HALCION / TRIAZOLAM

DESCRIPTION / DEFINITIONS: Halcion is benzodiazapene with the active ingredient Triazolam.  It is a tranquilizer usually used to treat certain types of sleep disorders but can also be used for other problems. See more information below.

ABUSE: Halcion is commonly abused. See more information below.

ADDICTION / DEPENDENCE: One can become dependent on Halcion even when taken as prescribed for a short period of time. See more information below, including half life and metabolism.

SIDE EFFECTS:  Shortness of breath, sleep disturbances, mania, amnesia, depressed mood, light headedness, loss of appetite, loss of balance or coordination. See more complete list below.

WITHDRAWAL SYMPTOMS: abdominal cramps, convulsions, tremor, vomiting, and others. See more information below.

TREATMENT: Treatment can be made safe and more comfortable with a medical detoxification program. Quitting Halcion without medical supervision can be dangerous.

 

DESCRIPTION / DEFINITIONS

Halcion is a potent benzodiazapene with the active ingredient Triazolam. It is a tranquilizer most often used to treat certain types of insomnia including difficulty falling asleep, waking up often during the night, or waking up early in the morning. It is also prescribed for anxiety, alcohol withdrawal, seizure control, muscle relaxation, for inducing amnesia for uncomfortable medical procedures. It is also often given before an anesthetic for surgery. It is classified as a Schedule IV drug because it can be abused or lead to dependence.

ABUSE

Benzodiazepines like Halcion are commonly abused. Halcion is supposed to be prescribed only for a short period of time of 7 to 10 days. But because it relieves anxiety and helps insomnia, it is often taken for longer than advised. You can become dependent physically on Halcion after taking it for even a short time and can experience withdrawal symptoms when you try to stop using it.

Halcion can be chronically abused or taken in overdose. Statistics show that over 50 percent of emergency department visits involve benzodiazepines. Sometimes the drugs are taken alone, but they are frequently taken with either alcohol or other medications. The combination of Halcion or other benzodiazepines with alcohol can be dangerous — and even lethal. 

ADDiCTION / DEPENDENCE

The effects of Halcion are short-acting. A person using it to help with sleep may even find its effects wearing off during the night, at which time they may begin to experience withdrawal symptoms and take more of the drug. Also, the dosage being used can become less effective after being used for a short time. At that point, people taking it may increase the dosage.

This increases the risk of overdose, along with physical dependence and can lead to psychological addiction.

 

HALF LIFE AND METABOLISM

The biological half-life of a substance is the time it takes for a drug to lose half of its pharmacologic activity. This is significant because it affects how soon withdrawal symptoms may appear.

The half life of Halcion is 1.5 to 5.5 hours. 

The initial step in triazolam metabolism is hydroxylation catalyzed by cytochrome P450 3A (CYP 3A). Drugs that inhibit this metabolic pathway may have a profound effect on the clearance of triazolam. Consequently, triazolam should be avoided in patients receiving very potent inhibitors of CYP 3A.

The CYP enzymes are the major enzymes involved in drug metabolism, and since many drugs may increase or decrease the activity of various CYP isozymes, this is a major source of adverse drug interactions, since changes in CYP enzyme activity may affect the metabolism and clearance of various drugs. For example, if one drug inhibits the CYP-mediated metabolism of another drug, the second drug may accumulate within the body to toxic levels, possibly causing an overdose.

Halcion should not be taken with CYP enzyme inhibiting drugs such as Cimetidine (Tagamet and other drugs that inhibit stomach acid), certain antifungal agents, Macrolide Antibiotics (like erythromycin and clarithromycin), and others.

