Overdosage of temazepam results in increasing CNS effects, including:
- Somnolence (difficulty staying awake)
- Mental confusion
- Respiratory depression
- Hypotension
- Impaired motor functions
- Impaired or absent reflexes
- Impaired coordination
- Impaired balance
- Dizziness, sedation
- Coma
- Death
Temazepam had the highest rate of drug intoxication, including overdose, among common benzodiazepines in cases with and without combination with alcohol in a 1985 study. Temazepam and nitrazepam were the two benzodiazepines most commonly detected in overdose-related deaths in an Australian study of drug deaths. A 1993 British study found temazepam to have the highest number of deaths per million prescriptions among medications commonly prescribed in the 1980s (11.9, versus 5.9 for benzodiazepines overall, taken with or without alcohol).
A 1995 Australian study of patients admitted to hospital after benzodiazepine overdose corroborated these results, and found temazepam overdose much more likely to lead to coma than other benzodiazepines (odds ratio 1.86). The authors noted several factors, such as differences in potency, receptor affinity, and rate of absorption between benzodiazepines, could explain this higher toxicity. Although benzodiazepines have a high therapeutic index, temazepam is one of the more dangerous of this class of drugs. The combination of alcohol and temazepam makes death by alcohol poisoning more likely.
Lupin poisoning is a nervous syndrome caused by alkaloids in bitter lupins, similar to neurolathyrism. Lupin poisoning affects people who eat incorrectly prepared lupin beans. Mediterranean cultures prefer the historic bitter lupin beans with the required toxin-removal by traditional leaching in water preparation methods due to the better flavour that results. Improper preparation of bitter lupins with insufficient soaking allows pharmacologically significant amounts of the anticholinergic alkaloids to remain in the beans, and poisoning symptoms result.
While the alkaloids found in raw and dried beans are bitter and unpalatable to many, with soaking the level is reduced. There are several references in medical literature to poisoning caused by errors in lupini preparation.
Symptoms of lupin bean poisoning (from excess alkaloid in cooked food) include dilated unresponsive pupils, confusion, slowed thought and disorientation, flushed face and/or fever, high heart rate and blood pressure, tremors, difficulty with or slurred speech, in-coordination, dizziness, burning dry mouth, stomach pain, and anxiety or “malaise”.
Many human symptoms are described in the Australian government’s evaluation of lupin food and livestock fodder export safety standards in the medical literature review section:
Current media describes the symptoms when referring to recent Australian Medical Journal reports of poisoning from overly bitter lupin flour used in foods reported in the media.
Mycotoxic lupinosis is a disease caused by lupin material that is infected with the fungus Diaporthe toxica;[13] the fungus produces mycotoxins called phomopsins, which cause liver damage.