Benzos Temazepam Metabolism

[Soulspark]

Hey guys,

So I was recently prescribed temazepam for insomnia. I had been prescribed ambien and lunesta before. Ambien was too short-acting, and lunesta I felt was not very effective. Anyway, I've tried the temazepam for a few nights and it seems to have next to no effect. I have a high benzo tolerance, but I feel like that cannot explain for its lack of efficacy. I'm prescribed 30 mg once per night, PO. I've taken doses up to 120 mg and felt pretty much nothing. In fact, as I write this, I've taken 60 mg about 30 minutes ago. I feel no drowsiness or anything, less than even something OTC like doxylamine would bring on. My question is, are there certain people who can't metabolize this drug? I know about 10 % of Caucasians can't metabolize codeine, for example. Do you guys think there could be something like that going on here? Thanks for your help.

 

[tricomb]

I highly doubt that's the problem.

How high is your tolerance? (preferably in terms of a short acting, like alprazolam)

 

[Kid Amine]

Some people (like myself) build up an extremely fast tolerance to sleeping pills. I was on Temazepam, it was the first one I was prescribed. Full or empty stomach makes a huge difference in how fast (or if) this one works imo.

I've learned to live with insomnia. Sucks but I dont have insurance. Ideally, I would be prescribed 4-7 different sleep meds and rotate between them daily. Ambien worked for a while but after a few months, not even 20mg (2x the recommended dose in the PDR) would help me sleep.

The only drug I found worse than temazepam for sleep was chloral hydrate. I guess the old 'Mickey Finn' needs to be mixed with alcohol to knock people out.

 

[Soulspark]

I've ever taken alprazolam, so I'm not sure. My tolerance for Gabaergics is pretty high. I drink maybe once a week, but I probably have upwards of 6-12 drinks in that night. I have never taken actual benzos before, just z-drugs, but I do usually take 2-3 times more ambien or lunesta than recommended to be honest. I'm trying to cut down, so I don't want to take a ton of temazepam just to see how much I need to get me to pass out. I guess it probably is my tolerance, but I just wanted to see if such a situation existed in which people couldn't metabolize this drug. Wikipedia (I know it's not the most credible source) says it's not metabolized by C450 like most benzos, so I thought maybe it had a unique metabolic pathway for which some people wouldn't be able to metabolize the drug.

 

[brutus]

Sounds like you just have a high tolerance or are expecting too much from temazepam. I wouldn't go eating handfuls of temazepam though, unless you like waking up in very awkward situations.

Just take your prescribed dose and actually attempt to sleep. I know that sounds very sophomoric but it's often that simple.

I know temazepam doesn't make me sleepy, but triazolam knocks me out regardless what I am doing. If you are looking for a drug to knock you out, temazepam is likely not that drug. It will just relax you enough to allow you to sleep IME.

 

[tricomb]

^ Good posting.

don't look for a pill to knock you out though, that's trouble (I use triazolam for this on rare occasions and for psych)

You should ask your doctor about Hydroxyzine, and look into diet and exercise (exponentially more effective than any pill)

 

[Soulspark]

Thanks for the information. I guess since I had never taken a true benzo before, I was expecting it to more or less "knock me out." The thing is, Temzaepam is marketed more as a hypnotic, not a anxiolytic (which is what it feels more like to me). Oh well, I was just trying to figure out what was going on here. I'll just try to take it as recommended for now and ask my doctor about something different next time i see them. Thanks guys!

 

[adder]

In my country temazepam used to be prescribed by first-contact doctors as a weak anxiolytic, actually. I've never heard of it being prescribed as a hypnotic. And I haven't felt much of its hypnotic effects myself back in the days when I had no tolerance or later almost no tolerance, this was the first benzodiazepine I took, it's been years ago when I was 14 or something. I was up even after doses exceeding 200mgs, call it paradoxical reaction but it was hardly an overdose. Maybe you could try something else, nitrazepam for example if z-drugs seem to be of no use either. Nitrazepam should have more pronounced hypnotic effects, yet it definitely isn't a knock-out benzodiazepine.

 

[mygreenbic]

are you joking?

