Triazolam (Halcion)
Triazolam is a very short-acting triazolobenzodiazepine licensed as a hypnotic for short-term insomnia. Its rapid clearance minimises next-day hangover but promotes rebound insomnia, and its high potency gives significant dependence and amnestic liability.
01 Overview
Triazolam enhances GABA-A signalling with a rapid onset and very short half-life, making it useful for sleep-onset insomnia. Its brief duration limits daytime sedation but favours middle-of-the-night wakening and rebound insomnia.
Because it is potent and short-acting, triazolam carries a notable risk of dependence, rebound anxiety, and marked anterograde amnesia; some jurisdictions restricted or withdrew it over behavioural adverse effects. Withdrawal after regular use can include seizures, and co-use with opioids or alcohol adds respiratory depression.
02 Mechanism
Positive allosteric modulator of the GABA-A receptor with rapid onset and short duration; shortens sleep latency.
03 Dosing
| Tier | Dose | Route | Notes |
|---|---|---|---|
| Light | 0.125 mg | Oral | Lower dose, e.g. in elderly. |
| Common | 0.125–0.25 mg | Oral | Typical bedtime hypnotic dose. |
| Strong | 0.25–0.5 mg | Oral | Upper range; higher amnesia and behavioural risk, generally avoided. |
04 Effects
| Effect | Magnitude | Evidence | |
|---|---|---|---|
| Sleep inductionEffective for sleep-onset insomnia. | Rapid onset, short duration | Clinical | |
| SedationShort-lived hypnotic sedation. | Clinical | ||
| AnxiolysisMild anxiolytic effect at bedtime. | Clinical |
05 Side effects
| Effect | Severity | Frequency | Evidence | Countermeasures |
|---|---|---|---|---|
| Dependence and rebound insomniaRebound insomnia and rebound anxiety on stopping; dependence with regular use; withdrawal can include seizures. | Severe | Common with regular use | Clinical | |
| Anterograde amnesia and complex sleep behavioursMemory loss and rare complex sleep behaviours (e.g. sleep-driving); prompted regulatory restrictions in some countries. | Moderate | Common | Clinical | |
| Respiratory depressionAdditive respiratory and CNS depression with opioids or alcohol. | Life-threatening | Uncommon alone, higher with CNS depressants | Clinical |