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Temazepam (sold under the brand name Restoril®) is a prescription sedative-hypnotic belonging to the benzodiazepine class. It is commonly prescribed for the short-term management of severe or disabling insomnia, characterized by difficulty falling asleep, staying asleep, or achieving restorative sleep. While temazepam is effective for short-term relief of acute insomnia, prolonged use may lead to tolerance, dependence, or addiction.
- Temazepam is a benzodiazepine sedative-hypnotic prescribed for the short-term treatment of insomnia.
- Common side effects include drowsiness, dizziness, and impaired coordination. Taking temazepam with other depressants (like alcohol or opioids) can cause severe sedation, breathing problems, or even death.
- Regular or high-dose use of temazepam can lead to tolerance, physical dependence, and addiction. Abruptly stopping it after prolonged use may cause withdrawal symptoms, so medical supervision is required for safe discontinuation.
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What is Temazepam?
Temazepam (Restoril®) is a short-to-intermediate-acting benzodiazepine with sedative, hypnotic, and anxiolytic effects. It positively modulates the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) in the central nervous system (CNS). [1] By binding to GABA receptors, temazepam suppresses excessive neural activity, which helps reduce anxiety and promotes sleep. [2]
Temazepam is approved by the Food and Drug Administration (FDA) for the short-term treatment of insomnia. [1] Because temazepam is habit-forming, healthcare providers usually prescribe it on a short-term basis. Guidelines generally recommend using temazepam for no more than 7–10 nights in a row. [1]
Brand names for temazepam
Restoril is the most common brand name under which temazepam appears in the U.S. Other brand names for temazepam exist internationally: [3]
- Normison
- Temaze
- Euhypnos
- Levanxol
- Tenox
Regardless of the brand name, the active ingredient—temazepam—remains the same, and the therapeutic and side-effect profiles are generally consistent across different brands.
How is it taken?
Temazepam is an oral capsule with dosages ranging from 7.5–30 mg. It is taken shortly before bedtime to help initiate and maintain sleep. [3] Using the lowest effective dose is preferred to minimize possible side effects and reduce the risk of dependence.
It is essential to follow the specific dosing instructions a doctor or pharmacist provides. Furthermore, before taking Restoril, ensure you have at least 7–8 hours of sleep before being active again. [4]
Temazepam side effects
Common side effects of Restoril include: [1]
- Drowsiness
- Dizziness
- Fatigue
- Impaired coordination
- Impaired concentration
- Headache
- Nausea
- Dry mouth
Temazepam can also cause memory problems or confusion. For example, a person might eat, drive, make phone calls, or have sex while not fully awake and later have no memory of the activity. This is a phenomenon called complex sleep behavior. [4] Rarely, paradoxical reactions can occur, where the person becomes agitated or restless instead of sedated. [1]
Serious side effects are more likely to occur if temazepam is taken in higher doses: [5]
- Over-sedation
- Extreme confusion
- Disinhibition
- Depersonalization
- Hallucinations
Using temazepam with opioids, alcohol, or other sedatives can dangerously suppress breathing and is not recommended. [5]
Is temazepam addictive?
Benzodiazepines, including temazepam, have a well-documented potential for misuse and dependence, especially if they are not taken as prescribed. [6] Temazepam is classified as a Schedule IV controlled substance under the Controlled Substances Act in the United States. This means that while it has legitimate medical uses, it also carries a risk of abuse. [5]
The DEA classifies Schedule IV drugs, substances, or chemicals as those with a low potential for abuse and a low risk of dependence. [7] However, taking temazepam over an extended period, especially at higher doses, can lead to physiological dependence. [5]
One of the primary concerns with benzodiazepines is the development of tolerance, where a person requires higher doses to achieve the same therapeutic effect or to feel normal. When a person then tries to stop or drastically reduce their dose of temazepam, withdrawal symptoms appear. This can precipitate a cycle of escalating use and increase the likelihood of problematic behaviors, such as drug-seeking. [5]
Signs of temazepam addiction
Recognizing signs of addiction or benzodiazepine use disorder early can help prevent serious health consequences. While only a medical professional can make a formal diagnosis of a substance use disorder through a careful clinical evaluation, the following signs may assist in recognizing potential Restoril addiction: [8]
- Cravings: A strong urge to use temazepam with difficulty thinking about anything else
- Drug-seeking behavior: Visiting multiple doctors (“doctor shopping”) to obtain prescriptions
- Increasing dosage without approval: Taking larger or more frequent doses of temazepam than originally prescribed
- Withdrawal symptoms: Experiencing anxiety, insomnia, tremors, and irritability when temazepam doses are missed or reduced
- Neglected responsibilities: Failing to fulfill obligations at work, school, or home due to problematic Restoril use
Temazepam polysubstance use
Temazepam is sometimes misused with opioids, alcohol, or stimulants to deepen sedation, enhance euphoria, or soften stimulant crashes and come downs. However, polysubstance abuse that includes temazepam with other CNS depressants, especially alcohol or opioid analgesics, can cause respiratory depression, coma, or even death. [1]
In some contexts, particularly in countries where gel-cap formulations are available, temazepam is injected to produce a rapid, intense sedative effect. [9]
This route of administration is particularly dangerous and is reported alongside opioid use (e.g., heroin or buprenorphine). Combinations like these increase the risk of overdose. Intravenous use of temazepam also carries a high risk of transmitting infectious diseases (like hepatitis C or HIV) due to shared or non-sterile injection equipment. [1][9]
Temazepam withdrawal
When someone becomes physically dependent on temazepam, withdrawal symptoms may emerge if the dose is reduced too quickly or the medication is stopped abruptly. A careful distinction should be made: Physical dependence is not the same as addiction, but it can still result in serious health risks if not medically managed.
