Can Lorazepam be Considered to be a Clinically Effective Means of Treating the Acutely Agitated Patient?

Research Paper Title

Treatment of Agitation With Lorazepam in Clinical Practice: A Systematic Review.

Background

Acute agitation is a frequent occurrence in both inpatient and outpatient psychiatric settings, and the use of medication to calm a patient may be warranted to mitigate the situation. Lorazepam is a benzodiazepine that is widely used for management of acute agitation. Despite its widespread use, there is remarkably little clinical evidence for the benefits of lorazepam in acute agitation.

Methods

The researchers performed a systematic review with focus on lorazepam, including all randomised clinical trials on lorazepam in mental and behavioural disorders, excluding studies on dementia and paediatric patients and in mixed conditions.

Results

A total of 11 studies met inclusion criteria, and all were in patients with mental and behavioural disorders. Most trials generally found improvements across a variety of outcomes related to agitation, although there was some disparity if specific outcomes were considered.

In the five studies with haloperidol, the combination of lorazepam and haloperidol was superior to either agent alone, but with no differences between monotherapy with the individual agents.

Conclusions

In the study comparing lorazepam to olanzapine, olanzapine was superior to lorazepam, and both were superior to placebo.

As expected, the safety of lorazepam among the different studies was consistent with its well-characterised profile with dizziness, sedation, and somnolence being the most common adverse events.

Based on this structured review, lorazepam can be considered to be a clinically effective means of treating the acutely agitated patient.

Reference

Amore, M., D’Andrea, M. & Fagiolini, F. (2021) Treatment of Agitation With Lorazepam in Clinical Practice: A Systematic Review.

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