The acute behavioural effects of triazolam (0.125 and 0.25 mg), temazepam (15 and 30 mg), and placebo, alone and in combination with ethanol (0 and 0.5 g/kg), were assessed in 10 volunteers. Ethanol alone did not impair performance and produced only a few subject-rated drug effects. Triazolam and temazepam alone produced some performance impairment and a few subject-rated drug effects. These effects tended to be dose-dependent and were comparable for the two drugs across the range of doses tested. The triazolam–ethanol and temazepam–ethanol combinations produced robust performance impairment and sedative-like subject-rated drug effects that were similar in magnitude. The findings of the present study suggest that even a moderate amount of ethanol in combination with a clinical dose of triazolam or temazepam can cause performance impairment that might diminish an individual's ability to respond adequately to unexpected demands (e.g. smoke alarms or middle-of-the-night child care).
Ancol-Israel S, Roth T (1999) Characteristics of insomnia in the United States: results of the 1991 National Sleep Foundation Survey. Sleep22(Suppl. 2): S347–S353
2.
Bixler E O, Kales A, Brubaker B H, Kales J D (1987) Adverse reactions to benzodiazepine hypnotics: spontaneous reporting system. Pharmacology35: 286–300
3.
Bixler E O, Kales A, Manfredi R L, Vgontzas A N, Tyson K L, Kales J D (1991) Next-day memory impairment with triazolam use. Lancet337: 827–831
4.
de Wit H, Uhlenhuth E H, Pierri J, Johanson C E (1987) Individual differences in behavioral and subjective responses to alcohol. Alcohol Clin Exp Res11: 52–59
5.
Evans S M, Funderburk F R, Griffiths R R (1990) Zolpidem and triazolam in humans: behavioral and subjective effects and abuse liability. J Pharmacol Exp Ther255: 1246–1255
6.
Foley D J, Monjan A A, Brown S L, Simonsick E M, Wallace R B, Blazer D G (1995) Sleep complaints among elderly persons: an epidemiologic study of three communities. Sleep18: 425–432
7.
Graham A, Parran T, Jaen C (1992) Physicians' failure to record alcohol use history when prescribing benzodiazepines. J Subst Abuse4: 179–185
8.
Grant B, Harford T (1990) Concurrent and simultaneous use of alcohol with sedatives and with tranquilizers: results of a national survey. J Subst Abuse2: 1–14
9.
Greenblatt D J, Harmatz J S, Engelhardt N, Shader R I (1989) Pharmacokinetic determinants of dynamic differences among three benzodiazepine hypnotics.Arch Gen Psychiatry46: 326–332
10.
Greenblatt D J, Harmatz J S, von Molitke L L, Ehrenberg B L, Harrel L, Corbett K et al. (1998) Comparative kinetics and dynamics of zaleplon, zolpidem, and placebo. Clin Pharmacol Ther64: 553–561
11.
Griffiths R R, Bigelow G E, Liebson I A (1983) Differential effects of diazepam and pentobarbital on mood and behavior. Arch Gen Psychiatry40: 865–873
12.
Haertzen C A (1974) An overview of the Addiction Research Center Inventory scales (ARCI): an appendix manual of scales. US Government Printing Office, Washington, DC
13.
Heishman S J, Stitzer M L, Bigelow G E (1989) Alcohol and marijuana: comparative dose effect profiles in humans. Pharmacol Biochem Behav31: 649–655
14.
Higgins S T, Bickel W K, O'Leary D K, Yingling J (1987) Acute effects of ethanol and diazepam on the acquisition and performance of response sequences in humans. J Pharmacol Exp Ther243: 1–8
15.
Higgins S T, Rush C R, Bickel W K, Capeless M A, Hughes J R, Lynn M (1992) Effects of alcohol and cocaine, alone and in combination on human learning and performance. J Exp Anal Behav58: 87–105
16.
