Management of acute anxiety syndrome with parenterally administered lorazepam

After the preliminary successful use of injectable lorazepam in calming 20 patients who presented with acute anxiety crises, a formal study of 115 other such patients was carried out. All were seen either in a hospital emergency room or on an emergency out-patient basis in private practice. Treatment consisted of an initial intravenous injection of lorazepam (3mg) followed, if necessary, by up to three further injections within a 24-hour period. The result was usually dramatic: complete abolition or reasonable control of symptoms within 30 minutes in all but 2 patients. The major effect was relaxant and sedative; 62 patients slept following the injections. although 55 could be easily aroused, 7 could not. Of the other patients, 49 remained awake but relaxed; only 4 remained tense and were regarded as treatment failures. No significant side-effects or changes in vital signs were noted. The results support and extend those reported by other invesigators in a recent controlled, double-blind (but otherwise similarly conducted) trial.