A Comparative 25‐Night Sleep Laboratory Study on the Effects of Quazepam and Triazolam on Chronic Insomniacs

  title={A Comparative 25‐Night Sleep Laboratory Study on the Effects of Quazepam and Triazolam on Chronic Insomniacs},
  author={Mortimer Mamelak and Adele C Csima and V Price},
  journal={The Journal of Clinical Pharmacology},
Abstract: The short‐ and intermediate‐term actions, as well as the carryover and withdrawal effects, of quazepam, a new benzodiazepine hypnotic with a half‐life of 60 to 100 hours, were compared with those of triazolam, a triazolodiazepine hypnotic with a half‐life of 2 to 3 hours. Both the subjective effects of these drugs as well as their objective actions on the sleep EEG were sought. The study was conducted on two groups of six subjects with chronic insomnia who ranged in age from 32 to 56… 
The Effects of a Single Night's Dosing with Triazolam on Sleep the Following Night
Higher doses of triazolam could lead to withdrawal effects in normal sleepers even when this drug was used for only a single night, and discontinuation of the 0.5 mg dose did lead to significant objective and subjective withdrawal effects.
Alprazolam: Effects on Sleep and Withdrawal Phenomena
The clinical utility of alprazolam when administered to insomniac patients appears to be limited because of a relatively rapid development of tolerance and possible disinhibitory reactions during drug use and the occurrence of rebound insomnia following withdrawal.
Effect of gradual withdrawal on the rebound sleep disorder after discontinuation of triazolam.
The triazolam period significantly reduced the interval before the onset of sleep (sleep latency), and it prolonged sleep duration, reduced the number of awakenings, and improved the self-rated soundness of sleep in all cohorts.
Rebound Insomnia and Elimination Half‐Life: Assessment of Individual Subject Response
Previous reports using group mean values that demonstrate a frequent, immediate, and intense degree of rebound insomnia following abrupt withdrawal of relatively rapidly eliminated hypnotic drugs and an infrequent, delayed, and milder degree of sleep difficulty following withdrawal of slowly eliminated drugs are confirmed.
Rebound Insomnia: A Critical Review
The results indicate that rebound insomnia is a distinct possibility after discontinuation of triazolam in both insomniacs and normal controls and is greater with the short half-life as compared with the long half- life benzodiazepines.
Comparison of Lorazepam and Flurazepam as Hypnotic Agents in Chronic Insomniacs
Both lorazepam 2 mg at bedtime and flurazepams 30 mg atBedtime were found to be effective and safe for treating chronic insomnia, as measured by parameters of sleep and daytime functioning.
Rebound insomnia after hypnotic withdrawal in insomniac outpatients
The results show that pill discontinuation itself may worsen sleep and daytime well-being in the sense of a rebound phenomenon and indicates that a deterioration of sleep after drug withdrawal is not apparent during a few days but may last for longer periods in some patients and is modified by marked night-to-night variations.
Quazepam: Hypnotic Efficacy and Side Effects
  • A. Kales
  • Medicine, Psychology
  • 1990
Quazepam is a benzodiazepine hypnotic that can be useful in the adjunctive pharmacologic treatment of insomnia and is more effective with short‐term use, and with continued use it maintains its efficacy in contrast to both of these drugs which show rapid development of tolerance.
Reintroduction of quazepam: an update on comparative hypnotic and adverse effects.
  • N. Moniri
  • Psychology, Biology
    International clinical psychopharmacology
  • 2019
The purpose of this review is to provide an update on distinguishing features of quazepam with regard to its pharmacology, pharmacokinetics, sleep efficacy and potential adverse effects compared to other agents used for insomnia.
Drug Treatment of Patients with Insomnia and Excessive Daytime Sleepiness
Recently obtained knowledge of the pharmacokinetics of hypnosedatives and CNS stimulants and their applications for patients affected with insomnia and EDS are introduced.


Hypnotic Efficacy of Triazolam: Sleep Laboratory Evaluation of Intermediate‐Term Effectiveness
The data indicate that triazolam is effective for short-term use, loses most of its effectiveness with intermediate- term use, and its withdrawal is followed by a significant sorsening of sleep.
Quazepam and flurazepam: Long‐term use and extended withdrawal
The data suggest that the optimal dose of quazepam is 15 mg, and some loss of effectiveness was noted during long‐term use of both doses of quzepam and, to a lesser extent, of flurazepams.
Comparative hypnotic effects of flurazepam, triazolam, and placebo: a long-term simultaneous nighttime and daytime study.
Daytime testing revealed significantly decreased daytime alertness and decreased performance for flurazepam subjects during weeks 3 to 7, although these effects reverted toward baseline despite continued drug administration, suggesting that the onset of the rebound insomnia depended on the rate of drug washout.
Pharmacology and Hypnotic Efficacy of Triazolam
Overall, triazolam is an effective and safe compound for the symptomatic treatment of insomnia complaints, making it the shortest acting benzodiazepine available in the United States.
Midazolam: dose-response studies of effectiveness and rebound insomnia.
There was less effectiveness on the last 3 drug nights, indicating a potential for the development of tolerance over a relatively short period of time and following withdrawal there was a marked dose-related worsening of sleep above baseline levels (rebound insomnia).
Effects of brotizolam on the sleep of chronic insomniacs.
Effects of 0.5 mg brotizolam on the sleep of chronic insomniacs were assessed electroencephalographically and subjectively over 14 days and the drug was well tolerated.
Quazepam, A New Benzodiazepine Hypnotic: Intermediate‐Term Sleep Laboratory Evaluation
Data regarding long-term safety or tolerance of the drug suggest that quazepam is well tolerated and that its pharmacological effects are similar to those of other benzodiazepines.
Rebound insomnia: a new clinical syndrome.
Rebound insomnia followed the withdrawal of three benzodiazepine hypnotic drugs, each of which had been administered in a single nightly dose for only short-term periods. The intense worsening of
Early morning insomnia with rapidly eliminated benzodiazepines.
Early morning insomnia, a significant increase in wakefulness during the final hours of drug nights, occurred after 1 or 2 weeks of nightly administration of benzodiazepine hypnotics with short
Rebound insomnia and rebound anxiety: a review.
Evidence suggests that drugs producing rebound insomnia and rebound anxiety show a more rapid development of tolerance and greater potential for drug dependence than benzodiazepines where the parent compound or its metabolites have a long elimination half-life.