Quazepam and flurazepam: Long-term use and extended withdrawal

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Abstract
Two investigational benzodiazepine hypnotics with long half-lives (30 and 15 mg quazepam and 30 mg flurazepam) were evaluated in 47-night sleep laboratory studies. The effectiveness and side effects of these benzodiazepines were assessed during short-, intermediate- and long-term use. Subjects were also assessed for presence of rebound insomnia during the 15 days following abrupt withdrawal. Quazepam 15 and 30 mg and flurazepam 30 mg each were effective in sleep induction and maintenance after short- and intermediate-term use. Some loss of effectiveness was noted during long-term use of both doses of quazepam and, to a lesser extent, general agreement with the objective data. During the 15 nights after abrupt withdrawal of these 2 long-half-life drugs there was no rebound insomnia, either immediate or delayed. Both drugs exerted carry-over effectiveness on the first 2-3 nights after withdrawal; with quazepam this effect persisted throughout the withdrawal period. Quazepam 30 mg induced frequent side effects related to sleepiness. Side effects noted with 30 mg flurazepam were less frequent and severe, while the side effects with 15 mg quazepam were minimal. Evidently, the optimal dose of quazepam is 15 mg.