Lorazepam comparative studies

An open, comparative study of 14 acutely psychotic patients treated with lorazepam alone n = 8, mean dose, 20.9 mg/day) or lorazepam plus haloperidol (mean dose, 15 mg/day mean dose, 5.2 mg/day, respectively) demonstrated a significant decrease in psychotic symptoms over 48 hours (118). Although the improvement in both groups was equal, the doses of haloperidol were low, and there was no comparative placebo group. 

The pharmacokinetics of intranasal lorazepam compared with oral administration have been evaluated in 11 volunteers in a randomized, crossover study (20). Lorazepam had favorable pharmacokinetics for intranasal administration compared with standard methods. Intranasal delivery could provide an alternative non-invasive delivery route for lorazepam. 

Diamond Bl, Nguyen H, et al. A comparative study of alpidem, a nonbenzodiazepine, and lorazepam in patients with nonpsychotic anxiety. Psychopharmacol Bull 1991 27 67-71. 

Allen D, Baylav A, LaderM. A comparative study of the interactionof alcohol with alpidem, lorazepam and placebo in normal subjects. Int Clin Psychopharmacol (1988) 3, 327-41. 

American Psychiatric Association Benzodiazepine Dependence, Toxicity, and Abuse A Task Force Report of the American Psychiatric Association. Washington, DC, American Psychiatric Association, 1990 Cohn JB, Wilcox CS Low-sedation potential of buspirone compared with alprazolam and lorazepam in the treatment of anxious patients a double-blind study. J Clin Psychiatry 47 409 12, 1986 Dolovich LR, Addis A, Vaillancourt JM, et al Benzodiazepine use in pregnancy and major malformations or oral cleft meta-analysis of cohort and case-control studies. BMJ 317 839-843, 1998 Goldberg HL, Finnerty RJ The comparative efficacy of buspirone and diazepam in the treatment of anxiety. Am J Psychiatry 136 1184—1187, 1979 Kupfer DJ, Reynolds CF 111 Management of insomnia. N Engl J Med 336 341-346, 1997... 

Lorazepam. Lenox et al. (118) found lorazepam and haloperidol comparable in efficacy when used as adjuncts to lithium in a double-blind study of 20 acutely manic patients. Interestingly, another report comparing lorazepam with clonazepam found a better outcome with lorazepam, using mean doses of 12 to 13 mg (119). 

Valproate Versus Lithium. The previously discussed Bowden et al. (135) study found the DVPX formulation to be comparable with lithium, which was used as a positive comparator in this placebo-controlled study. Freeman et al. (99) conducted a 3-week, double-blind, parallel-group comparison of VPA and lithium for acute mania. Both drugs demonstrated clinically significant efficacy (i.e., 9 of 14 responded to DVPX and 12 of 13 to lithium), and there was no difference in the need for rescue medications (i.e., lorazepam or chloral hydrate) between the two treatment groups. Response to VPA was associated with high pretreatment depression scores. 

Verapamil Versus Other Psychotropics. Garza-Trevino et al. (258) conducted a 4-week, randomized, double-blind study comparing verapamil with lithium for acute mania and found no clinical or statistically significant differences between the two treatments. These results are difficult to interpret, however, because data about the amount and timing of rescue medication (i.e., haloperidol, lorazepam) were not presented. Further, more patients on verapamil required these agents. 

There is some evidence that higher than usual doses of lower potency BZDs may also be effective in treating PD ( 17, 25, 43, 81, 82, 83 and 84). For example, studies comparing alprazolam with lorazepam or diazepam indicate approximately equal efficacy ( 25, 43, 84, 85). In addition, there is evidence that higher than usual doses of diazepam, lorazepam, bromazepam, or clobazam may also block panic attacks. 

Compared with focused attention, fewer studies have examined the effects of benzodiazepines on selective attention. Two studies have shown that performance on the Stroop test was impaired by lorazepam.119 131 Acute administration of triazolam and lorazepam produced dose-dependent decrements in response rate and accuracy in a simultaneous matching-to-sample task, which required subjects to determine which of two comparison visual stimuli was identical to the sample stimulus.148 161 The drug effects differed as a function of task difficulty, such that the benzodiazepine-induced impairment was reduced when discriminability of the non-matching stimulus was increased. 

A 6-week, double-blind, randomized, parallel, phase II, single-center, outpatient study has been performed to study the efficacy and safety of lesopitron 40-80 mg/day compared with lorazepam 2-4 mg/day and placebo in 161 patients with generalized anxiety disorder (1). The most common adverse events associated with lesopitron were somnolence, headache, and dyspepsia, compared with headache, somnolence, and insomnia with lorazepam. Patients treated with placebo mainly experienced headache, somnolence, and pharyngitis. 

A 6-week, double-bUnd, randomized, parallel, phase II, single-center, outpatient study has been performed to study the efficacy and safety of lesopitron 40-80 mg/day compared with lorazepam 2-4 mg/day and placebo in 161... 

