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Lorazepam (By injection)

Treats seizure disorders, such as epilepsy. Also used before certain medical procedures, such as surgery, to relieve anxiety. Belongs to a class of drugs called benzodiazepines.

What works?

Learn more about the effects of these drugs. The most reliable research is summed up for you in our featured article.

Lorazepam injection is used before certain medical procedures, such as surgery, to relieve anxiety. When lorazepam is used before surgery, the patient will not remember some of the details about the procedure. This medicine is also used to treat certain convulsive (seizure) disorders, such as epilepsy. Lorazepam is a benzodiazepine. Benzodiazepines belong to the group of medicines called central Read more
Brand names include
Ativan
Other forms
By mouth
Drug classes About this
Antianxiety, Anticonvulsant, Skeletal Muscle Relaxant

What works? Research summarized

Evidence reviews

At this time, benzodiazepines cannot be recommended for the treatment of non‐alcohol related delirium

A systematic review of benzodiazepine treatment of non‐alcohol related delirium discovered very few trials (one randomized, controlled study of mechanically ventilated patients, and thus poorly reflective of delirious patients as a whole; and two partially controlled studies), the results of which indicate that at this time there is no evidence to support the use of benzodiazepines in the treatment of non‐alcohol withdrawal related delirium among hospitalised patients.

Benzodiazepines alone or in combination with antipsychotic drugs for acute psychosis

People with mental health problems may exhibit agitated, violent and aggressive behaviour which can be a danger to themselves or others. Usually, de‐escalation techniques such as talking to the patient are used to calm down the situation. However, people’s behaviour may be too disturbed, violent or agitated. In these circumstances, rapid tranquillisation is given to achieve a state of calm. Three major classes of drugs are used to achieve rapid tranquillisation: typical antipsychotics; benzodiazepines; and more recently atypical antipsychotics. The review included 21 studies involving 1968 people. The aim was to explore the tranquillising effects of benzodiazepines (alone or in combination with antipsychotics; placebo; and antihistamines). Overall, there is insufficient information in these 21 studies to support or refute the use of benzodiazepines (alone or in combination with other drugs, where emergency drugs are needed). The majority of studies are too small, so that larger and more informative studies are required before definite conclusions can be drawn as to the effectiveness of benzodiazepines. However, there was good evidence to suggest that benzodiazepines are at least as effective as antipsychotics in reducing the agitation associated with mental illness. Side effects such as weight gain, shaking, tremors and slurred speech were significantly higher in people who received antipsychotics. Therefore, if antipsychotics are used for rapid tranquillisation, they should be given with other calming drugs (anticholinergic medication) which can prevent side effects. There was also some evidence that the combination of benzodiazepines with antipsychotics was superior to either drug alone and may also reduce side effects.

Drug therapy for delirium in terminally ill adult patients

There is limited evidence from clinical trials on the role of drug therapy for the treatment of delirium in terminally ill patients. The key feature of delirium is a decreased level of consciousness (awareness). People may experience impaired memory, thinking and judgement, and become disorientated. They may experience distressing hallucinations or delusions. It occurs frequently in patients with terminal illness, and may be caused by the illness itself or occur as a side effect of drug treatments for symptom management. Our search of the international literature for trials of drug therapies for the treatment of delirium in patients with terminal illness yielded one small study, and therefore it was not possible to assess the effectiveness of drug treatment options. It is hoped that this review will provide an incentive for further research.

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Summaries for consumers

At this time, benzodiazepines cannot be recommended for the treatment of non‐alcohol related delirium

A systematic review of benzodiazepine treatment of non‐alcohol related delirium discovered very few trials (one randomized, controlled study of mechanically ventilated patients, and thus poorly reflective of delirious patients as a whole; and two partially controlled studies), the results of which indicate that at this time there is no evidence to support the use of benzodiazepines in the treatment of non‐alcohol withdrawal related delirium among hospitalised patients.

Benzodiazepines alone or in combination with antipsychotic drugs for acute psychosis

People with mental health problems may exhibit agitated, violent and aggressive behaviour which can be a danger to themselves or others. Usually, de‐escalation techniques such as talking to the patient are used to calm down the situation. However, people’s behaviour may be too disturbed, violent or agitated. In these circumstances, rapid tranquillisation is given to achieve a state of calm. Three major classes of drugs are used to achieve rapid tranquillisation: typical antipsychotics; benzodiazepines; and more recently atypical antipsychotics. The review included 21 studies involving 1968 people. The aim was to explore the tranquillising effects of benzodiazepines (alone or in combination with antipsychotics; placebo; and antihistamines). Overall, there is insufficient information in these 21 studies to support or refute the use of benzodiazepines (alone or in combination with other drugs, where emergency drugs are needed). The majority of studies are too small, so that larger and more informative studies are required before definite conclusions can be drawn as to the effectiveness of benzodiazepines. However, there was good evidence to suggest that benzodiazepines are at least as effective as antipsychotics in reducing the agitation associated with mental illness. Side effects such as weight gain, shaking, tremors and slurred speech were significantly higher in people who received antipsychotics. Therefore, if antipsychotics are used for rapid tranquillisation, they should be given with other calming drugs (anticholinergic medication) which can prevent side effects. There was also some evidence that the combination of benzodiazepines with antipsychotics was superior to either drug alone and may also reduce side effects.

Drug therapy for delirium in terminally ill adult patients

There is limited evidence from clinical trials on the role of drug therapy for the treatment of delirium in terminally ill patients. The key feature of delirium is a decreased level of consciousness (awareness). People may experience impaired memory, thinking and judgement, and become disorientated. They may experience distressing hallucinations or delusions. It occurs frequently in patients with terminal illness, and may be caused by the illness itself or occur as a side effect of drug treatments for symptom management. Our search of the international literature for trials of drug therapies for the treatment of delirium in patients with terminal illness yielded one small study, and therefore it was not possible to assess the effectiveness of drug treatment options. It is hoped that this review will provide an incentive for further research.

See all (15)

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