and increasing the potential for drug dependence.
Temazepam 7.5 mg: effects on sleep in elderly insomniacs
Temazepam, 7.5 mg is effective in elderly subjects with short-term use and has a minimum of adverse effects and its low propensity for producing rebound insomnia, can be effectively used in this manner.
Reintroduction of quazepam: an update on comparative hypnotic and adverse effects.
  • N. Moniri
  • Psychology, Biology
    International clinical psychopharmacology
  • 2019
The purpose of this review is to provide an update on distinguishing features of quazepam with regard to its pharmacology, pharmacokinetics, sleep efficacy and potential adverse effects compared to other agents used for insomnia.
Rebound insomnia and newer hypnotics
  • M. Lader
  • Psychology, Medicine
  • 2005
Present evidence, while limited, is consistent with claims of less rebound potential than older benzodiazepine hypnotics of equivalent duration of action, but further rigorous studies are essential before these claims can be totally accepted.
Rebound Insomnia: A Critical Review
The results indicate that rebound insomnia is a distinct possibility after discontinuation of triazolam in both insomniacs and normal controls and is greater with the short half-life as compared with the long half- life benzodiazepines.
Benzodiazepine hypnotics and insomnia.
In summary, it is proposed that the more frequent or severe side effects associated with the newer triazolo-benzodiazepines are related to an interaction of several factors, including rapid
The benzodiazepine withdrawal syndrome.
Physiological dependence on benzodiazepines is accompanied by a withdrawal syndrome which is typically characterized by sleep disturbance, irritability, increased tension and anxiety, panic attacks,
The dependence potential of short half-life benzodiazepines: a meta-analysis.
The present meta-analysis confirms clinical impressions of the greater dependence potential of short vs long half-life benzodiazepines and advises doctors, patients, and policymakers to be informed so as to avoid harm to the public health through unintended drug dependence.


Quazepam and flurazepam: Long‐term use and extended withdrawal
The data suggest that the optimal dose of quazepam is 15 mg, and some loss of effectiveness was noted during long‐term use of both doses of quzepam and, to a lesser extent, of flurazepams.
Effectiveness of Temazepam with Short‐, Intermediate‐, and Long‐Term Use: Sleep Laboratory Evaluation
Effectiveness of 30 mg temazepam for inducing and maintaining sleep was evaluated in the sleep laboratory in six insomniac subjects under conditions of short-, intermediate-, and long-term drug administration, and effectiveness was not demonstrated for sleep maintenance.
Dose‐response studies of quazepam
The efficacy and comparatively less severe side effects of the 7.5‐and 15‐mg doses of quazepam suggest that these doses may be optimal when the drug is considered for the adjunctive treatment of insomnia.
Effectiveness of hypnotic drugs with prolonged use: Flurazepam and pentobarbital
Pentobarbital was found to be effective in inducing and maintaining sleep only with short‐term drug administration, which strongly suggests that it is of limited value for insomniac patients who require nightly medication beyond short-term use.
Dose—Response Studies of Lormetazepam: Efficacy, Side Effects, and Rebound Insomnia
There was less efficacy on the later drug nights, indicating a potential for the development of tolerance over a relatively short period of time, and following drug withdrawal, there was a dose‐related worsening of sleep above baseline levels (rebound insomnia).
Hypnotic efficacy of temazepam: a long-term sleep laboratory evaluation.
Temazepam seemed to be both safe and effective at doses of 15 and 30 mg with up to 5 weeks of ingestion, and no evidence was found for development of tolerance or rebound effects.
Evaluation of Temazepam as a Hypnotic
  • M. Mitler
  • Psychology, Medicine
  • 1981
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, and in patients for whom hypnotic medication is appropriate, it should be an effective drug for reducing most symptoms of insomnia.
Lorazepam—Efficacy, side effects, and rebound phenomena
The results suggest that while 4 mg lorazepam may be effective in inducing and maintaining sleep, this dose induces clinically significant side effects that are followed by consistent rebound phenomena after withdrawal.
Quazepam, A New Benzodiazepine Hypnotic: Intermediate‐Term Sleep Laboratory Evaluation
Data regarding long-term safety or tolerance of the drug suggest that quazepam is well tolerated and that its pharmacological effects are similar to those of other benzodiazepines.
Hypnotic Efficacy of Triazolam: Sleep Laboratory Evaluation of Intermediate‐Term Effectiveness
The data indicate that triazolam is effective for short-term use, loses most of its effectiveness with intermediate- term use, and its withdrawal is followed by a significant sorsening of sleep.