Triazolam (Halcion) versus flunitrazepam (Rohypnol) against midwinter insomnia in Northern Norway

In a double-blind, cross-over trial, triazolam (0.25 mg) was tested against flunitrazepam (1 mg) in the typical midwinter insomnia which is often seen among otherwise healthy people in Northern Norway. Each drug was given for five nights, in random order, with a five-night placebo period between the active drugs (providing for a single blind comparison with placebo). A total of 2 outpatients started the trial; 19 completed. There were highly significant differences between each active drug and placebo on the subjectively scored variables sleep latency, duration of sleep, and total evaluation of sleep, and also significant differences for feeling in the morning, number of awakenings, and quality of sleep; all differences were in favour of the active drugs. Generally, the sleep variables were rated on the same level in the placebo period as they were for the last five nights prior to the trial. There were no significant differences between triazolam and flunitrazepam on any variable. However, eight patients stated a preference for triazolam and eight for flunitrazepam. These two groups of patients did not differ significantly with regard to sex, age, previous use of hypnotics, or severity of insomnia. Only three patients complained about side effects. Notably, the feeling of being alert and refreshed in the morning was significantly superior in the active drug periods as against the placebo period. It is concluded that both active drugs were highly effective, with a minimum of side effects, in this type of insomnia and with the relatively low dosage used.