A patient takes temazepam [Restoril] for insomnia. The patient tells the nurse that a recent telephone bill lists several calls to friends that the patient does not remember making. What will the nurse do?

Question

a. Ask the patient about any alcohol con-sumption in conjunction with the benzo-diazepine.
b. Contact the prescriber to request an order for a benzodiazepine with a shorter dura-tion.
c. Reassure the patient that this is most likely caused by a paradoxical reaction to the benzodiazepine.
d. Tell the patient that this is an example of anterograde amnesia, which is an expected effect of the benzodiazepine.

Answer 1

A
This patient is describing complex sleep-related behavior, which occurs when patients carry out complex behaviors while taking benzodiazepines but have no memory of their actions. These actions can occur with normal doses but are more likely with excessive doses or when benzodia-zepines are combined with alcohol or other CNS depressants, so the nurse is correct in evaluating this possibility. The duration of the benzodiazepine does not contribute to this phenomenon. Pa-radoxical effects of benzodiazepines include insomnia, excitation, euphoria, anxiety, and rage. Anterograde amnesia occurs when patients have impaired recall of events that occur after dosing.