Lorazepam: a randomized, double-blind, crossover study of a new antiemetic in patients receiving cytotoxic chemotherapy and prochlorperazine.

Abstract

Lorazepam was compared to placebo to assess its control of nausea and vomiting in patients receiving cytotoxic chemotherapy and prochlorperazine. The study design was a randomized, double-blind crossover in which three consecutive chemotherapy courses were compared so that each patient acted as his or her own control. Of 107 patients entered, 80 were evaluable for analysis. Lorazepam significantly reduced the severity and duration of nausea, the severity of vomiting, and the number of vomiting episodes when compared to placebo. Anxiety was reduced during lorazepam courses but not significantly when compared to placebo. There was significantly more sedation with lorazepam courses. Overall, patients preferred lorazepam courses although this preference was significant only in the patient subset receiving doxorubicin and cyclophosphamide. Lorazepam is a useful adjunct to prochlorperazine in patients receiving cytotoxic chemotherapy.

Guidelines for the control of nausea and vomiting with chemotherapy of low or minimal emetic potential

“…Lorazepam is an adjunctive drug to antiemetics, and, when added to agents such as prochlorperazine, improves the control of emesis over prochlorperazine alone for a number of anticancer regimens, including those with low emetic potential, but elderly patients may not tolerate it well [1].…”

Acute and Delayed Emesis after Cisplatin-Based Regimen: Description and Prevention

“…Lorazépam [5,6], dexa methasone and high-dose meloclopramide [7] have improved tolerance to cisplatin. Their association is one of the best in the prevention of cisplatin-induced emesis [2], However, lorazépam, a central nervous system depressant, could have important side effects as amnesia at high doses [8,9].…”

Psychopharmacological Agents in Physical Disorders

“…The reports indi cate that about 80% were anxiety free after the injection [158,160], and 80% were se dated but rouscable [161]. Bishop et al [157], in a randomized double-blind crossover pro spective design, noted that benzodiazepines were beneficial in reducing chemotherapyinduced nausea and vomiting. Even though these drugs did not prove to be superior to metaclopramide, they have the advantage of not inducing extrapyramidal symptoms.…”

“…Lorazepam [157][158][159][160][161][162][163] and diazepam [164][165][166] have been evaluated in clinical trials for chemotherapy-induced nausea and vomiting. Either of them was given within 2 h after various chemotherapy.…”