The three most commonly used classes of anticonvulsants for the initial treatment of GCSE are the benzodiazepines, hydantoins, and barbiturates. Five prospective, randomized smdies have compared these therapies for the treatment of GCSE. The first two studies were a blinded comparison of lorazepam versus diazepam in adults and children. The third study was a randomized comparison of... 

In another study, Malsch and Kieser (2001) investigated the anxiolytic effects of WS 1490 compared to placebo in patients previously treated with a benzodiazepine. They evaluated the potential of the kava preparation as a replacement for the benzodiazepine, as well as the ability of the kava preparation to reduce benzodiazepine withdrawal symptoms. This was a five-week randomized, double blind placebo-controlled study in outpatients with non-psychotic anxiety (e.g., generalized anxiety disorder, social phobia, and simple phobia). Forty patients were included, and all had been on benzodiazepines (i.e., lorazepam, bromazepam, oxazepam, or alprazolam) for a mean duration of 20 months prior to entering the study. Of the 40 patients, 25 were males, and the mean age of the total sample was 40 years (range 21—75 years). 

It is very difficult to assess and compare the results of the very many studies of this interaction because of the differences between the tests, their duration, the dosages of the benzodiazepines and alcohol, whether given chronically or acutely, and a number of other variables. However, the overall picture seems to be that benzodiazepines and related drugs including diazepam, " alprazolam,bromazepam, brotizolam, chlo-rdiazepoxide, " clobazam, dipotassium clorazepate, flunitrazepam, flurazepam, loprazolam, " lorazepam, lormetazepam, medazepam, midazolam, nitrazepam, " " oxazepam, temazepam, " triazolam, and zopiclone enhance the effects of alcohol i.e. cause increased drowsiness, impaired performance and driving skills. 

The pharmacokinetics of high-dose cyclophosphamide, cisplatin and carmustine in 23 patients given ondansetron, lorazepam and diphenhydramine as antiemetics were compared with those in 129 patients who received prochlorperazine instead of ondansetron. It was found that the AUCs of cyclophosphamide and cisplatin, but not that of carmustine, were significantly lower (by 15% and 19%, respectively) in the ondansetron group. Similarly, in another study, the pharmacokinetics of antineoplastics were analysed in 54 patients with breast cancer who were receiving high-dose cyclophosphamide, cisplatin and carmustine with lorazepam and ondansetron with or without prochlorperazine and com-... 

A controlled study, comparing 7 women taking an oral contraceptive with 8 women not taking oral contraceptives found that the mean half-life of intravenous lorazepam 2 mg was over 50% shorter in the oral contraceptive group (6 hours compared to 14 hours) and the total clearance was over threefold greater. ... 

Psychological The effects of rupatadine 10 mg od with or without lorazepam 2 mg have been studied in a double-blind, crossover, randomized, placebo-controlled trial in 16 healthy young volunteers [30. The effects were evaluated by seven objective tests of psychomotor performance and eight subjective visual analogue scales before the dose and at several times thereafter. Compared with placebo rupatadine alone did not significantly impair psychomotor performance or subjective sedation and neither... 

A general and persistent anxiety with nervousness and other symptoms is termed generalized anxiety disorder (GAD). It can lead to a chronic condition exacerbated by stressful events. Benzodiazepines are commonly used in treatment but they cause sedation, and long-term use may induce dependence or abuse. A second study (Woelk and Schlafke, 2010) compared the effects of Silexan with lorazepam in 78 patients with GAD. Over a 6-week period, they were administered daily either one Silexan capsule with a lorazepam placebo or a 0.5 mg lorazepam capsule and a Silexan placebo. Assessments were based on HAMA, HSQ, SAS, CGI, and the Penn State Worry Questionnaire. Results showed that the total HAMA score decreased by 45% and 46% in the Silexan and lorazepam groups, respectively. Other assessment scores improved to a similar extent for both groups. It was concluded that both Silexan and lorazepam had comparable positive effects in adults with GAD (Woelk and Schlafke, 2010). 

Five benzodiazepines, diazepam, nordiazepam, oxazepam, temazepam, and lorazepam, were determined in urine and serum using SPME [49]. The SPME parameters were optimized in aqueous solutions using calibration curves, and LODs ranged from 20 to 70 ng/ml. Serum and urine samples were successfully qualitatively analyzed for the five benzodiazepines studied using El GG-MS, however it was noted that the extraction of oxazepam and lorazepam was suppressed in the biological matrices compared with aqueous solution [49]. 

A trial was carried out comparing lorazepam 1 mg t.d.s. and diazepam 5 mg t.d.s. over a period of 6 months (49 ). No untoward effects were reported by the patients, laboratory tests including blood studies, urinalysis, blood sugar and serum bilirubin levels were unaffected by lorazepam. French literature was reviewed and confirmed acceptability, efficacy as an... 

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