Temazepam Can Cause Tremor in Elderly Patients
Yes, temazepam can cause tremor in elderly patients as it is listed as a potential adverse effect of benzodiazepines, particularly in older adults who are more susceptible to medication side effects.
Mechanism and Risk Factors
- Benzodiazepines like temazepam can cause various central nervous system effects including tremor, especially in elderly patients who have increased sensitivity to these medications 1
- Risk factors that increase the likelihood of tremor with temazepam in the elderly include:
Evidence for Tremor as an Adverse Effect
- Benzodiazepines are known to potentially cause tremor as a side effect, particularly in elderly patients 3
- Quinidine, which shares some pharmacological properties with benzodiazepines in terms of CNS effects, is specifically listed as causing tremor as a common adverse effect 1
- The American Geriatrics Society Beers Criteria® identifies benzodiazepines as potentially inappropriate medications in older adults due to increased sensitivity to adverse effects, including motor impairments 1
Recommendations for Elderly Patients
- Start with lower doses of temazepam in elderly patients (7.5 mg rather than standard adult doses) to minimize adverse effects including tremor 1, 4
- Monitor elderly patients closely for the development of tremor and other adverse effects when initiating temazepam 1
- Consider that benzodiazepines in general should be used with caution in the elderly due to increased risk of adverse effects 1
- Be aware that benzodiazepines can cause paradoxical reactions in approximately 10% of elderly patients, which may include agitation and tremor 1
Management of Temazepam-Induced Tremor
- If tremor develops, consider dose reduction or medication discontinuation 3
- Taper temazepam gradually rather than stopping abruptly to avoid withdrawal symptoms 1
- Consider alternative non-benzodiazepine options for insomnia in elderly patients who develop tremor 1
- Evaluate for drug interactions that may be exacerbating tremor, as polypharmacy is common in the elderly 1
Alternative Options for Elderly Patients with Insomnia
- Non-pharmacological approaches should be considered first-line for insomnia in elderly patients 1
- If medication is necessary, consider agents with fewer adverse effects in the elderly 1
- Melatonin receptor agonists like ramelteon may have a more favorable side effect profile than benzodiazepines 1
- Short-term, intermittent use of hypnotics is preferable to continuous use in elderly patients 4
Important Precautions
- Elderly patients taking temazepam should be cautioned about the increased risk of falls, which may be related to tremor and other CNS effects 1
- Drug-induced tremor usually resolves once the medication is discontinued, but may persist in some cases 3
- Benzodiazepines should generally be avoided in elderly patients with a history of falls or cognitive impairment 1
- Prescriptions for benzodiazepines in the elderly should be limited in quantity to avoid long-term use and associated adverse effects 2