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Related Experiment Videos

Sensitivity to triazolam in the elderly.

D J Greenblatt1, J S Harmatz, L Shapiro

  • 1Department of Psychiatry, Tufts University School of Medicine, New England Medical Center Hospital, Boston 02111.

The New England Journal of Medicine
|June 13, 1991
PubMed
Summary

Elderly individuals experience greater sedation and impaired psychomotor performance from triazolam due to reduced drug clearance. Lowering triazolam dosage by 50% in older adults is recommended to mitigate these effects.

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Area of Science:

  • Pharmacology
  • Gerontology
  • Clinical Pharmacy

Background:

  • Central nervous system depressants affect the elderly disproportionately.
  • Triazolam, a benzodiazepine hypnotic, is frequently prescribed in the United States.
  • Age-related differences in drug response necessitate pharmacokinetic and pharmacodynamic investigation.

Purpose of the Study:

  • To investigate the impact of age on triazolam pharmacokinetics and pharmacodynamics.
  • To compare the effects of triazolam in healthy young and elderly subjects.
  • To determine appropriate triazolam dosage adjustments for the elderly population.

Main Methods:

  • A four-way crossover study involving 26 young (mean age 30) and 21 elderly (mean age 69) healthy subjects.
  • Administration of placebo, 0.125 mg, and 0.25 mg triazolam in a double-blind, randomized manner.

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  • Assessment of plasma triazolam levels, psychomotor performance, memory, and sedation for 24 hours post-administration.

    • Main Results:

    • Elderly subjects exhibited higher plasma triazolam concentrations due to reduced drug clearance.
    • Greater sedation and impaired psychomotor performance (digit-symbol substitution test) were observed in the elderly group at equivalent doses.
    • Memory recall impairment from triazolam was comparable between young and elderly participants.

    Conclusions:

    • Triazolam induces more pronounced sedation and psychomotor impairment in the elderly compared to younger individuals at the same dosage.
    • These age-related differences stem from decreased triazolam clearance and elevated plasma concentrations, not increased drug sensitivity.
    • A 50% reduction in triazolam dosage for elderly individuals is suggested to enhance safety and efficacy.