Triazolam treatment of insomnia in depressed patients taking tricyclics.

A double-blind crossover study in 53 psychiatric outpatients compared the safety and efficacy of triazolam and placebo in relieving insomnia refractory to treatment with a tricyclic antidepressant. Patients with a depressive disorder who had been taking a TCA for at least 6 weeks received triazolam or placebo for 4 days, neither medication for 1 day, and the alternative treatment for 4 days. The antidepressant regimen was maintained throughout the study. Sleep measurements showed triazolam to be consistently more effective than placebo in promoting and maintaining sleep and enabling the patient to awaken feeling rested. No worsening in depression or anxiety was seen with either triazolam or placebo; some measures indicated improvement in anxiety and depression symptoms on triazolam. One patient on triazolam dropped out because of side effects. The most common side effect was mild to moderate drowsiness.