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Restoril vs Dalmane
Introduction
For patients dealing with insomnia or other sleep disorders, certain drugs that affect the activity of neurotransmitters in the brain can aid in inducing sleep and managing symptoms. Restoril and Dalmane are two such medications often prescribed for these conditions. Both influence GABA receptors in the brain, a key neurotransmitter involved in promoting sleep. Restoril is a benzodiazepine hypnotic agent which increases total sleep time by reducing how long it takes to fall asleep while also minimizing nighttime awakenings. Dalmane, on the other hand, is another type of benzodiazepine used primarily for its sedative-hypnotic properties; it helps induce and maintain sleep but may create more pronounced aftereffects upon waking such as grogginess or cognitive impairment.
What is Restoril?
Temazepam (the generic name for Restoril) and Flurazepam (the generic name for Dalmane) are both drugs from the class of benzodiazepines, which represented a significant advancement over barbiturates, the earlier class of sedative-hypnotic medications. Temazepam was first approved by the FDA in 1981. It enhances the activity of GABA receptors, a neurotransmitter in the brain that inhibits brain activity, thereby creating a calming effect to aid sleep. This drug is typically prescribed as short-term treatment for insomnia.
Restoril works selectively on GABA receptors with little to no influence on other neurotransmitters such as dopamine or serotonin- this results in fewer side effects compared to other sleep aids which may have stronger effects on these neurotransmitters. However, it's important to note that all benzodiazepines carry risks such as dependency and withdrawal symptoms upon cessation after long term use.
What conditions is Restoril approved to treat?
Restoril is approved for the treatment of insomnia symptoms, such as:
- Trouble falling asleep
- Frequent night-time awakenings
- Early morning awakenings
It can also be used short-term for patients with sleep disturbances including difficulty in falling asleep and/or frequent nocturnal awakening.
How does Restoril help with these illnesses?
Restoril, known generically as temazepam, helps manage insomnia by enhancing the effects of a neurotransmitter called gamma-aminobutyric acid (GABA) in the brain. It does this by binding to GABA receptors and increasing their activity, leading to sedation. GABA is an inhibitory neurotransmitter that reduces neuronal excitability throughout the nervous system. Its increased activity results in a calming effect which can aid with sleep initiation and maintenance. In contrast, individuals who have insomnia are believed to have relatively lower levels of GABA or decreased reactivity to it. Therefore, by enhancing the efficacy of GABA, Restoril can mitigate insomnia symptoms and help patients attain better quality sleep.
What is Dalmane?
Dalmane, the brand name for flurazepam, is a benzodiazepine. As such, it acts on GABA receptors in the brain to produce sedative and hypnotic effects. This makes it an effective treatment for insomnia and certain sleep disorders. Flurazepam was first approved by the FDA in 1970.
As a benzodiazepine, Dalmane does not act on serotonin or norepinephrine reuptake mechanisms like antidepressants do. Therefore its side-effect profile is different from that of SSRIs such as Prozac or NDRI drugs like Wellbutrin. The primary side effect of concern with Dalmane is drowsiness which can persist into the following day; this may be beneficial for individuals suffering from severe insomnia but could disrupt normal daily activities if not managed carefully.
Flurazepam's action on GABA receptors also means that it has potential for dependence and withdrawal syndrome after prolonged use - these are common concerns with all benzodiazepines and something patients need to consider when choosing between treatments such as Restoril (temazepam) and Dalmane.
What conditions is Dalmane approved to treat?
Dalmane, more commonly known by its generic name flurazepam, is a prescription drug that has been approved for use in the treatment of certain conditions such as:
- Insomnia (short-term treatment)
- Sleep disturbances and disorders This medication works by slowing down activity in your brain to allow sleep. It's important to remember that Dalmane should not be used for long periods due to potential dependency issues. Always use this medication under the supervision of a healthcare provider.
How does Dalmane help with these illnesses?
Dalmane, like Restoril, is a benzodiazepine that acts on the central nervous system by enhancing the effects of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter in the brain. This results in sedative, hypnotic (sleep-inducing), anxiolytic (anti-anxiety), anticonvulsant and muscle relaxant properties.
Dalmane works primarily by increasing levels of GABA available in the brain, thereby promoting sleep and reducing anxiety. Its action on other neurotransmitters may also contribute to its efficacy as a sedative-hypnotic medication. Because it does not significantly affect serotonin levels, Dalmane can sometimes be prescribed when a patient does not respond well to typical SSRI antidepressants or certain insomnia medications such as Restoril. In some cases, it might even be combined with these types of drugs for enhanced effectiveness.
