Summary
The pharmacokinetics of triazolam 0.25 mg p.o. and psychomotor coordination were compared in nine healthy, elderly volunteers and nine middle aged controls. Motor coordination, as measured by pursuit rotor performance, was impaired in the elderly even before triazolam administration, and in contrast to the controls it deteriorated to a critical level after the drug. Factors associated with the major decrease in psychomotor performance in the elderly volunteers were poor baseline performance, an additional independent-age factor, and the plasma concentration of free triazolam.
Although short acting benzodiazepines may have a less detrimental effect on performance on the morning following their intake, there may be serious motor incoordination and falls may occur if the patients have to rise during the night, particularly when the plasma concentration is high, i.e. about 2 h after dosing.
Similar content being viewed by others
References
Everitt DE, Avorn J (1986) Drug prescribing for the elderly. Arch Intern Med 146: 2392–2396
Ray WA, Griffin MR, Schaffner W, Baugh DK, Melton LJ (1987) Psychotropic drug use and the risk of hip fracture. N Engl J Med 316: 363–369
Sorock GS, Shimkin EE (1988) Benzodiazepines sedatives and the risks of falling in a community-dwelling elderly cohort. Arch Intern Med 148: 2441–2444
Tinetti ME, Speechley M, Ginter SF (1988) Risk factors for falls among elderly persons living in the community. N Engl J Med 319: 1701–1706
Dehlin O, Björnson G, Börjesson L, Abrahamsson L, Smith RB (1983) Pharmacokinetics of triazolam in geriatric patients. Eur J Clin Pharmacol 25: 91–94
Carskadon MA, Seidel WF, Greenblatt DJ, Dement WC (1982) Daytime carryover of triazolam and flurazepam in elderly insomniacs. Sleep 5: 361–371
Greenblatt DJ, Divoll M, Abernethy DR, Moschitto LJ, Smith RB, Shader RI (1983) Reduced clearance of triazolam in old age: relation to antipyrine oxidizing capacity. Br J Clin Pharmacol 15: 303–309
Baktir G, Fisch HU, Karlaganis G, Minder CH, Bircher J (1987) Mechanism of the excessive sedative response of cirrhotics to benzodiazepines: Model experiments with triazolam. Hepatology 7: 629–638
Diagnostic and statistical manual of mental disorders (1987) 3rd ed-revised). DSM-III-R. American Psychiatric Association, Washington DC
Jochemsen R, Breimer DD (1981) Assay of triazolam in plasma by capillary gas chromatography. J Chormatogr 228: 438–444
Baktir G, Bircher H, Fisch HU, Karlaganis G (1985) Capillary gas-liquid chromatographic determination of the benzodiazepine triazolam in plasma using a retention gap. J Chromatogr 339: 192–197
Baktir G, Fisch HU, Huguenin P, Bircher J (1983) Triazolam concentration-effect relationships in healthy subjects. Clin Pharmacol Ther 34: 195–201
Pomara N, Stanley B, Block R, Berchou RC, Stanley M, Greenblatt DJ, Newton RE, Gershon S (1985) Increased sensitivity of the elderly to the central depressant effects of diazepam. J Clin Psychiatry 46: 185–187
Author information
Authors and Affiliations
Additional information
Some of the data were published in Baktir et al.: Mechanism of the excessive response of cirrhotics to benzodiazepines: Model experiments with triazolam (Hepatology 1987; 7: 629–38)
Rights and permissions
About this article
Cite this article
Fisch, H.U., Baktir, G., Karlaganis, G. et al. Excessive motor impairment two hours after Triazolam in the elderly. Eur J Clin Pharmacol 38, 229–232 (1990). https://doi.org/10.1007/BF00315021
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00315021