Triazolam is a sedative/hypnotic triazolo-benzodiazepine, structurally related to alprazolam. Recently, it has been approved for the short-term management of insomnia characterized by difficulty in falling asleep, frequent nocturnal awakenings, and/or early morning awakenings. Triazolam is metabolized with a half-life of 1.5–5.0 hours. Its one active metabolite, which appears in low concentrations and is inactivated rapidly, is not thought to contribute to its pharmacologic activity. Triazolam has been shown to decrease sleep latency and the number of nocturnal awakenings while increasing total sleep time in patients with insomnia. Sleep electroencephalogram studies show that triazolam has no effect on δ-sleep (Stages 3 and 4) and has variable effects on rapid-eye-movement sleep. Nighttime administration of triazolam increases daytime alertness in insomniacs and improves or has no effect on performance. The reported side effects are similar to those of other benzodiazepines and include drowsiness, dizziness, and dry mouth. The recommended dosage of triazolam is 0.25–0.5 mg hs. A reduced initial dose of 0.125 mg should be used in geriatric patients.
PakesGEBrogdenRNHeelRCSpeightTMAveryGS. Triazolam: A review of its pharmacological properties and therapeutic efficacy in patients with insomnia. Drugs1981; 22: 81–110.
2.
WincorMZ. Insomnia and the new benzodiazepines. Clin Pharm1982; 1: 425–32.
3.
StudyREBarkerJL. Cellular mechanisms of benzodiazepine action. JAMA1982; 247: 2147–51.
4.
SethyVHHarrisDW. Determination of biological activity of alprazolam, triazolam and their metabolites. J Pharm Pharmacol1982; 34: 115–6.
SmithRBDivollMGillespieWRGreenblattDJ. The effect of subject age and gender on pharmacokinetics of triazolam and temazepam. J Clin Psychopharmacol1983;in press.
8.
GreenblattDJDivollMAbernethyDRMoschittoLJSmithRBShaderRI. Reduced clearance of triazolam in old age: Relation to antipyrine oxidizing capacity. Br J Clin Pharmacol1983; 15: 303–9.
9.
CarskadonMASeidelWFGreenblattDJDementWC. Daytime carryover of triazolam and flurazepam in elderly insomniacs. Sleep1982; 5: 361–71.
10.
RahwanRG. Sleep disorders and their treatment. US Pharmacist1981; 6: 34–43.
11.
PegramVHydePLintonP. Chronic use of triazolam: The effects on the sleep patterns of insomniacs. J Int Med Res1980; 8: 224–31.
12.
VogelGWBarkerKGibbonsPThurmondA. A comparison of the effects of flurazepam 30 mg and triazolam 0.5 mg on the sleep of insomniacs. Psychopharmacologia1976; 47: 81–6.
13.
SpinweberCLJohnsonLC. Effects of triazolam (0.5 mg) on sleep, performance, memory, and arousal threshold. Psychopharmacology1982; 76: 5–12.
14.
VogelGThurmondAGibbonsPEdwardsKSloanKBSextonK. The effect of triazolam on the sleep of insomniacs. Psychopharmacologia1975; 41: 65–9.
15.
KalesAKalesJDBixlerEOScharfMBRussekE. Hypnotic efficacy of triazolam: Sleep laboratory evaluation of intermediate-term effectiveness. J Clin Pharmacol1976; 16: 399–406.
16.
Fernandez-GuardiolaAJuradoJLSolisH. The effect of triazolam on insomniac patients using a laboratory sleep evaluation. Curr Ther Res1981; 29: 950–8.
17.
KalesABixlerEOKalesJDScharfMB. Comparative effectiveness of nine hypnotic drugs: Sleep laboratory studies. J Clin Pharmacol1977; 17: 207–13.
OguraCNakazawaKMajimaKNakamuraKUedaHUmezawaY. Residual effects of hypnotics: Triazolam, flurazepam, and nitrazepam. Psychopharmacology1980; 68: 61–5.
20.
NicholsonANStoneBM. Activity of the hypnotics, flunitrazepam and triazolam, in man. Br J Clin Pharmacol1980; 9: 187–94.
