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Detoxification for triazolam physical dependence.

The clinical characteristics of a series of patients who developed physical dependence to triazolam has not previously been described. We report five cases of high-dose triazolam abuse in which the daily dosage ranged from 5 to 15 mg (100-300 mg diazepam equivalent) and the duration of use ranged from 3 months to 5 years. Physical dependence usually occurs in the context of a history of alcohol or other drug abuse, a history of panic attacks or anxiety disorder, substitution of triazolam for a longer-acting benzodiazepine, or inappropriate use of triazolam as an anxiolytic agent given as multiple daily doses. A rational approach to the pharmacotherapy of triazolam withdrawal is described. Treatment to replace the triazolam with a long half-life CNS depressant and strategies for this pharmacologic therapy are discussed. The abuse liability of triazolam may be no greater and is most likely less than that of some other benzodiazepines.