Benzodiazepines
Restoril (Temazepam) And Suicide
Q. Are you aware of any particular association between Restoril and suicidal acts or suicidal ideation when the medication is taken in therapeutic doses and/or overdosage?
A. From a purely clinical standpoint, I am not aware of, nor have I observed, any specific correlation between Restoril (temazepam) and suicidal acts or ideation.
However, let's put this question in a broader perspective. Temazepam is a member of the class of drugs called benzodiazepines (BZDs), which includes diazepam (Valium), alprazolam (Xanax), and many others.
In a small percentage of cases, some of the BZDs may provoke or worsen depression, and thus lead to increased risk for suicidal ideation or behavior.
In my experience, this usually occurs when the prescribing physician has misdiagnosed the individual as suffering from an anxiety disorder, or focuses on insomnia per se, and has missed the underlying major depression, which goes untreated.
From a research perspective, there are some data suggesting that temazepam may be more frequently involved in drug-related deaths than are some other BZDs.
Thus, Hammersley et al, in Addiction, July 1995, found that there was a four-fold increase in drug-related deaths in Glasgow, Scotland, between 1991-1992.
Heroin was implicated, often mixed with other drugs, which most often included temazepam, diazepam and alcohol.
Another study by Buckley et al, in the January 28, 1996, issue of British Medical Journal, looked at the relative toxicity of BZDs in overdose.
Temazepam produced more sedation than did other BZDs, in overdose situations. Thus, there is some reason to think that temazepam (once taken in overdose) may have greater toxicity than other BZDs.
But, it is not clear that simply using temazepam provokes suicidal ideation or acts. The manufacturer reports only a 1.7% incidence of depression with temazepam, which is actually less than that of placebo.
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