Higgins S T, Rush C R, Hughes J R, Bickel W K, Lynn M, Capeless M A (1993) Acute behavioral and cardiac effects of cocaine and alcohol combinations in humans. Psychopharmacology111: 285–294
17.
Huff J S, Plunkett H G (1989) Antereograde amnesia following triazolam use in two emergency room physicians. J Emerg Med7: 153–155
18.
Jasinski D R (1977) Assessment of the abuse potentiality of morphine-like drugs (methods used in man). In Martin W (ed), Drug addiction 1, pp. 197–258.Springer-Verlag, New York
19.
Johnson J E (1997) Insomnia, alcohol, and over-the-counter drug use in old-old urban women. J Commun Health Nurs14: 181–188
20.
Johnson E O, Roehrs T, Roth T, Breslau N (1998) Epidemiology of alcohol and medication as aids to sleep in early adulthood. Sleep21: 178–186
21.
Kelly T H, Foltin R W, Serpick E, Fischman M W (1997) Behavioral effects of alprazolam in humans. Behav Pharmacol8: 47–57
22.
Kirk T, Roache J D, Griffiths R R (1990) Dose–response evaluation of the amnestic effects of triazolam and pentobarbital in normal subjects. J Clin Psychopharmacol10: 160–167
23.
Kuitunen T (1994) Drug and ethanol effects on the clinical test for drunkennes: single doses of ethanol, hypnotic drugs, and antidepressant drugs. Pharmacol Toxicol75: 91–98
24.
Kuitunen T, Mattila M J, Seppala T (1990) Actions and interactions of hypnotics on human performance: single doses of zopiclone, triazolam, and alcohol. Int Clin Psychopharmacol5 (Suppl. 2): 115–130
25.
Kunsman G W, Manno J E, Przekop M A, Manno B R, Kunsman C M (1992) The effects of temazepam and ethanol on human psychomotor performance. Eur J Clin Pharmacol43: 603–611
26.
Lehmann W, Lilenberg B (1991) Effect of temazepam and temazepam/ethanol on sleep. Eur J Clin Pharmacol20: 201–205
27.
Linnoila M, Stapleton JM, Lister R, Moss H, Lane E, Granger A, Eckhardt M J (1990) Effects of single doses of alprazolam and diazepam, alone and in combination with ethanol, on psychomotor and cognitive performance and on autonomic nervous system reactivity in healthy volunteers. Eur J Clin Pharmacol39: 21–28
28.
Martin W R, Sloan J W, Sapiro J D, Jasinski D R (1971) Physiologic, subjective, and behavioral effects of amphetamine, methamphetamine, ephedrine, phenmatrzine, and methylphenidate in man. Clin Pharmacol Ther12: 245–258
29.
McLeod D R, Griffiths R R, Bigelow G E, Yingling J E (1982) An automated version of the digit symbol substitution test (DSST). Behav Res Methods Instrum14: 463–466
30.
McNair D M, Lorr M, Droppleman L F (1971) Profile of mood states (manual). Educational and Industrial Testing Services, San Diego, CA
31.
Mitler M M (2000) Nonselective and selective benzodiazepine receptor agonists – where are we today?Sleep23 (Suppl. 1): S39–S47
32.
Morris H H, Estes M L (1987) Traveler's amnesia: transient global amnesia secondary to triazolam. JAMA258: 945–948
33.
National Sleep Foundation/Gallup Organization (1995) Sleep in America. Gallup Organization, Princeton, NJ
34.
Nyenhuis D L, Yamamoto C, Luchetta T, Terrien A, Parmentier A (1999) Adult and geriatric normative data and the validation of the profile of mood states. J Clin Psychol55: 79–86
35.
Physician's Desk Reference (2000) American Psychiatric Association, Washington, DC
36.
Radecki S E, Brunton S A (1993) Management of insomnia in office-based practice. National prevalence and therapeutic patterns. Arch Family Med2: 1129–1134
37.
