Triazolam
Definition
Triazolam is a hypnotic drug. It is a member of the benzodiazepine family of drugs. In the United States, it is sold under the brand name Halcion as well as under its generic name.
Purpose
Triazolam is used for the short-term (generally seven to 10 days) treatment of insomnia . Continued usage for more than two to three weeks requires a complete reevaluation of the person receiving the drug.
Description
Triazolam increases the speed with which people achieve sleep, it increases the duration of sleep, and decreases the likelihood of being awakened during sleep. The effect of triazolam decreases after 14 days of continuous use. Often, sleep patterns return to those experienced prior to beginning use of triazolam or worse. This is called rebound insomnia.
Recommended dosage
The recommended dose of triazolam is 0.25 mg before going to bed. Persons with smaller body masses and older individuals can receive a comparable effect with 0.125 mg of triazolam. The lowest effective dosage of drug should be used to minimize adverse reactions.
Precautions
Because of problems with rebound insomnia, patients should not receive triazolam for more than seven consecutive days. Accompanying rebound insomnia may be daytime anxiety.
Triazolam can cause serious birth defects. Women should not take this medicine if they are pregnant, think they may be pregnant, or are trying to get pregnant.
The drug may cause daytime anxiety after as few as 10 days of continuous usage. If this occurs, triazolam use should be discontinued.
Persons using triazolam should exercise caution when driving or using power tools or machinery.
People who use temazepam to reduce jet lag on long flights should be aware of a condition sometimes called "traveler's amnesia." This is a condition where the traveler completes the flight and carries on with normal activities but has no memory of these activities. The period of amnesia may last for a few minutes to a few hours. Traveler's amnesia is most common when the traveler has had too little sleep or has been drinking alcohol.
Side effects
Triazolam has relatively few side effects. Those that have been reported include drowsiness, headache, dizziness, nervousness, a feeling of being light-headed, problems with coordination, nausea and vomiting.
Less frequent side effects include euphoria, tachycardia, fatigue , confusion, impaired memory, muscle cramping and pain and depression.
Interactions
Triazolam increases the effect of drugs and substances that depress the central nervous system. This class of drugs includes anesthetics, narcotics, sedatives and other sleeping pills, atropine and alcohol.
Some drugs and foods increase the effects of triazolam. They may also increase the chances of having side effects. These include cimetidine, isoniazid, oral contraceptives, and grapefruit juice.
Resources
BOOKS
Adams, Michael and Norman Holland. Core Concepts in Pharmacology. Philadelphia: Lippincott-Raven, 1998.
Foreman, John C. and Torben Johansen. Textbook of Receptor Pharmacology. 2nd ed. Boca Raton, FL: CRC Press,2002.
Page, Clive P., and Michael Murphy. Integrated Pharmacology. St. Louis: Mosby-Year Book, 2002.
Von Boxtel, Chris J., Budiono Santoso, and I. Ralph Edwards. Drug Benefits and Risks: International Textbook of Clinical Pharmacology. New York: John Wiley and Sons,2001.
PERIODICALS
Fillmore M. T., C. R. Rush, T. H. Kelly, and L. Hays. "Triazolam impairs inhibitory control of behavior in humans." Experimental Clinical Psychopharmacology 9, no. 4 (2001): 363-371.
Mintzer, M. Z., R. R. Griffiths, C. Contoreggi, A. S. Kimes, E. D. London, and M. Ernst. "Effects of triazolam on brain activity during episodic memory encoding: a PET study." Neuropsychopharmacology 25, no. 5 (2001): 744-756.
Nelson, J. C. "Diagnosing and treating depression in the elderly." Journal of Clinical Psychiatry 62, Supplement 24(2001): 18-22.
ORGANIZATIONS
American Academy of Clinical Toxicology. 777 East Park Drive, PO Box 8820, Harrisburg, PA 17105-8820. Telephone: (717) 558-7750. Fax: (717) 558-7845. Web site: <http://www.clintox.org/index.html> .
American Academy of Family Physicians. 11400 Tomahawk Creek Parkway, Leawood, KS 66211-2672. Telephone:(913) 906-6000. Web site: <http://www.aafp.org/> .
American Medical Association. 515 N. State Street, Chicago, IL 60610. Telephone: (312) 464-5000. Web site: <http://www.ama-assn.org/> .
American Psychiatric Association. 1400 K Street NW, Washington, DC 20005. Telephone: (888) 357-7924. Fax(202) 682-6850. Web site: <http://www.psych.org/> .
American Society for Clinical Pharmacology and Therapeutics. 528 North Washington Street, Alexandria, VA 22314. Telephone: (703) 836-6981. Fax: (703) 836-5223.
American Society for Pharmacology and Experimental Therapeutics. 9650 Rockville Pike, Bethesda, MD 20814-3995. Telephone: (301) 530-7060. Fax: (301) 530-7061. Web site: <http://www.aspet.org/> .
L. Fleming Fallon, Jr., M.D., Dr.P.H.