Benzodiazepine withdrawal can be highly distressing and, in some cases, dangerous. Acute withdrawal from Restoril may cause problems in various organ systems of the body. [5]
Psychological & cognitive symptoms
- Anxiety
- Depression
- Derealization
- Panic attacks
- Irritability
- Insomnia
- Memory impairment
- Restlessness
Neurological & sensory disturbances
- Abnormal involuntary movements
- Dizziness
- Tremor
- Headache
- Photophobia (sensitivity to light)
- Hyperacusis (sensitivity to sound)
- Blurred vision
Musculoskeletal symptoms
- Muscle pain and stiffness
Cardiovascular symptoms
- Hypertension (high blood pressure)
- Tachycardia (rapid heart rate)
Gastrointestinal & appetite changes
- Nausea
- Vomiting
- Diarrhea
- Weight loss
- Decreased appetite
Some people may also experience protracted withdrawal symptoms, such as persistent anxiety, sleep disturbances, or mood instability, for weeks or even months after stopping temazepam. [4]
In more severe cases, acute withdrawal can lead to hallucinations, seizures, or delirium due to the sudden disruption of GABA signaling in the brain. [5] Because of these potentially life-threatening risks, temazepam should never be stopped abruptly without medical supervision.
Diagnosing temazepam addiction
Although DSM-5 criteria provide a formal framework for the diagnosis of addiction, identifying temazepam addiction involves a comprehensive clinical assessment by a qualified healthcare provider. The assessment typically includes these components: [1][10]
- Take a detailed medical and psychiatric history, including the duration, dose, and context of temazepam use.
- Evaluate co-occurring conditions, such as depression, anxiety, post-traumatic stress disorder (PTSD), or chronic pain, that may have contributed to Restoril use.
- Establish a differential diagnosis, ruling out other causes of symptoms, like primary insomnia, medication side effects, or withdrawal from other substances.
- Assess functional impairment and motivations for use, differentiating physical dependence from compulsive drug-seeking behavior.
- Utilize toxicology screening, prescription drug monitoring programs (PDMPs), and collateral information (e.g., from family or prior records) when appropriate.
Validated screening tools (e.g., BDQ, DAST-10) can help identify patients who are at high risk of addiction in a structured, less resource-intensive way. These tools guide brief interventions and referrals to addiction specialists when needed. [11]
Treatment options
Treating Restoril addiction involves a comprehensive, multi-pronged approach. Given the drug’s capacity for physical dependence and the potential severity of withdrawal, professional oversight is critical. Standard treatment options include:
Medically supervised detoxification: [12]
- A gradual tapering schedule helps in the detoxification process to minimize withdrawal symptoms and reduce the risk of complications, such as seizures. In some cases, healthcare providers may transition patients from temazepam to a longer-acting benzodiazepine, proceeding with a taper after that.
Behavioral therapies:
- Cognitive behavioral therapy (CBT): Addresses maladaptive thought patterns and behaviors associated with substance use
- Motivational interviewing (MI): Helps enhance motivation and readiness to change
- Contingency management: Uses positive reinforcement for maintaining sobriety or treatment compliance
Inpatient or residential treatment programs:
- Inpatient and residential programs may be suitable for people with severe temazepam dependence or co-occurring disorders (e.g., mood disorders or polysubstance misuse). They offer around-the-clock medical and psychological support, facilitating a structured environment for recovery.
Outpatient programs:
- Partial hospitalization or intensive outpatient programs can be effective for those who do not require 24-hour supervision. Outpatient programs encourage patient autonomy while providing counseling, group therapy, and medical follow-up.
Support groups and aftercare:
- Peer support groups, like Narcotics Anonymous (NA) or SMART Recovery, can offer long-term support for those who recover from benzodiazepine dependence and addiction.
- Ongoing therapy and follow-up appointments help reinforce coping strategies and relapse-prevention techniques.
If you or someone you care about is struggling with temazepam misuse or addiction, consult a medical professional or an addiction specialist. Early intervention and medically-guided tapering can reduce complications, restore healthy sleep, and help regain control over your life.
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