SIDE EFFECTS

According to the drug label, serious adverse reactions may be associated with Halcion. The side effects include:

  • agitation
  • aggressiveness
  • allergic reactions such as hives, difficulty breathing, swelling of the face, lips, tongue, or throat
  • anxiety
  • burning in the eyes
  • burning tongue, inflammation of the tongue or inflammation of the mucous membrane of the mouth
  • changes in menstrual periods
  • chest pain
  • clay-colored stools
  • confusion
  • congestion
  • constipation
  • cramps
  • dark urine
  • daytime drowsiness (or during hours when you are not normally sleeping)
  • delusions
  • depressed mood
  • dermatitis
  • diarrhea
  • Dysesthesia – an unpleasant, abnormal sense of touch. It can include sensations in any bodily tissue, including most often the mouth, scalp, skin, or legs, and is commonly associated with multiple sclerosis.
  • dizziness
  • dreaming
  • dry mouth
  • euphoria
  • falling
  • fast or pounding heartbeats
  • feeling excited
  • feeling like you might pass out
  • shortness of breath
  • feelings of extreme happiness or sadness
  • hallucinations
  • headache
  • incontinence
  • increased or decreased interest in sex
  • insomnia
  • irritability
  • itching
  • jaundice – yellowing of the skin or eyes
  • light headedness
  • loss of appetite
  • loss of balance or coordination
  • mania
  • memory problems and amnesia
  • mild itching
  • nausea
  • nervousness
  • nightmares
  • numbness
  • pain
  • problems with urination
  • shortness of breath
  • sleep disturbances
  • sleep walking
  • slurred speech
  • staggering walk
  • symptoms of depression could be intensified
  • syncope – temporary loss of consciousness caused by a fall in blood pressure
  • taste alterations
  • tingly feeling
  • tinnitus
  • tired feeling
  • upper stomach pain
  • very stiff (rigid) muscles
  • vision problems
  • vomiting
  • weakness

Other Potentially Dangerous Effects

The Halcion label also warns of the following:

  • when used with opioids one can experience fatal respiratory depression and sedation.
  • taking Halcion with isoniazid (an antibiotic used to treat and prevent tuberculosis), oral contraceptives, or grapefruit juice can increase the blood concentration of Halcion and increase Halcion’s half life.
  • Halcion taken while on diuretics can cause death from liver failure.
  • when taken with other benzodiazipenes, the risk of all side effects is higher and they will be more severe and dangerous. These include incontinence, amnesia, confusional states (disorientation, derealization, depersonalization, and/or clouding of consciousness), dystonia, anorexia, fatigue, sedation, slurred speech, jaundice, pruritus, dysarthria, changes in libido, menstrual irregularities, incontinence, and urinary retention.
  • “Sleep-driving” and other complex behaviors – there have been reports of people getting out of bed after taking a sedative-hypnotic and driving their cars while not fully awake, often with no memory of the event.
  • other complex behaviors (e.g., preparing and eating food, making phone calls, or having sex) have been reported in patients who are not fully awake after taking a sedative hypnotic. As with sleep-driving, patients usually do not remember these events.
  • an increase in daytime anxiety has been reported for HALCION after as few as 10 days of continuous use
  • hazardous occupations requiring complete mental alertness such as operating machinery or driving a motor vehicle
  • Benzodiazepines may cause fetal damage such as congenital malformations when administered during pregnancy.

WITHDRAWAL SYMPTOMS

Symptoms of withdrawal are generally more severe when Halcion has been used in higher dosages or for longer periods of time. However, even patients given a therapeutic dose for one to two weeks can also experience these symptoms. Some may even experience withdrawal symptoms in the middle of the night as the drug wears off. The symptoms include:

  • abdominal cramps
  • convulsions
  • dysphoria (a state of unease or generalized dissatisfaction with life)
  • muscle cramps
  • panic attacks
  • perceptual disturbances
  • shakiness
  • sweating
  • tremor
  • vomiting
  • unpleasant feelings

TREATMENT

Quitting Halcion without medical supervision can be dangerous. Medical detox facilities are available to assist in the withdrawal and make it safe and more comfortable. Call us to talk to a Novus Detox Advisor.