A reassessment of triazolam

Concern over the safety of triazolam is reflected in the actions taken against the drug world-wide by many drug regulatory agencies, ranging from restrictions in duration of use and dosage to banning of the drug. There is extensive scientific literature documenting that triazolam produces frequent and severe psychiatric adverse events: during drug administration these include memory impairment/amnesia and other cognitive impairments and daytime anxiety states and early morning insomnia; following drug withdrawal there can be a marked worsening of sleep (rebound insomnia). It is difficult to improve triazolam's benefit-to-risk ratio either by lowering the dose or by short and intermittent use. The 0.5 mg and 1.0 mg doses of triazolam are effective, but produce severe psychiatric adverse events while the 0.25 mg dose has limited efficacy while still being associated with frequent adverse events. Moreover, many of triazolam's adverse events are associated with the first (or first several) doses used, and rebound insomnia often occurs on withdrawal even after only one night of use.