View source for Tetrazepam

{{Drugbox|
|IUPAC_name = 7-Chloro-5-cyclohex-1-en-1-yl-1-methyl-1,3-dihydro-2''H''-1,4-benzodiazepin-2-one
| image=Tetrazepam Structural Formulae.png
| width = 230
| image2=Tetrazepam3d.png
| width2 = 200
| CAS_number=10379-14-3
| ChemSpiderID = 23551
| ATC_prefix=M03
| ATC_suffix=BX07
| ATC_supplemental=
| PubChem=25215
| DrugBank=
| C=16 | H=17 | Cl=1 | N=2 | O=1 
| molecular_weight = 288.772
| bioavailability= 
| metabolism = 
| elimination_half-life= 3-26 hours
| excretion =  
| pregnancy_category = 
| legal_status = Schedule IV US
| routes_of_administration= Oral
}}
'''Tetrazepam''', (and is marketed under the following brand names, '''Clinoxan''', '''Epsipam''', '''Myolastan''', '''Musaril''', '''Relaxam''' and '''Spasmorelax''') is a [[benzodiazepine]] derivative with [[anticonvulsant]], [[anxiolytic]], [[hypnotic]] and [[muscle relaxant]] properties. It is used mainly in [[Austria]], [[France]], [[Belgium]], [[Germany]] and [[Spain]] to treat muscle spasm, anxiety disorders such as [[panic attacks]], or more rarely to treat [[clinical depression|depression]], [[premenstrual syndrome]] or [[agoraphobia]]. Tetrazepam has relatively little [[sedative]] effect at low doses while still producing useful muscle relaxation and anxiety relief.

Delayed type 4 allergic hypersensitivity reactions including [[aculopapular exanthema]], [[erythematous rash]], [[urticarial eruption]], [[erythema multiforme]], [[photodermatitis]], [[eczema]] and [[Stevens-Johnson syndrome]] can occasionally occur as a result of tetrazepam exposure. These hypersensitivity reactions to tetrazepam share no cross-reactivity with other benzodiazepines.<ref name=agepdtt>{{cite journal |pmid=18447141 |url=http://www.jiaci.org/issues/vol18issue2/7.pdf |year=2008 |last1=Thomas |first1=E |last2=Bellón |last3=Barranco |last4=Padial |last5=Tapia |last6=Morel |last7=Alves-Ferreira |last8=Martín-Esteban |title=Acute generalized exanthematous pustulosis due to tetrazepam |volume=18 |issue=2 |pages=119–22 |issn=1018-9068 |journal=Journal of investigational allergology & clinical immunology : official organ of the International Association of Asthmology (INTERASMA) and Sociedad Latinoamericana de Alergia e Inmunologia |first2=T |first3=P |first4=A |first5=B |first6=E |first7=J |first8=M }}</ref>

==Indications==
Tetrazepam is used therapeutically as a muscle relaxant.<ref>{{cite journal |pmid=2567153 |year=1989 |month= January|last1=Simiand |first1=J |last2=Keane |last3=Biziere |last4=Soubrie |title=Comparative study in mice of tetrazepam and other centrally active skeletal muscle relaxants |volume=297 |pages=272–85 |issn=0301-4533 |journal=Archives internationales de pharmacodynamie et de therapie |url= |format= |first2=PE |first3=K |first4=P }}</ref><ref>{{cite journal |pmid=8961167 |year=1996 |month= November|last1=Perez-Guerrero |first1=C |last2=Herrera |last3=Marhuenda |title=Relaxant effect of tetrazepam on rat uterine smooth muscle: role of calcium movement. |volume=48 |issue=11 |pages=1169–73 |issn=0022-3573 |journal=The Journal of pharmacy and pharmacology |url= |format= |first2=MD |first3=E }}</ref>

==Availability==
The indicated adult dose for muscle spasm is 50&nbsp;mg three to four times per day, increased if necessary to a ''maximum'' of 800&nbsp;mg per day, in ''divided doses''. Tetrazepam is not generally recommended for use in children, except on the advice of a specialist.

