Article: Triazolam

Triazolam
Systematic (IUPAC) name
8-chloro-6-(2-chlorophenyl)-1-methyl-4H- [1,2,4]triazolo[4,3-a][1,4]benzodiazepine
Identifiers
CAS number	28911-01-5
ATC code	N05CD05
PubChem	5556
DrugBank	APRD00313
Chemical data
Formula	C17H12Cl2N4
Mol. weight	343.2
Pharmacokinetic data
Bioavailability	?
Metabolism	Hepatic
Half life	1.5-5.5 hours
Excretion	Renal
Therapeutic considerations
Pregnancy cat.	X (US)
Legal status	Schedule IV(US)
Routes	Oral

Triazolam (marketed under brand names Halcion®, Novodorm®, Songar®) is a drug which is a benzodiazepine derivative. It possesses pharmacological properties similar to other benzodiazepines, but it is generally only used as a sedative.^[1]

History

Triazolam was temporarily withdrawn from the market in several countries because of concerns about serious side effects (mostly psychological) associated with high dosages of the drug. Its use at lower doses has been deemed safe by the Food and Drug Administration (FDA) and most other countries.^[1]

However, Triazolam remains banned in the UK since 1991, when the Committee on the Safety of Medicines (CSM) concluded that it caused a higher frequency of psychiatric side-effects than other hypnotics.

It has been alleged to cause strange behavior and in some instances violent reactions. However, these allegations are anectdotal in nature. While triazolam as the instigator of violence has been accepted in some trials (particularly criminal offenses of defendants without violent tendencies) the anectdotal evidence has not risen to the level that the FDA has determined it statistically verifiable.

Pharmacology

The pharmacological effects of triazolam are similar to those of most other benzodiazepines. Triazolam does not generate active metabolites.^[1]

Indications

Triazolam is usually used for short term treatment of acute insomnia including jet lag. It is an ideal benzodiazepine for this use, due to the fact that its fast onset of action and short half-life (approximately 3 hours) allows its user to avoid morning drowsiness. Triazolam is also sometimes used as an adjuvant in medical procedures requiring anesthesia.^[1]

Dosage

Dosages for triazolam are significantly lower than other benzodiazepines, and should be individualized depending on the needs of the patient. For insomnia, 0.125mg to 0.25mg are given at bedtime. Up to 0.5mg may be needed for resistant individuals. Dosages exceeding 0.5mg are generally unsafe.

Side effects

Triazolam causes transient anterograde amnesia at dosages higher than 1-3mg.^[2]

Interactions

Drug interactions with Triazolam aren't well documented. Therefore, as with most prescription medications, caution is advisable when combining other drugs with Triazolam.

Contraindications

Pregnancy

Halcion belongs to the Pregnancy Category X of the FDA. This means that it is known to cause birth defects.

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Overdose

Symptoms of overdose^[1] include:

• Somnolence (drowsiness)
• Impaired motor function
• Slurred speech
• Coma
• Hypoventilation (respiratory depression)

Legal status

Internationally, triazolam is a Schedule IV drug under the Convention on Psychotropic Substances.^[3]