Quazepam

Definition

Quazepam belongs to a class of drugs called benzodiazepines. These drugs ease anxiety and slow the central nervous system. In the United States quazepam is sold under brand name Doral.

Purpose

Quazepam is approved by the United States Food and Drug Administration for the treatment of insomnia .

Description

Quazepam is unique in its drug properties in two ways. Several medications from the same class of drugs have an effect called rebound insomnia. This means that the insomnia becomes worse than the original insomnia when the drug is used for extended periods. Quazepam has a minimal tendency to cause rebound insomnia. Secondly, quazepam is eliminated from the body slowly. This gives quazepam advantage over certain other medications in the benzodiazepine class, such as alprazolam or halazepam, in that patients do not experience earlymorning insomnia, since there is still enough medication to induce sleep in the very early morning hours.

Quazepam's sedating effect that reduces insomnia lasts only for about four weeks of continuous use. The medication is most effective for an intermediate-term treatment of insomnia (two weeks), rather than a long duration of treatment of over four weeks. Hence, long-term treatment for insomnia with quazepam should be avoided.

Quazepam comes in 7.5-mg and 15-mg tablets.

Recommended dosage

Effective doses of quazepam for the treatment of insomnia range from 7.5 mg to 30 mg at bedtime. Most patients start by taking 15 mg at bedtime. Adjustments from this dosage can be made as determined by individual. In some patients, a dosage as low as 7.5 mg is sufficient to reduce insomnia.

Elderly patients (over age 65) should receive a reduced dosage of 7.5 mg, because it takes a longer time to eliminate the drug from their bodies. Because quazepam is eliminated by the liver, dosage reduction may be necessary in patients with liver problems.

Precautions

Patients who have a condition known as sleep apnea should not use quazepam. This condition involves episodes of breathing difficulty and oxygen deficiency that occur throughout the night. Patients who are pregnant or who had an allergic reaction to quazepam should not take quazepam

People who need to remain mentally alert such as those who are driving or operating dangerous machinery, need to take quazepam with caution as it may cause drowsiness. This effect is intensified when quazepam is taken with alcohol. It is best not to drink alcoholic beverages while taking quazepam. Patients with compromised respiratory function (breathing problems), as well as patients with a history of drug or alcohol abuse, should closely be monitored during the short-term treatment with quazepam.

Side effects

The effects of quazepam taken at bedtime may last, or hang over, into the next day. This is the most common side effect of quazepam. The symptoms of this condition include drowsiness, daytime sleepiness, slurred speech, and mental sluggishness. This effect is dose related, and seems to occur most frequently in patients taking 30-mg doses. These effects are experienced less commonly with the 15-mg dose, but this dose may not be effective in eliminating insomnia some patients. Some people experience headache and dizziness when taking quazepam.

A small number of patients experience dry mouth, weight loss, abnormal taste perception, abdominal pain, nausea, vomiting, and either diarrhea or constipation due to quazepam. These effects occur in about 1% to 10% of people taking the drug.

Side effects that occur in less than 1% of patients include skin problems, such as rash or skin inflammation, muscle cramps, rigidity, and blurred vision.

Interactions

Cimetidine (Tagamet) and ketoconazole increase the levels of quazepam in the body, potentially causing toxicity or increased side effects.

Theophylline decreases the effectiveness of quazepam. Valerian , kava kava , and alcohol cause increased central nervous depression, which may increase sedation, drowsiness, and slowed reflexes if used while taking quazepam.

Resources

BOOKS

Gilman, Alfred G. The Pharmacological Basis of Therapeutics. McGraw-Hill, 1996.

Kaplan, Harold. Comprehensive Textbook of Psychiatry. Williams and Wilkins, 1995.

Lacy, Charles F. Drug Information Handbook. Lexi-Comp, Inc. 2002.

Ajna Hamidovic, Pharm.D.