Tetrazepam is only available in one strength and formulation, 50&nbsp;mg [[tablets]]. The [[benzodiazepine equivalent]] of tetrazepam is ''approximately'' 5&nbsp;mg of [[diazepam]].<ref>{{cite web| url= http://www.non-benzodiazepines.org.uk/benzodiazepine-names.html| title=Benzodiazepine Names| accessdate=2009-04-05| publisher=non-benzodiazepines.org.uk}}</ref>

==Adverse effects==
Allergic reactions to tetrazepam occasionally occur involving the skin.<ref name=agepdtt/>

Allergic reactions can develop to tetrazepam<ref>{{cite journal |pmid=2140761 |year=1990 |month= April|last1=Camarasa |first1=JG |last2=Serra-Baldrich |title=Tetrazepam allergy detected by patch test |volume=22 |issue=4 |pages=246 |issn=0105-1873 |journal=Contact dermatitis |doi=10.1111/j.1600-0536.1990.tb01587.x |first2=E }}</ref><ref>{{cite journal |pmid=1356710 |year=1992 |month= April|last1=Collet |first1=E |last2=Dalac |last3=Morvan |last4=Sgro |last5=Lambert |title=Tetrazepam allergy once more detected by patch test |volume=26 |issue=4 |pages=281 |issn=0105-1873 |journal=Contact dermatitis |doi=10.1111/j.1600-0536.1992.tb00259.x |first2=S |first3=C |first4=C |first5=D }}</ref> and it is considered to be a potential allergen.<ref>{{cite journal |pmid=7493477 |year=1995 |month= July|last1=Ortiz-Frutos |first1=FJ |last2=Alonso |last3=Hergueta |last4=Quintana |last5=Iglesias |title=Tetrazepam: an allergen with several clinical expressions |volume=33 |issue=1 |pages=63–5 |issn=0105-1873 |journal=Contact dermatitis |doi=10.1111/j.1600-0536.1995.tb00462.x |first2=J |first3=JP |first4=I |first5=L }}</ref><ref>{{cite journal |pmid=10604563 |year=1999 |month= November|last1=Del Pozo |first1=MD |last2=Blasco |last3=Lobera |title=Tetrazepam allergy. |volume=54 |issue=11 |pages=1226–7 |issn=0105-4538 |journal=Allergy |doi=10.1034/j.1398-9995.1999.00362.x |first2=A |first3=T }}</ref> Drug rash and drug-induced [[eosinophilia]] with systemic symptoms is a known complication of tetrazepam exposure.<ref>{{cite journal |pmid=18666600 |year=2007 |month= November|last1=Dinić-Uzurov |first1=V |last2=Lalosević |last3=Milosević |last4=Urosević |last5=Lalosević |last6=Popović |title=Current differential diagnosis of hypereosinophilic syndrome |volume=60 |issue=11-12 |pages=581–6 |issn=0025-8105 |journal=Medicinski pregled |doi=10.2298/MPNS0712581D |first2=V |first3=I |first4=I |first5=D |first6=S }}</ref><ref>{{cite journal |pmid=18031497 |year=2008 |month= July|last1=Bachmeyer |first1=C |last2=Assier |last3=Roujeau |last4=Blum |title=Probable drug rash with eosinophilia and systemic symptoms syndrome related to tetrazepam. |volume=22 |issue=7 |pages=887–9 |issn=0926-9959 |doi=10.1111/j.1468-3083.2007.02490.x |journal=Journal of the European Academy of Dermatology and Venereology : JEADV |first2=H |first3=JC |first4=L }}</ref> These hypersensitive allergic reactions can be of the [[Type IV hypersensitivity|delayed type]].<ref>{{cite journal |pmid=9404574 |year=1997 |month= November|last1=Blanco |first1=R |last2=Díez-Gómez |last3=Gala |last4=Quirce |title=Delayed hypersensitivity to tetrazepam. |volume=52 |issue=11 |pages=1146–7 |issn=0105-4538 |journal=Allergy |doi=10.1111/j.1398-9995.1997.tb00194.x |first2=ML |first3=G |first4=S }}</ref><ref>{{cite journal |pmid=8681544 |year=1996 |month= February|last1=Ortega |first1=NR |last2=Barranco |last3=López Serrano |last4=Romualdo |last5=Mora |title=Delayed cell-mediated hypersensitivity to tetrazepam |volume=34 |issue=2 |pages=139 |issn=0105-1873 |journal=Contact dermatitis |doi=10.1111/j.1600-0536.1996.tb02147.x |first2=P |first3=C |first4=L |first5=C }}</ref><ref>{{cite journal |pmid=8565501 |year=1995 |month= November|last1=Kämpgen |first1=E |last2=Bürger |last3=Bröcker |last4=Klein |title=Cross-reactive type IV hypersensitivity reactions to benzodiazepines revealed by patch testing |volume=33 |issue=5 |pages=356–7 |issn=0105-1873 |journal=Contact dermatitis |doi=10.1111/j.1600-0536.1995.tb02060.x |first2=T |first3=EB |first4=CE }}</ref>

