Skip Navigation



Family Practice Advance Access published online on February 18, 2005
Family Practice, doi:10.1093/fampra/cmh726
This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
22/2/152    most recent
cmh726v1
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by Wegman, A. C. M.
Right arrow Articles by de Vries, Th. P. G. M
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Wegman, A. C. M.
Right arrow Articles by de Vries, Th. P. G. M
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author (2005). Published by Oxford University Press. All rights reserved.
Received July 6, 2004
Accepted September 27, 2004

Article

Efficacy of temazepam in frequent users: a series of N-of-1 trials

A. C. M. Wegman 1, D. A. W. M. van der Windt 2*, M. Bongers 2, J. W. R. Twisk 3, W. A. B. Stalman 2, and Th. P. G. M de Vries 4

1 Institute for Research in Extramural Medicine, VU University Medical Center, Amsterdam; Department of General Practice, VU University Medical Center, Amsterdam; Department of Medical Pharmacology/Pharmacotherapy, VU University Medical Center, Amsterdam
2 Institute for Research in Extramural Medicine, VU University Medical Center, Amsterdam; Department of General Practice, VU University Medical Center, Amsterdam
3 Institute for Research in Extramural Medicine, VU University Medical Center, Amsterdam; Department of Clinical Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
4 Department of Medical Pharmacology/Pharmacotherapy, VU University Medical Center, Amsterdam

* To whom correspondence should be addressed.
D. A. W. M. van der Windt, E-mail: dawm.vanderwindt{at}vumc.nl


  Abstract

Background. Benzodiazepines are frequently prescribed for sleep disturbances. However, benzodiazepines are associated with side effects, and may be ineffective when used for a prolonged period of time.

Objectives. To investigate for individual patients whether placebo was as effective as temazepam, or whether 10 mg was as effective as 20 mg temazepam, and whether these results influenced their future temazepam use.

Methods. A series of randomized double-blind N-of-1 trials were conducted in general practices in The Netherlands for patients who were using temazepam regularly. Each patient received five pairs of treatments consisting of one week of temazepam (10 or 20 mg) and one week of the control intervention (placebo or 10 mg temazepam). Per pair, the sequence of treatments was randomized. Main outcome measures were: time to fall asleep, and the individual main complaint.

Results. Twelve out of 15 patients completed their trial. In three patients there was no difference, in five a large difference, and in four a small difference in favour of temazepam. At follow-up, seven patients had stopped or reduced their temazepam use.

Conclusion. The results regarding the efficacy of temazepam varied across patients. N-of-1 trials seem to be valuable in patients who are motivated to stop or reduce their temazepam use. They clearly demonstrate the efficacy of temazepam, and may give patients additional confidence to discontinue regular hypnotic use. The value of N-of-1 trials for patients who are less motivated is unclear, as the size of treatment effect does not seem to influence future hypnotic use.

Keywords: Benzodiazepines; hypnotics and sedatives; placebos; randomized controlled trials; temazepam.
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Behav Res MethodsHome page
I. BULTE and P. ONGHENA
An R package for single-case randomization tests
Behav Res Methods, May 1, 2008; 40(2): 467 - 478.
[Abstract] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.