How effective are both Restoril and Dalmane?
Both temazepam (Restoril) and flurazepam (Dalmane) are benzodiazepines approved by the FDA for short-term treatment of insomnia, particularly when it involves difficulty falling asleep. They act on similar neurotransmitters by enhancing GABA's inhibitory effects in the central nervous system, which helps induce sleep. Their effectiveness was directly studied in several clinical trials; both drugs exhibited similar efficacy in managing symptoms of insomnia as well as comparable safety profiles.
A 1981 review of research found that temazepam provides significant improvement in sleep latency and maintenance with minimal side effects like daytime drowsiness or rebound insomnia. The optimal dose for treating insomnia is thought to be 15-30 mg/day taken shortly before bedtime.
Flurazepam was evaluated in a 1973 study where it demonstrated effectiveness at reducing time to fall asleep and increasing total sleep duration at doses ranging from 15-30 mg/nightly. However, its longer half-life can lead to excessive daytime sedation, especially among older patients.
While both medications are effective options for treating short-term bouts of insomnia, they should not typically be first-line treatment options due to risks associated with long-term use such as dependency or withdrawal symptoms upon discontinuation. These medicines may work best when used intermittently rather than nightly over an extended period.
At what dose is Restoril typically prescribed?
Oral dosages of Restoril typically range from 7.5–30 mg/day, with studies indicating that a dose of 15 mg/day is generally sufficient for treating insomnia in most adults. Elderly or debilitated patients may be started on a lower dose of 7.5 mg/day to minimize the potential for oversedation, dizziness, or impaired motor functioning. In either population, dosage can be increased after careful monitoring if there is no response. The maximum dosage that should not be exceeded in any case is 30 mg/day.
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At what dose is Dalmane typically prescribed?
Dalmane treatment typically begins at a dosage of 15-30 mg/day, taken orally before bedtime. The dose can be adjusted based on individual response to medication and tolerability, with an increased dose of up to 45 mg/day if necessary. However, the maximum recommended daily dose is 60 mg, divided into two doses (if needed), spaced around 6 hours apart. This maximum dosage may be considered if there's no satisfactory response to treatment after several weeks at lower dosages. Always remember that this medicine should only be used for short periods (1-2 weeks) due to the risk of dependency.
What are the most common side effects for Restoril?
While Restoril and Dalmane both serve as sedative-hypnotics, they do have distinct side effect profiles. For Restoril (temazepam), users may experience:
- Drowsiness or sleepiness
- Dizziness, unsteadiness
- Fatigue
- Headache
- Nervousness
- Dry mouth
- Nausea or vomiting
- Changes in libido (sex drive)
On the other hand, with Dalmane (flurazepam), common side effects include:
- Daytime drowsiness/ "hangover" feeling
- Memory problems,
- Feeling unsteady,
- Coordination issues,
- Vivid or abnormal dreams.
It's important to remember that not everyone experiences these side effects and if they do occur, they are usually temporary. However, if any of these symptoms persist or become bothersome, you should contact your healthcare provider immediately.
Are there any potential serious side effects for Restoril?
While taking Restoril, you should be aware of the potential for severe side effects, though these are rare. These might include:
- An allergic reaction: signs can include difficulty breathing; hives; swelling of your face, lips, tongue or throat
- Changes in mood or behavior such as agitation, hallucinations and suicidal thoughts
- New or worsening depression
- Confusion and unusual thought patterns
- Unusual risk-taking behaviour like seeking out dangerous activities
- Signs of low sodium levels in the body - headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination leading to feeling unsteady.
Similarly with Dalmane (flurazepam), some serious side effects can occur which may need immediate medical attention. These can include:
- Severe drowsiness that impacts daily activities
- Mood swings including aggression or agitation
- Memory problems
- Depression including thoughts about suicide or self-harm.
If you experience any symptoms mentioned above while using either medication it's important to stop taking them immediately and seek medical advice right away. Remember never change your dosage without consulting your healthcare provider first!
What are the most common side effects for Dalmane?
Dalmane, a similar medication to Restoril, can induce certain side effects in users. These may include:
- Dry mouth or altered taste
- Drowsiness during the day
- Nausea or upset stomach
- Headache or dizziness
- Feeling nervous or excited (rare)
- Skin rash (rare)
It's worth noting that Dalmane is designed to help you fall asleep and stay asleep; therefore, it might also cause unusual dreams and memory problems. More serious side effects like confusion, hallucinations, changes in behavior or mood swings should be reported immediately to your healthcare professional. Keep in mind that this list does not cover all possible side effects of Dalmane - always consult with your doctor for personalized advice.