[[Toxic epidermal necrolysis]] has occurred from the use of tetrazepam<ref>{{cite journal |pmid=16650186 |year=2006 |month= April|last1=Delesalle |first1=F |last2=Carpentier |last3=Guatier |last4=Delaporte |title=Toxic epidermal necrolysis caused by tetrazepam. |volume=45 |issue=4 |pages=480 |issn=0011-9059 |doi=10.1111/j.1365-4632.2006.02654.x |journal=International journal of dermatology |first2=O |first3=S |first4=E }}</ref><ref>{{cite journal |pmid=17040464 |year=2006 |month= October|last1=Wolf |first1=R |last2=Orion |last3=Davidovici |title=Toxic epidermal necrolysis caused by tetrazepam. |volume=45 |issue=10 |pages=1260–1 |issn=0011-9059 |doi=10.1111/j.1365-4632.2006.03061.x |journal=International journal of dermatology |first2=E |first3=B }}</ref> including at least one reported death.<ref>{{cite journal |pmid=11471372 |year=2001 |month= March|last1=Lagnaoui |first1=R |last2=Ramanampamonjy |last3=Julliac |last4=Haramburu |last5=Ticolat |title=Fatal toxic epidermal necrolysis associated with tetrazepam. |volume=56 |issue=2 |pages=187–8 |issn=0040-5957 |journal=Therapie |first2=R |first3=B |first4=F |first5=R }}</ref> [[Stevens-Johnson syndrome]] and [[erythema multiforme]] has been reported from use of tetrazepam. Cross-reactivity with other benzodiazepines does not typically occur in such patients.<ref>{{cite journal |pmid=12492544 |year=2002 |month= September|last1=Pirker |first1=C |last2=Misic |last3=Brinkmeier |last4=Frosch |title=Tetrazepam drug sensitivity -- usefulness of the patch test. |volume=47 |issue=3 |pages=135–8 |issn=0105-1873 |journal=Contact dermatitis |doi=10.1034/j.1600-0536.2002.470302.x |first2=A |first3=T |first4=PJ }}</ref><ref>{{cite journal |pmid= 9645262|date=2 March 1998|last1=Sánchez |first1=I |last2=García-Abujeta |last3=Fernández |last4=Rodríguez |last5=Quiñones |last6=Duque |last7=López |last8=Jerez |title=Stevens-Johnson syndrome from tetrazepam. |volume=26 |issue=2 |pages=55–7 |issn=0301-0546 |journal=Allergologia et immunopathologia |url=http://www.elsevier.es/revistas/ctl_servlet?_f=7064&ip=90.216.52.234&articuloid=13011386&revistaid=105 |first2= JL |first3= L |first4= F |first5= D |first6= S |first7= R |first8= J }}</ref><ref>{{cite journal |pmid=11093904 |year=2000 |month= September|last1=Rodríguez Vázquez |first1=M |last2=Ortiz De Frutos |last3=Del Río Reyes |last4=Iglesias Díez |title=Erythema multiforme by tetrazepam |volume=115 |issue=9 |pages=359 |issn=0025-7753 |journal=Medicina clinica |first2=J |first3=R |first4=L }}</ref> [[Exanthema]]<ref>{{cite journal |pmid=11173688 |year=2000 |month= December|last1=Ghislain |first1=PD |last2=Roussel |last3=Bouffioux |last4=Delescluse |title=Tetrazepam (Myolastan)-induced exanthema: positive patch tests in 2 cases |volume=127 |issue=12 |pages=1094–6 |issn=0151-9638 |journal=Annales de dermatologie et de venereologie |first2=S |first3=B |first4=J }}</ref> and [[eczema]] may occur.<ref>{{cite journal |pmid=19453384 |year=2009 |month= April|last1=Breuer |first1=K |last2=Worm |last3=Skudlik |last4=Schröder |last5=John |title=Occupational airborne contact allergy to tetrazepam in a geriatric nurse. |issn=1610-0379 |doi=10.1111/j.1610-0387.2009.07096.x |journal=Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG |first2=M |first3=C |first4=C |first5=SM |volume=7 |issue=10 |pages=896–8 }}</ref> The lack of cross-reactivity with other benzodiazepines is believed to be due to the molecular structure of tetrazepam.<ref>{{cite journal |pmid=19659970 |year=2009 |month= July|last1=Barbaud |first1=A |last2=Girault |last3=Schmutz |last4=Weber-Muller |last5=Trechot |title=No cross-reactions between tetrazepam and other benzodiazepines: a possible chemical explanation. |volume=61 |issue=1 |pages=53–6 |issn=0105-1873 |doi=10.1111/j.1600-0536.2009.01558.x |journal=Contact dermatitis |first2=PY |first3=JL |first4=F |first5=P }}</ref><ref name=emtt>{{cite journal |pmid=17583114 |url=http://www.jiaci.org/issues/vol17issue03/14to17.pdf |format=PDF |year=2007 |last1=Cabrerizo Ballesteros |first1=S |last2=Méndez Alcalde |last3=Sánchez Alonso |title=Erythema multiforme to tetrazepam. |volume=17 |issue=3 |pages=205–6 |issn=1018-9068 |journal=Journal of investigational allergology & clinical immunology : official organ of the International Association of Asthmology (INTERASMA) and Sociedad Latinoamericana de Alergia e Inmunologia |first2=JD |first3=A }}</ref> [[Photodermatitis]]<ref>{{cite journal |pmid=9746190 |year=1998 |month= August|last1=Quiñones |first1=D |last2=Sanchez |last3=Alonso |last4=Garcia-Abujeta |last5=Fernandez |last6=Rodriguez |last7=Martin-Gil |last8=Jerez |title=Photodermatitis from tetrazepam. |volume=39 |issue=2 |pages=84 |issn=0105-1873 |journal=Contact dermatitis |doi=10.1111/j.1600-0536.1998.tb05840.x |first2=I |first3=S |first4=JL |first5=L |first6=F |first7=D |first8=J }}</ref> and [[phototoxicity]] have also been reported.<ref>{{cite journal |pmid=9840980 |year=1998 |last1=Schwedler |first1=S |last2=Mempel |last3=Schmidt |last4=Abeck |last5=Ring |title=Phototoxicity to tetrazepam - A new adverse reaction. |volume=197 |issue=2 |pages=193–4 |issn=1018-8665 |journal=Dermatology (Basel, Switzerland) |first2=M |first3=T |first4=D |first5=J }}</ref> Occupational [[contact allergy]] can also develop from regularly handling tetrazepam.<ref>{{cite journal |pmid=11417526 |year=2001 |month= June|last1=Choquet-Kastylevsky |first1=G |last2=Testud |last3=Chalmet |last4=Lecuyer-Kudela |last5=Descotes |title=Occupational contact allergy to tetrazepam. |volume=44 |issue=6 |pages=372 |issn=0105-1873 |journal=Contact dermatitis |first2=F |first3=P |first4=S |first5=J }}</ref><ref>{{cite journal |pmid=14996051 |year=2003 |month= November|last1=Lepp |first1=U |last2=Zabel |last3=Greinert |title=Occupational airborne contact allergy to tetrazepam. |volume=49 |issue=5 |pages=260–1 |issn=0105-1873 |journal=Contact dermatitis |doi=10.1111/j.0105-1873.2003.0225c.x |first2=P |first3=U }}</ref> Airborne [[contact dermatitis]] can also occur as an allergy which can develop from occupational exposure.<ref>{{cite journal |pmid=15811045 |year=2005 |month= March|last1=Ferran |first1=M |last2=Giménez-Arnau |last3=Luque |last4=Berenguer |last5=Iglesias |last6=Pujol |title=Occupational airborne contact dermatitis from sporadic exposure to tetrazepam during machine maintenance. |volume=52 |issue=3 |pages=173–4 |issn=0105-1873 |doi=10.1111/j.0105-1873.2005.0548o.x |journal=Contact dermatitis |first2=A |first3=S |first4=N |first5=M |first6=RM }}</ref> Patch testing has been used successfully to demonstrate tetrazepam allergy.<ref>{{cite journal |pmid=11846746 |year=2001 |month= December|last1=Barbaud |first1=A |last2=Gonçalo |last3=Bruynzeel |last4=Bircher |last5=European Society Of Contact |title=Guidelines for performing skin tests with drugs in the investigation of cutaneous adverse drug reactions. |volume=45 |issue=6 |pages=321–8 |issn=0105-1873 |journal=Contact dermatitis |doi=10.1034/j.1600-0536.2001.450601.x |first2=M |first3=D |first4=A }}</ref><ref>{{cite journal |pmid=11336014 |year=2001 |month= April|last1=Barbaud |first1=A |last2=Trechot |last3=Reichert-Penetrat |last4=Granel |last5=Schmutz |title=The usefulness of patch testing on the previously most severely affected site in a cutaneous adverse drug reaction to tetrazepam. |volume=44 |issue=4 |pages=259–60 |issn=0105-1873 |journal=Contact dermatitis |doi=10.1034/j.1600-0536.2001.440409-15.x |first2=P |first3=S |first4=F |first5=JL }}</ref> Oral testing can also be used. Skin prick tests are not always accurate and may produce false negatives.<ref>{{cite journal |pmid=18973107 |url=http://www.jiaci.org/issues/vol18issue5/14.pdf |format=PDF |year=2008 |last1=Sánchez-Morillas |first1=L |last2=Laguna-Martínez |last3=Reaño-Martos |last4=Rojo-Andrés |last5=Ubeda |title=Systemic dermatitis due to tetrazepam. |volume=18 |issue=5 |pages=404–6 |issn=1018-9068 |journal=Journal of investigational allergology & clinical immunology : official organ of the International Association of Asthmology (INTERASMA) and Sociedad Latinoamericana de Alergia e Inmunologia |first2=JJ |first3=M |first4=E |first5=PG}}</ref>

