Improved tolerance of cytotoxic chemotherapy with lorazepam. A pilot study

Nausea and vomiting may be the most distressing part of cytotoxic chemotherapy for malignant disease and frequently leads to default from treatment. Furthermore, in some patients, anxiety associated with chemotherapy precipitates anticipatory vomiting. 24 patients with refractory vomiting associated with chemotherapy were selected from a homogeneous group of malignancies. 25% of these also had anticipatory vomiting. Lorazepam, a benzodiazepine, in a dose of 3 mg/m2, was given by mouth in conjunction with a standard centrally acting antiemetic 30 min before chemotherapy. Vomiting was totally abolished in 70% of patients; in only 4% two vomiting episodes occurred. In addition, 17% of patients had complete amnesia of the events of chemotherapy. This pilot study suggests that lorazepam in conjunction with standard antiemetic therapy may be an effective means of controlling refractory nausea and vomiting.