Richardson G S (2000) Managing insomnia in the primary care setting: Raising the issues. Sleep23 (Suppl. 1): S9–S12
38.
Roache J D, Griffiths R R (1985) Comparison of triazolam and pentobarbital: performance impairment, subjective effects, and abuse liability. J Pharmacol Exp Ther234: 120–133
39.
Roache J D, Cherek D R, Bennett R H, Schenkler J C, Cowan K A (1993) Differential effects of triazolam and ethanol on awareness, memory, and psychomotor performance. J Clin Psychopharmacol13: 3–15
40.
Roehrs T, Vogel G, Sterling W (1990) Dose effects of temazepam in transientinsomnia. Drug Research40: 859–862
41.
Rush C R, Ali J A (1999) A follow-up study of the acute behavioral effects of benzodiazepine receptor ligands in humans: comparison of quazepam and triazolam. Exp Clin Psychopharmacol7: 257–265
42.
Rush C R, Griffiths R R (1996) Zolpidem, triazolam, and temazepam: behavioral and subject-rated effects in normal volunteers. J Clin Psychopharmacol16: 146–157
43.
Rush C R, Griffiths R R (1997) Acute participant-rated and behavioral effects of alprazolam and buspirone, alone and in combination with ethanol in normal volunteers. Exp Clin Psychopharmacol4: 28–38
44.
Rush C R, Higgins S T, Bickel W K, Hughes J R (1993a) A comparison of the acute behavioral effects of triazolam and temazepam in normals. Psychopharmacology12: 407–414
45.
Rush C R, Higgins S T, Hughes J R, Bickel W K, Wiegner M S (1993b) Acute behavioral and cardiac effects of alcohol and caffeine, alone and in combination, in humans. Behav Pharmacol4: 562–572
46.
Rush C R, Frey J M, Griffiths R R (1999) Zaleplon and trizaolam in humans: acute behavioral effects and abuse potential. Psychopharmacology145: 39–51
47.
Sanger D J, Griebel G, Perrault G, Claustre Y, Schoemaker H (1999) Discriminative stimulus effects of drugs acting at GABA (A) receptors: differential profiles and receptor selectivity. Pharmacol Biochem Behav64: 269–273
48.
Scharf M, Fletcher K, Graham J (1988) Comparative amnestic effects of benzodiazepine hypnotic agents. J Clin Psychiatry49: 134–137
49.
Shochat T, Umphress J, Israel A G, Anoli-Israel S (1999) Insomnia in primary care patients. Sleep22 (Suppl. 2): S359–S365
50.
Simon G E, VonKorff M (1997) Prevalence, burden, and treatment of insomnia in primary care. Am J Psychiatry154: 1417–1423
51.
Stone B M (1984) Pencil and paper tests – sensitivity to psychotropic drugs. Br J Clin Pharmacol18 (Suppl. 1): 15S–20S
52.
van der Kroef C (1979) Reactions to triazolam. Lancet2: 526-526.
53.
Walsh J K, Muehlbach M J, Schwietzer P K (1984) Acute administration of triazolam for daytime sleep of rotating shift workers. Sleep7: 223–229
54.
Walsh J K, Engelhardt C L (1999) The direct economic costs of insomnia in the United States for 1995. Sleep22 (Suppl. 2): S386–S393
55.
Woods J H, Winger G D (1995) Current benzodiazepine issues. Psychopharmacology118: 107–115
56.
Woods J H, Katz J L, Winger G D (1988) Use and abuse of benzodiazepines: Issues relevant to prescribing. JAMA260: 3476–3480
57.
Woods J H, Katz J L, Winger G D (1992) Benzodiazepines: use, abuse, and consequences. Pharmacol Rev44: 151–347
58.
Wysowski D K, Baum C (1991) Outpatient use of prescription sedative-hypnotic drugs in the United States, 1970–1989. Arch Intern Med151: 1779–1883