[[Drowsiness]] is a common side effect of tetrazepam.<ref>{{cite journal |pmid=12746699 |year=2003 |month=May |last1=Rode |first1=G |last2=Maupas |last3=Luaute |last4=Courtois-Jacquin |last5=Boisson |title=Medical treatment of spasticity |volume=49 |issue=2-3 Pt 2 |pages=247–55 |issn=0028-3770 |journal=Neuro-Chirurgie |first2=E |first3=J |first4=S |first5=D }}</ref>  A reduction in muscle force can occur.<ref>{{cite journal |pmid=8901152 |year=1996 |month= March|last1=Lobisch |first1=M |last2=Schaffler |last3=Wauschkuhn |last4=Nickel |title=Clinical pilot study of the myogenic effects of flupirtine in comparison to tetrazepam and placebo |volume=46 |issue=3 |pages=293–8 |issn=0004-4172 |journal=Arzneimittel-Forschung |first2=K |first3=H |first4=B }}</ref> [[Myasthenia gravis]], a condition characterised by severe muscle weakness is another potential adverse effect from tetrazepam.<ref>{{cite journal |pmid=11213590 |year=2000 |month= December|last1=Vargas Ortega |first1=I |last2=Canora Lebrato |last3=Díez Ruiz |last4=Rico Irles |title=Myasthenia gravis after tetrazepam treatment |volume=17 |issue=12 |pages=669 |issn=0212-7199 |journal=Anales de medicina interna (Madrid, Spain : 1984) |url= |format= |first2=J |first3=A |first4=J }}</ref> Cardiovascular and respiratory adverse effects can occur with tetrazepam similar to other benzodiazepines.<ref name=emtt/>

