Alprazolam (Xanax) vs. Temazepam (Restoril)

• Alprazolam and temazepam are benzodiazepines used to treat anxiety disorders.
• Alprazolam is also used to treat panic attacks.
• Temazepam is also used to treat insomnia.
• Brand names for alprazolam include Xanax and Niravam.
• A brand name for temazepam is Restoril.
• Side effects of alprazolam and temazepam that are similar include drowsiness, fatigue, and headache.
• Side effects of alprazolam that are different from temazepam include memory problems, speech problems, constipation, changes in weight, addiction (dependency), and dry mouth.
• Side effects of temazepam that are different from alprazolam include dizziness, weakness, unsteadiness, depression, loss of orientation, and sleep disturbances.
• Withdrawal symptoms such as insomnia, headaches, nausea, vomiting, lightheadedness, sweating, anxiety, and fatigue may occur if you suddenly stop taking alprazolam or temazepam.

Alprazolam (brand names: Xanax XR, Niravam) is an anti-anxiety medication used to treat anxiety disorders and panic attacks. Alprazolam is a benzodiazepine, the same drug class that includes diazepam (Valium), clonazepam (Klonopin), lorazepam (Ativan), and flurazepam (Dalmane). Alprazolam and other benzodiazepines act by enhancing the effects of the neurotransmitter gamma-aminobutyric acid (GABA) that inhibits activity in the brain. It is believed that excessive activity in the brain may cause anxiety or other psychiatric disorders.

Temazepam (brand name: Restoril) is a drug used to treat anxiety. Temazepam also increases total sleep time and is used to treat insomnia. It is a benzodiazepine, the same class of drugs as diazepam (Valium), alprazolam (Xanax), clonazepam (Klonopin), flurazepam (Dalmane), and lorazepam (Ativan). Temazepam and other benzodiazepines act by enhancing the effects of the neurotransmitter gamma-aminobutyric acid (GABA) that inhibits activities of the brain. It is believed that excessive activity in the brain may lead to anxiety or other psychiatric disorders and temazepam reduces the activity.

Alprazolam

The most common side effects of Xanax taken at lower doses are:

• Drowsiness
• Fatigue

Other side effects include:

• Memory problems
• Speech problems
• Constipation
• Changes in weight
• Addiction (dependency)
• Headache
• Constipation
• Dry mouth

What are the withdrawal symptoms of Xanax?

Withdrawal Addiction is more likely to occur at high doses given over prolonged periods. Abrupt discontinuation of alprazolam after prolonged use can lead to symptoms of withdrawal such as:

• Insomnia
• Headaches
• Nausea
• Vomiting
• Lightheadedness
• Sweating
• Anxiety
• Fatigue

Seizures can occur in more severe cases of withdrawal. Consequently, patients on alprazolam for extended periods of time should slowly taper the medication under a doctor's supervision rather than abruptly stopping the medication.

Temazepam

The most common side effects associated with temazepam are

• excessive sleepiness,
• dizziness,
• weakness, and
• unsteadiness.

Other important side effects include:

• depression,
• loss of orientation,
• headache, and
• sleep disturbances.

Alprazolam

• The starting dose for treating anxiety is 0.25-0.5 mg 3 to 4 times daily using immediate release tablets. The dose may be increased every 3-4 days to a maximum dose of 4 mg daily.
• The starting dose for treating panic attacks is 0.5 mg 3 times daily. Doses can be increased every 3-4 days but by no more than 1 mg daily.
• The effective dose for preventing panic attacks may be as high as 10 mg daily for some patients. The starting dose when using extended release tablets to treat panic disorder is 0.5 mg once daily and the average dose is 3-6 mg once daily.
• Alprazolam may be taken with or without food.

Temazepam

• The recommended dose of temazepam is 7.5 to 30 mg taken about 30 minutes prior to bedtime. For elderly patients, start with 7.5 mg until the response is determined.

Alprazolam

• Ketoconazole (Nizoral), itraconazole (Sporanox), nefazodone (Serzone), cimetidine (Tagamet), and fluvoxamine (Luvox) increase concentrations in the blood of alprazolam and therefore may increase the side effects of alprazolam.
• Alprazolam interacts with alcohol and medications (for example, barbiturates, and narcotics) that suppress activity in the brain by suppressing activity more and causing sedation.
• Carbamazepine and rifampin reduce the effect of alprazolam by increasing metabolism and elimination of alprazolam in the liver.

Temazepam

• Alcohol or drugs that cause sleepiness increase the effects of temazepam.

Alprazolam

• Benzodiazepines, such as alprazolam, can cause fetal abnormalities and should not be used in pregnancy.
• Alprazolam is excreted in breast milk and it can affect nursing infants. Therefore, women who are should not take alprazolam while breastfeeding.

Temazepam

• Temazepam and other benzodiazepines have been associated with fetal damage, including congenital malformations, when taken by pregnant women in their first trimester. Temazepam should be avoided during pregnancy.
• Use by nursing mothers has not been adequately studied.