I had a croaker a few years back and every month he would let me pick whatever Benz i wanted and whatever sleeping pill. I wanted to try chloral hydrate so like the writer he is, i left the pharmacy with two pretty big bottles of chloral and an oral syringe. The dose was to take 5 ml. I took it and wanted to stay up to fill the high but every time i took it i was lucky to stay up for five minutes. And i have a huge tolerance to benzos and downers. Maybe your pharmacist was addicted to it and watered it down. The withdrawal from that is cross with barbituate withdrawal as to move on topic
TEMAZEPAM
this is also cross tolerant with barbituates. The only benzo. I love it. Especially with buperenorphine, I just took 12 30mg temazepam and i am getting euphoria like from no other benzo. I'm also prescribed clonazepam1.5 mg daily and recently 3 ten mg daily diazepam, which is euphoric as well but clon is my favorite because it's a sturdy benzo and doesn't wear off from stupid things like smoking. But high dose temaz is a super feeling.

Some people (like myself) build up an extremely fast tolerance to sleeping pills. I was on Temazepam, it was the first one I was prescribed. Full or empty stomach makes a huge difference in how fast (or if) this one works imo.

I've learned to live with insomnia. Sucks but I dont have insurance. Ideally, I would be prescribed 4-7 different sleep meds and rotate between them daily. Ambien worked for a while but after a few months, not even 20mg (2x the recommended dose in the PDR) would help me sleep.

The only drug I found worse than temazepam for sleep was chloral hydrate. I guess the old 'Mickey Finn' needs to be mixed with alcohol to knock people out.

 

[tricomb]

In my country temazepam used to be prescribed by first-contact doctors as a weak anxiolytic, actually. I've never heard of it being prescribed as a hypnotic. And I haven't felt much of its hypnotic effects myself back in the days when I had no tolerance or later almost no tolerance, this was the first benzodiazepine I took, it's been years ago when I was 14 or something. I was up even after doses exceeding 200mgs, call it paradoxical reaction but it was hardly an overdose. Maybe you could try something else, nitrazepam for example if z-drugs seem to be of no use either. Nitrazepam should have more pronounced hypnotic effects, yet it definitely isn't a knock-out benzodiazepine.

Are you serious? It's the first line treatment? That's not only strange because it was prescribed for anxiolytic effects instead of hypnotic, but first line treatment? What country are you in?

 

[Fire&Water]

We used to bite our "Dill Pickles" (chloral hydrate) to get a faster onset Blahhhwow - what a horrible taste...
I remember feeling like a blank sheet of paper, bouncing off the walls...

 

[kokaino]

Are you serious? It's the first line treatment? That's not only strange because it was prescribed for anxiolytic effects instead of hypnotic, but first line treatment? What country are you in?

tricomb, adder is from Poland and I wouldn't take what he says as true. I sincerely believe he's lying because if you translate the Polish wiki temazepam page, it clearly says that it is ONLY prescribed for SEVERE INSOMNIA. It then also says, it is NOT indicated for states of tension and anxiety. Now why would Poles lie about that? adder has the weirdest metabolism I've heard of - on the one hand he thinks temazepam is a weak anxiolytic and on the other he thinks that lorazepam is the greatest thing since sliced bread. Go figure.

 

[tricomb]

tricomb, adder is from Poland and I wouldn't take what he says as true. I sincerely believe he's lying because if you translate the Polish wiki temazepam page, it clearly says that it is ONLY prescribed for SEVERE INSOMNIA. It then also says, it is NOT indicated for states of tension and anxiety. Now why would Poles lie about that? adder has the weirdest metabolism I've heard of - on the one hand he thinks temazepam is a weak anxiolytic and on the other he thinks that lorazepam is the greatest thing since sliced bread. Go figure.

That's very odd indeed... Temazepam is never 1st line of treatment for anything in the USA. Only benzo that requires a special code at the pharmacy depending on your state.

Even IV lorazepam at the hospitals wasn't effective enough to stop seizures from WD.... beyond maxed out the hospitals record. I know two other people who also couldn't be stabilized with huge doses IV'd by EMTs.

 

[kokaino]

That's very odd indeed... Temazepam is never 1st line of treatment for anything in the USA. Only benzo that requires a special code at the pharmacy depending on your state.

Even IV lorazepam at the hospitals wasn't effective enough to stop seizures from WD.... beyond maxed out the hospitals record. I know two other people who also couldn't be stabilized with huge doses IV'd by EMTs.