===Tolerance, dependence and withdrawal===
{{See also|Benzodiazepine withdrawal syndrome}}
Prolonged use, as with all [[benzodiazepines]], should be avoided, as tolerance occurs and there is a risk of [[benzodiazepine dependence]] and a [[benzodiazepine withdrawal syndrome]] after stopping or reducing dosage.<ref name=emtt/>

==Overdose==
{{See also|Benzodiazepine overdose}}
Tetrazepam, like other benzodiazepines is a drug which is very frequently used in overdoses. These overdoses are often mixed overdoses, i.e. a mixture of other benzodiazepines or other drug classes with tetrazepam.<ref>{{cite journal |pmid=14617855 |year=2003 |last1=Zevzikovas |first1=A |last2=Bertulyte |last3=Dirse |last4=Ivanauskas |title=Determination of benzodiazepine derivatives mixture by high performance liquid chromatography |volume=39 Suppl 2 |pages=30–6 |issn=1010-660X |journal=Medicina (Kaunas, Lithuania) |url= |format= |first2=A |first3=V |first4=L }}</ref><ref>{{cite journal |pmid=12474705 |year=2002 |last1=Zevzikovas |first1=A |last2=Kiliuviene |last3=Ivanauskas |last4=Dirse |title=Analysis of benzodiazepine derivative mixture by gas-liquid chromatography |volume=38 |issue=3 |pages=316–20 |issn=1010-660X |journal=Medicina (Kaunas, Lithuania) |url=http://medicina.kmu.lt/0203/0203-12l.pdf |format=PDF |language=lithuanian |first2=G |first3=L |first4=V }}</ref>