21.
RothTHartseKMSaabPGPiccionePMKramerM. The effects of flurazepam, lorazepam and triazolam on sleep and memory. Psychopharmacology1980; 70: 231–7.
22.
RothTKramerMSchwartzJL. Triazolam: A sleep laboratory study of a new benzodiazepine hypnotic. Curr Ther Res1974; 16: 117–23.
23.
DementWSeidelWCarskadonM. Daytime alertness, insomnia, and benzodiazepines. Sleep1982; 5: S28–45.
24.
RothTHartseKMZorickFJKaffemanME. The differential effects of short- and long-acting benzodiazepines upon nocturnal sleep and daytime performance. Arzneim Forsch1980; 30: 891–4.
25.
MattmanPLoepfeMScheitlinT. Day-time residual effects and motor activity after three benzodiazepine hypnotics. Arzneim Forsch1982; 32: 461–5.
26.
HindmarchIClydeCA. The effects of triazolam and nitrazepam on sleep quality, morning vigilance and psychomotor performance. Arzneim Forsch1980; 30: 1163–6.
27.
VeldkampWStrawRNMetzlerCMDemissianosHV. Efficacy and residual effect evaluation of a new hypnotic, triazolam. J Clin Pharmacol1974; 14: 102–11.
28.
SunshineA. Comparison of the hypnotic activity of triazolam, flurazepam hydrochloride, and placebo. Clin Pharmacol Ther1975; 17: 573–7.
29.
BowenAJ. Comparative efficacy of triazolam, flurazepam and placebo in out-patient insomniacs. J Int Med Res1978; 6: 337–42.
30.
OkawaKKAllenGS. A clinical comparison of triazolam with placebo and with secobarbital in insomniac patients. J Int Med Res1978; 6: 343–7.
31.
WangRIHStockdaleSL. The hypnotic efficacy of triazolam. J Int Med Res1973; 1: 600–7.
32.
FabreLFMcLendonDMHarrisRT. Preference studies of triazolam with standard hypnotics in out-patients with insomnia. J Int Med Res1976; 4: 247–54.
33.
PiccionePZorickFLutzTGrissomTKramerMRothT. The efficacy of triazolam and chloral hydrate in geriatric insomniacs. J Int Med Res1980; 8: 361–7.
34.
FabreLFBrachfeldJMeyerLRSloweIACalvoRMetzlerC. Multi-clinic double-blind comparison of triazolam (Halcion) and placebo administered for 14 consecutive nights in outpatients with insomnia. J Clin Psychiatry1978; 39: 679–82.
35.
FabreLFGrossLPasigajenVMetzlerC. Multiclinic double-blind comparison of triazolam and flurazepam for seven nights in outpatients with insomnia. J Clin Pharmacol1977; 17: 402–9.
36.
SinghANSaxenaB. Double-blind crossover comparison of triazolam and flurazepam in hospitalized psychiatric patients with insomnia. Curr Ther Res1980; 27: 627–34.
37.
LeibowitzMSunshineA. Long-term hypnotic efficacy and safety of triazolam and flurazepam. J Clin Pharmacol1978; 18: 302–9.
38.
DeberdtR. Long-term use of triazolam, a benzodiazepine hypnotic. Curr Ther Res1979; 26: 1005–14.
39.
OkawaKK. Comparison of triazolam 0.25 mg and flurazepam 15 mg in treating geriatric insomniacs. Curr Ther Res1978; 23: 381–7.
40.
ReevesRL. Comparison of triazolam, flurazepam, and placebo as hypnotics in geriatric patients with insomnia. J Clin Pharmacol1977; 17: 319–23.
41.
TrapplerBBezerediT. Triazolam intoxication. Can Med Assoc J1982; 126: 893–4.
42.
EinarsonTRYoderES. Triazolam psychosis—a syndrome?. Drug Intell Clin Pharm1982; 16: 330.
43.
EinarsonTR. Hallucinations from triazolam. Drug Intell Clin Pharm1980; 14: 714–5.
