Read our guide on Restoril vs. Ambien to learn more about these drugs and how to choose between them.
According to the American Sleep Association (ASA), 50-70 million adults in the United States suffer from a sleep disorder. One of the most common sleep disorders is insomnia, which can be described as having difficulty falling and staying asleep for at least 3 days of the week over an extended period of time. There are many factors that influence sleep such as stress, caffeine, nicotine, and alcohol. A pivotal part of the treatment process for sleep disorders like insomnia is called Cognitive Behavioral Therapy for Insomnia (CBT-I) and the use of over-the-counter supplements such as melatonin or CBD supplements. However, more often than not patients require the use of prescription medications to fall asleep and help with increasing sleep duration. 1
Through the course of this article, a more in-depth review of two prescription medications (Restoril and Ambien) will be illustrated and compared for their treatment of insomnia.
Restoril vs. Ambien: How Do They Work?
Temazepam (Restoril) belongs to a class of drugs known as benzodiazepines, which work by binding to GABA-A receptors in the brain. When benzodiazepines bind to these receptors, it calms the nerves in the brain resulting in drowsiness and ultimately producing sleep. The sedating effects of Restoril can also be used to promote muscle relaxation and treat symptoms of anxiety and seizures. 2
Ambien is a branded version of a drug called zolpidem, which belongs to a class of medications known as sedative-hypnotics. It enhances the effects of GABA (inhibitory neurotransmitter) in the brain by binding to the benzodiazepine-1 (BZ-1) receptor. The binding to this specific receptor allows Ambien to explicitly treat insomnia as opposed to helping with other symptoms such as seizures and anxiety.3
Restoril vs. Ambien: Indications, Formulations, and Strengths
The following chart illustrates the different indications, formulations, and strengths of Restoril and Ambien available in the United States.
|Temazepam (Restoril)||Insomnia||Capsule||7.5mg, 22.5mg, & 30mg|
|Zolpidem (Ambien)||Insomnia||-Oral Mist Solution
-Tablet (Extended Release)
-5mg & 10mg
-6.25mg & 12.5mg
-1.75mg, 3.5mg, 5mg, & 10mg
Restoril vs. Ambien: Side Effects
Whether you take Restoril or Ambien, there's always the possibility of experiencing side effects. Consult the chart below to see which side effects are common for Restoril and Ambien.
|Side Effects||Temazepam (Restoril)||Zolpidem (Ambien)|
In addition to the potential side effects that Restoril and Ambien can produce, these medications are controlled substances. This means there is an increased risk that Restoril and Ambien can be habit-forming and abused by patients. In addition, these medications cannot be abruptly stopped and require slow weaning of the medications due to the risks of seizures and hospitalizations. All to be considered when beginning treatment with these medications for insomnia. 4 5
Restoril vs. Ambien: Genetic Impact on Metabolism
To comprehend genetics, there needs to be a basic understanding of DNA. It is easiest to think of DNA as a code that utilizes the letters A, C, G, and T to comprise its many genes. Different combinations of these letters signify the instructions those genes utilized to produce proteins in the body. Proteins are made up of amino acids sequenced from a corresponding gene. Proteins carry out many different functions of the body and one of those functions is the breakdown or activation of medications (CYP450 enzymes). To put it simply, pharmacogenetic (PGx) testing evaluates someone’s genetic makeup to see if any variations or mutations in their genes can impact how their body responds to drugs. CYP450 enzymes are produced in the body from a unique genetic code of an individual by the liver. Having knowledge of any genetic abnormalities that can affect CYP450 enzymes can help providers select the most appropriate medications for each patient.6 Let's take a closer look at how someone’s genetics can impact Restoril or Ambien in the body.