==Contraindications and special caution==
Benzodiazepines require special precaution if used in the elderly, during pregnancy, in children, alcohol or drug-dependent individuals and individuals with [[comorbid]] [[psychiatric disorders]].<ref>{{Cite journal | last1 = Authier | first1 = N. | last2 = Balayssac | first2 = D. | last3 = Sautereau | first3 = M. | last4 = Zangarelli | first4 = A. | last5 = Courty | first5 = P. | last6 = Somogyi | first6 = AA. | last7 = Vennat | first7 = B. | last8 = Llorca | first8 = PM. | last9 = Eschalier | first9 = A. | title = Benzodiazepine dependence: focus on withdrawal syndrome. | journal = Ann Pharm Fr | volume = 67 | issue = 6 | pages = 408–13 | month= November| year = 2009 | doi = 10.1016/j.pharma.2009.07.001 | pmid = 19900604 }}</ref>

==Pharmacology==
Tetrazepam is an unusual benzodiazepine in its molecular structure as it has cyclohexenyl group which has substituted the typical 5-phenyl moiety seen in other benzodiazepines.<ref name=maotm>{{cite journal |pmid=17021899 |url=http://www.springerlink.com/content/b31j372r75666658/fulltext.pdf |format=PDF |year=2007 |month=May |last1=Pavlic |first1=M |last2=Libiseller |last3=Grubwieser |last4=Schubert |last5=Rabl |title=Medicolegal aspects of tetrazepam metabolism. |volume=121 |issue=3 |pages=169–74 |issn=0937-9827 |doi=10.1007/s00414-006-0118-6 |journal=International journal of legal medicine |first2=K |first3=P |first4=H |first5=W }}</ref>
Tetrazepam, is rapidly absorbed after oral administration, within 45 mins and reaches peak plasma levels in less than 2 hours. It is classed as an intermediate acting benzodiazepine with an elimination half-life of approximately 15 hours. It is primarily metabolised to the inactive metabolites 3-hydroxy-tetrazepam and norhydroxytetrazepam.<ref name=maotm/><ref>{{cite journal |pmid=6148954 |year=1984 |last1=Baumgärtner |first1=MG |last2=Cautreels |last3=Langenbahn |title=Biotransformation and pharmacokinetics of tetrazepam in man |volume=34 |issue=6 |pages=724–9 |issn=0004-4172 |journal=Arzneimittel-Forschung |first2=W |first3=H }}</ref> The pharmacological effects of tetrazepam are significantly less potent when compared against [[diazepam]], in animal studies.<ref>{{cite journal |pmid=2896794 |year=1988 |month=May |last1=Keane |first1=PE |last2=Simiand |last3=Morre |last4=Biziere |title=Tetrazepam: a benzodiazepine which dissociates sedation from other benzodiazepine activities. I. Psychopharmacological profile in rodents |volume=245 |issue=2 |pages=692–8 |issn=0022-3565 |journal=The Journal of pharmacology and experimental therapeutics |first2=J |first3=M |first4=K }}</ref> Tetrazepam is a benzodiazepine site agonist and binds unselectively to type 1 and type 2 benzodiazepine site types as well as to [[translocator protein|peripheral benzodiazepine receptors]].<ref>{{cite journal |pmid=2896795 |year=1988 |month=May |last1=Keane |first1=PE |last2=Bachy |last3=Morre |last4=Biziere |title=Tetrazepam: a benzodiazepine which dissociates sedation from other benzodiazepine activities. II. In vitro and in vivo interactions with benzodiazepine binding sites. |volume=245 |issue=2 |pages=699–705 |issn=0022-3565 |journal=The Journal of pharmacology and experimental therapeutics |first2=A |first3=M |first4=K }}</ref> The muscle relaxant properties of tetrazepam are most likely due to a reduction of calcium influx.<ref>{{cite journal |pmid=9299217 |year=1997 |month=May |last1=Pérez-Guerrero |first1=C |last2=Suárez |last3=Herrera |last4=Marhuenda |title=Spasmolytic effects of tetrazepam on rat duodenum and guinea-pig ileum. |volume=35 |issue=5 |pages=493–7 |issn=1043-6618 |doi=10.1006/phrs.1997.0173 |journal=Pharmacological research : the official journal of the Italian Pharmacological Society |first2=J |first3=MD |first4=E }}</ref> Small amounts of [[diazepam]] as well as the [[active metabolites]] of diazepam are produced from metabolism of tetrazepam.<ref>{{cite journal |pmid=19233363 |year=2009 |month= April|last1=Baumann |first1=A |last2=Lohmann |last3=Schubert |last4=Oberacher |last5=Karst |title=Metabolic studies of tetrazepam based on electrochemical simulation in comparison to in vivo and in vitro methods. |volume=1216 |issue=15 |pages=3192–8 |issn=0021-9673 |doi=10.1016/j.chroma.2009.02.001 |journal=Journal of chromatography. A |first2=W |first3=B |first4=H |first5=U }}</ref><ref>{{cite journal |pmid=18949465 |year=2008 |month= December|last1=Schubert |first1=B |last2=Pavlic |last3=Libiseller |last4=Oberacher |title=Unraveling the metabolic transformation of tetrazepam to diazepam with mass spectrometric methods. |volume=392 |issue=7-8 |pages=1299–308 |issn=1618-2642 |doi=10.1007/s00216-008-2447-4 |journal=Analytical and bioanalytical chemistry |first2=M |first3=K |first4=H }}</ref> The metabolism of tetrazepam has led to false accusations of prisoners prescribed tetrazepam of taking illicit diazepam; this can lead to increased prison sentences for prisoners.<ref name=maotm/>

