Temazepam and respiratory depression

Hello,

Thank you for choosing DoctorSpring.

YES. 300mg of Temazepam is a toxic dose which can potentially cause respiratory depression. It SHOULD NOT BE CONSUMED IN THIS DOSAGE. In addition to the respiratory depression it can cause CNS depression, arrhythmia, cardiac arrest and even death. These can occur even before respiratory depression. The effects not entirely predictable and varies in individuals.

I am legally required to say, but do take it in all seriousness - If you or someone has consumed it rush to the ER without any delay. If you or someone is considering taking this dosage, you should stop and call the National Suicide prevention hotline. Get in touch with family and friends as soon as possible. Take this as a request. Alternatively you can talk to me in case of you need any support.

In ED - a basic Pulse, BP will taken . Followed by Neurological examination, assessment of O2 saturation , ECG , Basic panel blood tests, Toxicology screen, Liver and renal function tests will also be done.


Please note :
If you or someone has consumed it rush to the ER without any delay. If you or someone is considering taking this dosage, you should stop and call the National Suicide prevention hotline. Get in touch with family and friends as soon as possible. Take this as a request. Alternatively you can talk to me in case of you need any support.

Hope this helps
Feel free to ask follwoups
Thank you

Thanks much for your prompt response.
Rest assured, no one is thinking of committing suicide. Am just curious.
Would 200 mg cause respiratory depression? At what dose level does it start getting dangerous?
One of my friends took 250mg once and she just slept in for long. Nothing happened to her so am perplexed by your answer stating it is dangerous. Could you please clarify, on scientific basis what happens?

I am relieved to hear that.

Now the reality is Temazepam is a Benozodiazepine. These class of drugs has high tolerance levels - That means even higher doses are well tolerated.

Regarding respiratory depression - Even 100mg can cause respiratory depression in individuals with a pre existing asthma or sleep apnoea . But in normal individuals respiratory depression is more of a textbook possibility and it rarely occurs if Temazepam is taken alone (with no other medications or alcohol). Even 1000 or 2000 mg will not cause respiratory depression in otherwise healthy individuals. I have treated patients with 1000mg overdose, who managed to walk out of the hospital after a couple of days. The classic presentation of a patient with an isolated BZD overdose consists of CNS depression with normal vital signs. So whatever happened to your friend is typical.

BUT this is not a rule always. 250mg can be toxic in individuals with compromised respiratory drive, liver or kidney condition. My first reply takes this into consideration.

Hope this clarifies
Feel free to ask followups.

Thanks for the clarification. I was really worried about my friend.

In ED, how would you treat a healthy individual who has taken 500mg temazepam 3 hours ago? I'd appreciate if you specify detailed medical/clinical procedures that will be conducted.

What are the long term effects? Would 500mg cause brain damage or memory loss?
What are the short term follow ups/medical check ups that one needs to keep an eye on?

Thank you so much

Hello,

It depends on the medical condition.
It is unlikely to cause significant brain damage. But the risk is always there. It is not predictable and there is no direct data on this. There is a chance for long term liver damage also

The patinet will be assessed and connected to monitoring devices. A stomach wash will be given. (Connecting tube to stomach and pumping out the contents ). Basic blood tests will be drawn. If there is respiratory depression patinet will be intubated ( a tube that helps in breathing ). In addition urinary catheterisation will also be done. Continuos viral monitoring and antidoes like Flumazenil will also be given.

Thank you

Am a (novice) biochemist and these thing pique my interest.
Would you be able to provide a link/article that illustrates or explains mechanism of liver damage, and or general metabolism of temazepam overdose in the body? I'd love to read details about what happens in the body

Hello,

There are a couple of good write ups in http://www.uptodate.com/home
But this is subscription based.

You can search in Pubmed and find plenty of articles in this regard. http://www.ncbi.nlm.nih.gov/pubmed

Thank you