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Temazepam, sold under the brand name Restoril®, is a prescription benzodiazepine used to treat short-term insomnia. Like other benzodiazepines, temazepam calms the central nervous system (CNS) and promotes sleep.
However, it can also cause a range of side effects, from mild drowsiness to more serious complications. Below, we explore how temazepam works, its potential side effects, and what to do if severe symptoms occur.
- Temazepam binds to GABA-A receptors to induce sedation and improve sleep initiation.
- Common side effects include drowsiness, fatigue, and dizziness; severe side effects can include confusion and breathing difficulties.
- If you experience severe or concerning symptoms from Restoril®, contact a healthcare professional promptly to discuss alternatives or adjustments in treatment.
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How does temazepam work?
Temazepam belongs to the benzodiazepine class of medications, which act on gamma-aminobutyric acid (GABA) receptors in the brain. GABA is a neurotransmitter that inhibits excessive neuronal activity, helping to reduce anxiety and induce sedation. By enhancing GABA’s effect, temazepam promotes a calming influence on the CNS. [1]
Doctors typically prescribe temazepam for short-term management of insomnia, especially difficulties falling asleep. Because of temazepam’s sedative properties, it can help people fall asleep and stay asleep throughout the night. [2]
However, as tolerance can develop over time, medical professionals generally recommend using temazepam only when necessary and for the shortest duration possible to minimize dependence risk.
Common temazepam side effects
Like many prescription medications, temazepam may cause unwanted effects alongside its therapeutic benefits. Most common side effects are usually mild. These typically include: [1][2][3]
- Drowsiness
- Fatigue
- Dizziness or lightheadedness
- Falls
- Headache
- Unsteadiness or coordination problems
- Dry mouth and/or altered taste
- Impaired concentration
- Nausea
Some people also experience memory lapses, especially of events that occur shortly after taking the medication (anterograde amnesia). For example, a person might eat, drive, make phone calls, or have sex while not fully awake or aware and then have no memory of the activity later on. These events are called complex sleep behavior, which is even more common with other sleep aids called z-drugs (zopiclone, eszopiclone, and zolpidem) than it is with temazepam. [4]
Furthermore, one should avoid operating machinery or driving a vehicle if one feels drowsy or dizzy after taking temazepam.
Doctors often recommend monitoring these symptoms while continuing treatment if they are mild and manageable. However, consult a healthcare professional for guidance if they persist or worsen.
Severe side effects
While most people tolerate Restoril® well, some may experience more serious reactions. These severe temazepam side effects require immediate medical attention: [5]
- Confusion or agitation
- Hallucinations or abnormal thoughts
- Over-sedation
- Disinhibition and depersonalization
- Difficulty breathing (respiratory depression)
- Yellowing of the eyes or skin (jaundice)
- Significant changes in heart rate or blood pressure
- Anaphylaxis or severe allergic reactions
These symptoms are medical emergencies, warranting prompt medical evaluation to determine the safety of temazepam treatment.
What to do when experiencing side effects
- Seek immediate medical attention for severe symptoms by calling 911 or going to the nearest hospital.
- Inform the doctor about all medications, including over-the-counter drugs, herbal supplements, and other prescriptions that could interact with temazepam.
- Follow your healthcare provider’s instructions, whether to discontinue temazepam, adjust the dose, or recommend supportive measures to manage acute symptoms.
Risks and complications
Temazepam poses risks of worsening other medical problems and causing potentially severe interactions with other medications.