As previously mentioned, temazepam (Restoril) falls in a class of medications known as benzodiazepines. Many benzodiazepines are impacted by CYP450 enzymes and rely on them in some cases to inactivate these medications in the body. Restoril has minor metabolism from the CYP3A4 enzyme and is not profoundly impacted by any genetic variation of this enzyme. However, there still is a low risk of Restoril building up in the body in the event that the CYP3A4 enzyme is impacted by a person’s genetics. Having this information still is helpful for prescribers because it allows for a more well-informed recommendation on dosing when starting therapy with Restoril. 7
Ambien has the potential to be impacted by many CYP450 enzymes through the course of how it's broken down in the body such as CYP3A4, CYP2C9, CYP1A2, CYP2D6, and CYP2C19. Though the supporting evidence on the genetic impact is limited for Ambien, knowing if someone is affected in any way by their genetics aids a provider in making better decisions around the use of Ambien with their patients. 8
ClarityX Pharmacogenomic (PGx) Testing
Trying to decide between two different medications can be overwhelming. ClarityX can help people make well-informed choices about their medications through pharmacogenetic (PGx) testing. Put simply, pharmacogenomic (PGx) testing evaluates your genes for variations that may affect how you metabolize certain drugs. With this information, you’ll know whether you need to adjust your dosage or avoid a drug entirely. The Mindwell test can help provide information on treatments designed for mental health conditions, including antidepressants, antipsychotics, and anxiolytics.
The Mindwell Test from ClarityX provides a seamless in-home testing experience. Simply visit the website clarityxdna.com, select the Mindwell test option from the drop-down menu, and complete the checkout process. Once the kit is received follow the package instructions, perform a simple cheek swab, then mail the sample back using the prepaid envelope. The sample is then sent to the lab for processing and the results are received by the patient or provider in 7-14 days on average.
One of the most important facts about pharmacogenetic (PGx) testing is the results can be reevaluated for future medication changes as this test does not have to be repeated for those specific genes tested. Another key function of the Mindwell test is that 130+ specific medications can be entered to be evaluated to see how an individual’s genetic makeup can affect those drugs. Pharmacogenetic (PGx) testing can provide a lifetime of knowledgeable decisions about medication selection for healthcare teams.
1 ASA Authors & Reviewers Sleep Physician at American Sleep Association Reviewers and WritersBoard-certified sleep M.D. physicians. (n.d.). Sleep statistics: Data about sleep disorders. American Sleep Association. Retrieved June 10, 2022, from ASA Authors & ReviewersSleep Physician at American Sleep Association Reviewers and WritersBoard-certified sleep M.D. physicians. (n.d.). Sleep statistics: Data about sleep disorders. American Sleep Association. Retrieved June 10, 2022, from https://www.sleepassociation.org/about-sleep/sleep-statistics/
2 Benzodiazepine Pathway, Pharmacodynamics. PharmGKB. (n.d.). Retrieved June 10, 2022, from https://www.pharmgkb.org/pathway/PA165111376
3 Zolpidem: Drug information. UpToDate. (n.d.). Retrieved June 10, 2022, from https://www.uptodate.com/contents/zolpidem-drug-information?source=auto_suggest&selectedTitle=1~1---1~4---ambie&search=ambien#F236141
4 Temazepam: Drug information. UpToDate. (n.d.). Retrieved June 10, 2022, from https://www.uptodate.com/contents/temazepam-drug-information?source=auto_suggest&selectedTitle=1~1---1~4---restori&search=restoril#F225148
5 Zolpidem: Drug information. UpToDate. (n.d.). Retrieved June 10, 2022, from https://www.uptodate.com/contents/zolpidem-drug-information?source=auto_suggest&selectedTitle=1~1---1~4---ambie&search=ambien#F236141
7 Benzodiazepine Pathway, Pharmacodynamics. PharmGKB. (n.d.). Retrieved June 10, 2022, from https://www.pharmgkb.org/pathway/PA165111376
8 Zolpidem: Drug information. UpToDate. (n.d.). Retrieved June 10, 2022, from https://www.uptodate.com/contents/zolpidem-drug-information?source=auto_suggest&selectedTitle=1~1---1~4---ambie&search=ambien#F236141