Are there any potential serious side effects for Dalmane?
While Dalmane is generally considered safe, it can occasionally induce serious side effects. These may include:
- Signs of an allergic reaction such as hives, itching, difficulty breathing or swelling of the face, lips, tongue or throat
- Mood changes and unusual thoughts or behavior; this could be new depression symptoms or suicidal ideation
- Confusion and hallucinations (seeing things that are not there)
- Unusual risk-taking behavior
- A decrease in inhibitions leading to inappropriate behavior
- Agitation and aggression
- Memory problems
- Slow heart rate combined with feeling like you might pass out.
If any of these severe side effects occur while taking Dalmane, stop using it immediately and seek medical attention.
Contraindications for Restoril and Dalmane?
Both Restoril and Dalmane, like many other sedative-hypnotics, may worsen symptoms of depression in some people. If you notice your depression worsening, or an increase in suicidal ideation, thoughts, or behavior while using these medications, please seek immediate medical attention.
Neither Restoril nor Dalmane should be taken if you are consuming alcohol or have been abusing drugs. Always tell your physician about any substance use; these substances can interact dangerously with both Restoril and Dalmane causing severe side effects such as respiratory distress or even death.
In addition to this warning regarding substance abuse interaction with sedative-hypnotic medication like Restoril and Dalmane – it is also important to note that neither of these medicines should be taken by individuals who have a history of addictive disorders unless under strict supervision due to their high potential for dependence.
How much do Restoril and Dalmane cost?
For brand-name versions of these drugs:
- The price for 30 capsules of Restoril (temazepam) at 15 mg averages around $185, which equates to approximately $6/day.
- In contrast, the cost for 30 capsules of Dalmane (flurazepam) at 15 mg is roughly $230, working out to about $7.60 per day.
As a result, if you're taking similar doses for both medications, then using brand-name Restoril can be less expensive on a daily basis. It's important to note that personal health considerations should take precedence over cost when deciding between these two drugs.
When it comes to generic versions of temazepam and flurazepam, costs are generally lower:
-
Temazepam (15 mg tablets) is available in packs from 10 up to several hundred tablets with approximate costs ranging from about $0.50 - $2 per day depending on your dosage and quantity purchased.
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Flurazepam also offers multiple pack sizes starting as low as ten capsules with prices approximately ranging from around $0.70 - $3 per day dependent upon the number bought upfront and dose administered daily.
Popularity of Restoril and Dalmane
Temazepam, in generic form as well as under brand names such as Restoril, was estimated to have been prescribed to about 3.1 million people in the US in 2020. Temazepam accounted for just over 7% of benzodiazepine prescriptions in the US. It is commonly used for short-term treatment of insomnia, particularly difficulty falling asleep.
Flurazepam, including brand versions such as Dalmane, was prescribed significantly less frequently with an estimation of around 100 thousand prescriptions filled in the same year. In comparison to temazepam's market share among benzodiazepines, flurazepam accounts for a little under 1%. Like temazepam, it is also primarily used for treating insomnia but its prevalence has been decreasing over recent years due to concerns about potential side effects and dependency issues associated with long-term use.
Conclusion
Both Restoril (temazepam) and Dalmane (flurazepam) have a long history of use in the treatment of insomnia, with numerous clinical studies indicating their efficacy over placebo treatments. They work by enhancing the effect of GABA, a neurotransmitter that inhibits activity in the brain, thereby promoting sleep. While both drugs may be used together under certain circumstances, this is subject to careful consideration by a physician given they can potentiate each other's effects which could lead to excessive sedation or respiratory depression.
Restoril tends to be prescribed for short-term use due to its shorter half-life compared to Dalmane; however, it has an advantage in terms of causing fewer next-day residual effects. Dalmane might be considered when longer duration of action is needed but comes with more pronounced potential for hangover-like symptoms.
Both medications are available as generics offering cost savings particularly significant for those paying out-of-pocket. Both Restoril and Dalmane often require an adjustment period whereby optimal therapeutic effects might not be achieved immediately.
The side-effect profiles are similar between these two benzodiazepines with drowsiness, dizziness and lightheadedness being common. However, patients should monitor themselves closely especially during initiation or change in dosage for unusual changes such as memory problems or mood/behavior changes including thoughts about self-harm and should seek immediate medical help if these occur.