Estazolam
Estazolam
Definition
Estazolam is a sedative-hypnotic drug belonging to the class of drugs known as benzodiazepines. It is sold in the United States under the names ProSom and Sedarest.
Purpose
Estazolam is used as a short-term treatment for insomnia . Given at bedtime, estazolam can help patients who have trouble falling asleep, staying asleep, or who have unwanted early morning awakening.
Description
Estazolam belongs to a group of drugs called benzodiazepines. Benzodiazepines are sedative-hypnotic drugs that help to relieve nervousness, tension, and other anxiety symptoms by slowing the central nervous system. To do this, they block the effects of a specific chemical involved in the transmission of nerve impulses in the brain , decreasing the excitement level of the nerve cells.
Estazolam, like other benzodiazepines, can be habit-forming and can cause tolerance. Tolerance occurs when a given dosage has less and less effect when the drug is taken over a long time. Therefore, estazolam is recommended only for short-term use.
Estazolam is available in 1- and 2-mg tablets, for oral use.
Recommended dosage
Adults are usually prescribed a single 1-2 mg dose of estazolam to be taken at bedtime. The elderly (over age 60) or people with serious health problems require much smaller doses, and are usually started at 0.5 mg at bedtime.
Precautions
Care must be taken when prescribing this medication to anyone with decreased liver or kidney functioning; the elderly; those with a history of substance abuse, depression , respiratory depression (such as asthma, chronic obstructive pulmonary disease, chronic bronchitis, or other chronic respiratory diseases); narrow-angle glaucoma; or known sleep apnea. People with these health conditions should discuss the risks and benefits of using estazolam with their doctor before starting treatment.
Pregnant women should not use estazolam, because it causes damage to the developing fetus. Because estazolam shows up in breast milk, women who are breast-feeding should not take this drug.
Because estazolam is a nervous system and respiratory depressant, it should not be taken with other such depressants, such as alcohol or other sedatives , sleeping pills, or tranquilizers. Furthermore, patients should not drive, operate dangerous machinery, or engage in hazardous activities until the drug’s effects have worn off.
Suddenly discontinuing estazolam after several weeks of use may cause uncomfortable symptoms of withdrawal. Patients should discuss with their doctor how to discontinue estazolam use gradually to avoid such symptoms.
Side effects
The most common side effects of estazolam include sleepiness, slowness of movement, dizziness, and difficulty with coordination.
KEY TERMS
Benzodiazapines —A group of central nervous system depressants used to relieve anxiety or to induce sleep.
Delusion —A false belief that is resistant to reason or contrary to actual fact.
Depressant —Something that slows down functioning.
Glaucoma —A group of eye diseases characterized by increased pressure within the eye significant enough to damage eye tissue and structures. If untreated, glaucoma results in blindness.
Hallucinations —False sensory perceptions. A person experiencing a hallucination may “hear” sounds or “see” people or objects that are not really present. Hallucinations can also affect the senses of smell, touch, and taste.
Sleep apnea —Short periods where a person stops breathing during sleep. Breathing restarts spontaneously, however, this condition can lead a lack of oxygen in the body.
Less common side effects include anxiety, confusion, depression, memory loss for events occurring after the drug is taken, increased heart rate, and pounding or irregular heartbeat.
Rare side effects include confused thinking, dis-orientation, delusions , irritability, agitation, hallucinations, seizures , bizarre and/or aggressive behavior, a drop in blood pressure, weak muscles, skin rash or itching, sores in mouth or throat, fever and chills, difficulty sleeping, odd body and/or eye movements, unusual bruising or easy bleeding, severe fatigue or weakness, and yellow eyes or skin (jaundice).
Interactions
Cimetidine (Tagamet), disulfiram (Antabuse), and erythromycin (an antibiotic) may increase estazolm’s sedative effects.
Rifampin may decrease the effects of estazolam.
Resources
BOOKS
Mosby’s Drug Consult. St. Louis: Mosby, 2002.
Preston, John D., John H. O’Neal, and Mary C. Talaga. Handbook of Clinical Psychopharmacology for Therapists, 4th ed. Oakland, CA: New Harbinger Publications, 2004.
PERIODICALS
Rosenberg, Russell P. “Sleep Maintenance Insomnia:
Strengths and Weaknesses of Current Pharmacologic Therapies.” Annals of Clinical Psychiatry 18.1 (Jan.-Mar.) 2006: 49–56.
Rosalyn Carson-DeWitt, MD
Ruth A. Wienclaw, PhD