Yes, exactly temazepam is rarely first line anything nowadays, especially in Europe. Specially coded prescription requirements for temazepam were enacted in some states back in the early 90's (even before flunitrazepam was taken off the market), when the temazepam craze in Europe and especially in the UK was at its peak and something had to be done (this was the point when the UK, Ireland and several other European countries upped temazepam in the "scheduling", while others like Norway and Sweden banned the drug outright - Sweden in 1992, Norway in 1993). Then the studies and media campaign against temazepam came out full force in the UK and elsewhere in Europe. When Europe calmed down, Australia had picked up the temazepam epidemic and the DEA started to wonder what it should do to avoid such a stupid trend of abuse of a benzo that was sort of reminiscent of the 1960's barbiturate era. Temazepam prescriptions in the US plummeted and flurazepam and triazolam dominated the hypnotic market in the United States. This law is still law in some states, like for example, here in Michigan. However, today it is not generally enforced due to drastically different conditions and most doctors write prescriptions for temazepam like they would for diazepam or alprazolam. Maybe some old school doctors still follow through with the law, but it is generally not enforced or required anymore.

When I went to Germany last year (I was originally born in Germany and then emigrated to the US when I was 11), temazepam was impossible to find anywhere despite being on the market in Germany. Flunitrazepam is prescribed for insomnia before temazepam is in Germany (both are on the market). I found a lot of lormetazepam (which is a temazepam derivative), clonazepam, oxazepam, and tetrazepam. Those four seemed to be the most common in Germany. Flunitrazepam wasn't too rare either. I didn't see temazepam, not even once.

So I'm more than certain that doctors in Poland don't prescribe temazepam as a "first line weak anxiolytic benzo". In Europe temazepam only comes in 10 mg and 20 mg formulations. No 30 mg.

 

[tricomb]

Flunitrazepam is very easy to find, and so is temazepam if you're in the USA. I agree about Flurazepam (Dalmane) dominating the market, although I was not aware that triazolam (Halcion) was prescribed more often as a hypnotic in the USA.

Flunitrazepam, IMO is a fun benzo, if such a thing exists, but it's nowhere near the hype people think it is.

I dunno, I think I've been on every benzodiazepine prescribed in the USA, but I'd have to make a list, and check it twice

 

[Codesan]

Here in Finland Temazepam is one of the most abused benzos still. It's pretty easy to get prescribed for insomnia only (althought the information pamphlet that comes with the pills says that it can also be prescribed for anxiety but I have NEVER heard of anyone who got it for anxiety..only insomnia)
You can get 10mg or 20mg tabs here and I even have couple 100 count bottles for it. The most prescribed benzo for anxiety is usually oxazepam for long term and diazepam for short term anxiety. I went to the emergency room last week and after 5 hours of waiting the doctor happily gave me five 10mg diazepam tablets with me (well one to take there and four in a baggie).

 

[RorerQuaalude714]

In Canada, temazepam is quite common. It and zopiclone are first-line hypnotics in most provinces. Older meds like nitrazepam and flurazepam are discouraged in most cases as hypnotics due to their hangover and metabolite buildup. Triazolam is extremely rare and its use is strongly discouraged in most cases. You'll find it occasionally on the streets, but that's about it.

Hell, with temazepam, there was this pill mill that I used to go to and the doc would walk in, say "Getting the usual?" and script me 90 x 30 mg temazepam capsules because "I was working nights for the next little while". His response: "Well if this medication works well for you, I have no problem prescribing it". Mind you, this can't really be done anymore since all the new medication monitoring systems came into effect.

 

[Psychonauticunt]

That's very odd indeed... Temazepam is never 1st line of treatment for anything in the USA. Only benzo that requires a special code at the pharmacy depending on your state.

It is very much the 1st-choice hypnotic in Finland. Your average GP will have you try zopiclone, zolpidem and temazepam with pertty equal frequency and ease - if those three are unsuitable, only then are other hypnotics usually even discussed.
Here in the Netherlands, temazepam has also always been the first hypnotic benzo my physicians have suggested.

 

[tricomb]

In countries where temazepam is a first line treatment for insomnia, I wonder if they don't have as many alternatives as countries like the United States where we have dozens of options.

 

[Psychonauticunt]

In countries where temazepam is a first line treatment for insomnia, I wonder if they don't have as many alternatives as countries like the United States where we have dozens of options.

What options would you typically have?

In Finland, at least the following are (more or less) commonly used as hypnotics: zopiclone, zolpidem, zaleplon, temazepam, diazepam, nitrazepam, midazolam, triazolam, mirtazapine, melatonin, quetiapine (chlordiazepoxide, oxazepam, lorazepam, levomepromazine, hydroxyzine are sometimes also prescribed).
In the Netherlands: zopiclone, zolpidem, temazepam, midazolam, brotizolam, flurazepam, lormetazepam, loprazolam, nitrazepam, flunitrazepam, chloral hydrate, melatonin (not sure what else, as I haven't lived here all that long).