Lorazepam—Efficacy, side effects, and rebound phenomena

  title={Lorazepam—Efficacy, side effects, and rebound phenomena},
  author={Martin B. Scharf and Judith A. Jacoby},
  journal={Clinical Pharmacology \& Therapeutics},
  • M. Scharf, J. Jacoby
  • Published 1 February 1982
  • Psychology, Medicine
  • Clinical Pharmacology & Therapeutics
Lorazepam, 4 mg, was evaluated in an 18‐night sleep‐laboratory study involving five insomniac subjects. Hypnotic effectiveness and effects on sleep stages and related parameters were assessed. Placebo was given on baseline nights 1 to 4, lorazepam on nights 5 to 11, and placebo was given again on withdrawal nights 12 to 18. Subjective and objective data clearly demonstrated that lorazepam was effective for both inducing and maintaining sleep. Sleep latency was reduced from a baseline value of… 
Rebound Insomnia and Elimination Half‐Life: Assessment of Individual Subject Response
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Rebound insomnia after hypnotic withdrawal in insomniac outpatients
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Quazepam and temazepam: Effects of short‐ and intermediate‐term use and withdrawal
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Comparison of short and long half‐life benzodiazepine hypnotics: Triazolam and quazepam
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Ceiling and floor effects in sleep research.
The results show powerful CF influences on sleep responses to hypnotics and exercise and suggest a need for comparing these treatments in poor sleepers.
Placebo‐controlled comparative study of the anxiolytic activity and of the pharmacokinetics of oral and sublingual lorazepam in generalized anxiety
Both the oral and sublingual lorazepam produced a significant anxiolytic effect; there was no statistically significant difference between the therapeutic effectiveness of the two forms of lorzepam.
Clorazepate and lorazepam: clinical improvement and rebound anxiety.
Some patients, however, experienced rebound anxiety, which appeared to be more intense and occurred earlier when placebo was substituted for a benzodiazepine with a short half-life than for one with a long half- life (clorazepate).
Rebound anxiety in anxious patients after abrupt withdrawal of benzodiazepine treatment.
In this double-blind, placebo-controlled study, 16 patients whose benzodiazepine was withdrawn abruptly were worse than 13 who had received placebo in terms of change in mean anxiety scores from the pretreatment level.
Diazepam in the Treatment of Moderate to Severe Alcohol Withdrawal
The comparative pharmacokinetics of the benzodiazepines used in the treatment of alcohol withdrawal together with a comprehensive review of the literature on their use strongly suggest that diazepam should be the preferred Benzodiazepine for the Treatment of patients experiencing moderate to severe alcohol withdrawal under most circumstances.
The natural history of tolerance to the benzodiazepines.
Ex-long-term benzodiazepine users are more likely to manifest two specific types of effects--immediate 'symptom' reduction and exacerbation of 'withdrawal symptoms' over the subsequent week following complete abstinence from the drug.


Anxiety and sleep after fosazepam.
Fosazepam administration improved subjective sleep quality, sleep was less broken, slow wave sleep stages 3 and 4 diminished in duration and so did REM sleep, suggesting action of a long half-life metabolite.
Hypnotic efficacy of lorazepam and flurazepam
In a double‐blind crossover study involving 15 insomniac subjects, the hypnotic efficacy of lorazepam, 2 and 4 mg, was compared with flurazepam, 15 and 30 mg, and placebo. Five subjective measures
Rebound insomnia. A potential hazard following withdrawal of certain benzodiazepines.
Rebound insomnia occurred following withdrawal of triazolam, nitrazepam, and flunitsepam after they had been given in only single, nightly doses for short periods, attributed to the short and intermediate half-lives of these drugs.
Lorazepam versus Glutethimide as a Sleep‐Inducing Agent for the Geriatric Patient
ABSTRACT: The safety of lorazepam was compared with that of a standard drug, glutethimide, in 50 chronically ill geriatric patients. Repeated physical examinations, laboratory determinations and
Rebound insomnia: a new clinical syndrome.
Rebound insomnia followed the withdrawal of three benzodiazepine hypnotic drugs, each of which had been administered in a single nightly dose for only short-term periods. The intense worsening of
Clinical pharmacokinetics of lorazepam. I. Absorption and disposition of oral 14C-lorazepam.
Biotransformation to a pharmacologically inactive glucuronide metabolite appeared to be the major mechanism of lorazepam clearance and its metabolites in body fluids were determined by appropriate analytic techniques.
Comparative metabolism of lorazepam in man and four animal species.
The urinary route of excretion predominates in man, dog, cat, rat and miniature swine while in the rat the bulk of the drug-related material is eliminated with the feces as a consequence of biliary excretion.
Benzodiazepines in Clinical Practice
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Abstract Methods for constructing simultaneous confidence intervals for all possible linear contrasts among several means of normally distributed variables have been given by Scheffe and Tukey. In
A Manual of Standardized Terminology, Techniques and Scoring System for Sleep Stages of Human Subjects.
Techniques of recording, scoring, and doubtful records are carefully considered, and Recommendations for abbreviations, types of pictorial representation, order of polygraphic tracings are suggested.