Worsening other medical conditions
Because temazepam is metabolized primarily in the liver, people with liver disease must use it with caution. Other conditions that can complicate temazepam use include severe respiratory disorders(e.g., COPD), sleep apnea, and a history of substance misuse or substance use disorder. [2]
Interactions with other medications
Temazepam produces additive effects when combined with other CNS depressant medications. These combinations can increase sedation, impair coordination, or slow breathing. [6][7]
Medications and substances of concern include:
- Xyrem (sodium oxybate) [8]
- Opioids (codeine, hydrocodone, oxycodone, or morphine) [7][9]
- Antihistamines (diphenhydramine and hydroxyzine) [10]
- Alcohol [10]
- Other benzodiazepines (diazepam, lorazepam, clonazepam, and alprazolam) [10]
- Muscle relaxers (carisoprodol, cyclobenzaprine, methocarbamol, and baclofen) [11]
- Barbiturates (phenobarbital and butalbital) [11]
- Sleep medications (zolpidem, zopiclone, eszopiclone, zaleplon, and suvorexant) [11]
- Antidepressants (mirtazapine, trazodone, and amitriptyline) [9][12]
- Mood stabilizers (valproate and lithium) [9][12]
Anyone with a pre-existing medical condition or who takes multiple medications should discuss these with a healthcare professional before starting temazepam therapy. They can help determine whether the possible benefits of temazepam therapy outweigh the potential risks and discuss potential Restoril® dosage adjustments to minimize the possibility of adverse events.
Temazepam abuse and dependence
All benzodiazepines, including temazepam, carry a risk of abuse and dependence, especially when they are not taken as directed, with prolonged use, or at high doses. Temazepam is a Schedule IV substance under the U.S. Controlled Substances Act. [5] This means that while the abuse potential is lower than some substances, it still carries a notable risk of dependence and addiction.
People may inadvertently develop a tolerance to Restoril®, requiring higher doses for the same effect, or they may misuse the medication to combat tolerance, to enhance sedation, or to experience euphoria. [13]
Signs of potential misuse or abuse:
- Seeking additional prescriptions from multiple providers (doctor shopping)
- Taking higher doses than prescribed
- Experiencing withdrawal symptoms (anxiety, restlessness, and tremors) between doses
- Combining temazepam with other substances, like alcohol, to enhance its effects [14]
Temazepam withdrawal and tapering
Abruptly discontinuing or significantly reducing temazepam after extended use can lead to withdrawal symptoms. These symptoms can range from mild anxiety and insomnia to more severe reactions, such as seizures or psychosis. [5] The severity of temazepam withdrawal often correlates with dose, duration, and individual factors, such as age, comorbidities, and metabolism. [15]
Common Restoril® withdrawal symptoms:
- Rebound insomnia and anxiety
- Irritability and mood swings
- Sweating and tremors
- Nausea and vomiting [5]
To avoid these complications, doctors typically recommend a gradual taper, which is a slow reduction in dosage over a set period of time.
Benzodiazepine tapering guidelines
| Method | How it works | Dose reduction | Frequency | Best for |
|---|---|---|---|---|
| Cut and Hold | Reduce dosage by a small amount and maintain that dose until stable. | 5–10% per reduction | Every 2–4 weeks | People needing clear, predictable intervals |
| Microtapering | Make tiny, precise daily dosage reductions using scales or liquids. | Very small increments daily (0.001–0.003 g) | Daily | People susceptible to dose changes |
Important tapering tips:
- Avoid rapid tapers (involving dose reductions over 10% weekly) to minimize severe withdrawal risks.
- Personalize your plan based on tolerance and symptom response.
- Always consult a healthcare professional familiar with benzodiazepine withdrawal.
- Utilize structured guides (like the Ashton Manual) for detailed support.
When to get help for severe side effects
It is vital to seek professional help if you experience any of these temazepam side effects:
- Frequent episodes of confusion or agitation that affect daily living and functioning
- Any signs of medical emergencies, like respiratory distress or severe allergy symptoms (throat swelling, hives, intense shortness of breath)
- Worsening mental health conditions, such as increased anxiety, depression, or suicidal thoughts
- Hallucinations
Additionally, it is vital to get help if you suspect dependence or addiction. Severe side effects of temazepam aren’t only physical; dependence itself is a serious consequence that warrants professional help.
If you have trouble stopping temazepam or experience withdrawal symptoms, reach out to your doctor, find an addiction specialist, or use our rehab directory. They can provide resources such as a structured tapering schedule, counseling, or rehabilitation services.
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