Reactions 435 - 23 Jan 1993

Are triazolam substitutes anysafer?

Since the suspension of triazolam in the UK, 12-22%of patients with insomnia receiving substitute therapyhave experienced adverse CNS effects, according to aGP survey. During previous treatment with triazolamthe incidence of CNS effects was 9% in these patients.

In the survey, 163 GPs reviewed the records of 1193patients who had to be switched from triazolam toalternative drugs after the UK suspension.

Temazepam was the most commonly prescribedtriazolam substitute (68% of patients) followed byloprazolam (9%), nitrazepam (7%), lormetazepam (5%),chloral betaine (4%) and zopiclone (4%).

Insomnia and memory problems were the CNS eventsmost frequently associated with triazolam, each with anincidence of 0.4%. During substitute therapy the mostfrequently reported adverse events were insomnia (7%),daytime drowsiness (1%) and anxiety (1%).

‘If the rationale for the suspension of triazolam wasto ensure the safety of patients using hypnotics, theUK regulators’ decision was faulty’, according to Dr IHindmarch and colleagues from the University ofSurrey, Milford Hospital, UK.

In addition, the survey showed that the GPsquestioned disagreed with the suspension of triazolam.They thought that the suspension had compromisedtheir prescribing flexibility and had not benefited theirpatients.Hindmarch I, et al. Adverse events after triazolam substitution. Lancet 341: 55, 2Jan 1993 800175321

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Reactions 23 Jan 1993 No. 4350114-9954/10/0435-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved