Disinhibition, amnestic reactions, and other adverse reactions secondary to triazolam: a review of the literature

Abstract

In the past 18 months, there has been considerable controversy regarding the benzodiazepine triazolam (Halcion). To review data supporting or not supporting the assertion that treatment with triazolam results in adverse reactions more frequently than with other benzodiazepines, the author used computerized literature searches (MEDLINE, English language articles from 1975 to the present) to identify reports of behavioral disinhibition, amnesia, delirium, rebound insomnia, and withdrawal reactions on benzodiazepines. Studies of disinhibitory reactions during benzodiazepine treatment do not substantiate the argument that they are more prevalent with triazolam than with other benzodiazepines. The behavioral disinhibition reactions during treatment with benzodiazepines are associated with higher dosages and pretreatment level of hostility. Anterograde amnesia occurs with many benzodiazepines, but usually without changes in a person's normal activities and behaviors. The reports of anterograde amnesia during benzodiazepine treatment describe people performing rather complex tasks during which outside observers could not detect any unusual behaviors. The prevalence of delirium during treatment with triazolam and other benzodiazepines is unclear, but delirium is more frequent at higher dosages and in the elderly. Controlled studies regarding the adverse effects of triazolam on sleep are lacking. The author concludes that despite the considerable adverse publicity in the lay press, there is little scientific evidence that triazolam is associated with disinhibitory or other adverse reactions at a greater frequency than other benzodiazepines.