==Abuse==
{{See also|Drug-related crime|Benzodiazepine misuse}}
Tetrazepam as with other benzodiazepines is sometimes abused. It is sometimes abused to incapacitate a victim in order to carry out a drug-facilitated crime.<ref>{{cite journal |pmid=16175127 |year=2005 |month= October|last1=Concheiro |first1=M |last2=Villain |last3=Bouchet |last4=Ludes |last5=López-Rivadulla |last6=Kintz |title=Windows of detection of tetrazepam in urine, oral fluid, beard, and hair, with a special focus on drug-facilitated crimes. |volume=27 |issue=5 |pages=565–70 |issn=0163-4356 |journal=Therapeutic drug monitoring |doi=10.1097/01.ftd.0000164610.14808.45 |first2=M |first3=S |first4=B |first5=M |first6=P }}</ref> or abused in order to achieve a state of intoxication.<ref>{{cite journal |pmid=15944062 |year=2005 |month= June|last1=Kintz |first1=P |last2=Villain |last3=Concheiro |last4=Cirimele |title=Screening and confirmatory method for benzodiazepines and hypnotics in oral fluid by LC-MS/MS. |volume=150 |issue=2-3 |pages=213–20 |issn=0379-0738 |doi=10.1016/j.forsciint.2004.12.040 |journal=Forensic science international |first2=M |first3=M |first4=V }}</ref>
Tetrazepam's abuse for to carry out drug facilitated crimes may be less however, than other benzodiazepines due to its reduced [[hypnotic]] properties.<ref>{{cite journal |pmid=17468852 |url=http://www.springerlink.com/content/l11426p7n0744r25/fulltext.pdf?page=1 |year=2007 |month= August|last1=Laloup |first1=M |last2=Fernandez Mdel |last3=Wood |last4=Maes |last5=De Boeck |last6=Vanbeckevoort |last7=Samyn |title=Detection of diazepam in urine, hair and preserved oral fluid samples with LC-MS-MS after single and repeated administration of Myolastan and Valium. |volume=388 |issue=7 |pages=1545–56 |issn=1618-2642 |doi=10.1007/s00216-007-1297-9 |journal=Analytical and bioanalytical chemistry |first2=M |first3=M |first4=V |first5=G |first6=Y |first7=N}}</ref>

==See also==
*[[Benzodiazepine]]
*[[Long-term effects of benzodiazepines]]

==References==
{{Reflist|colwidth=40em}}

{{Benzodiazepines}}
{{Muscle relaxants}}

[[Category:Benzodiazepines]]
[[Category:Lactams]]
[[Category:Organochlorides]]

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