Lorazepam for Psychosis

(GABAmech Trial)

This trial explores how lorazepam affects brain activity in individuals with psychotic illnesses such as schizophrenia or bipolar disorder. Researchers will compare brain responses to emotional images between those with these conditions and healthy individuals. Participants will attend several sessions involving MRI scans, where they may receive lorazepam (Ativan) or a placebo. This trial suits individuals who have lived with a psychotic illness for over two years or those without any mental illness who can tolerate enclosed spaces like an MRI machine. As a Phase 4 trial, lorazepam is already FDA-approved and proven effective, and this research aims to understand how it benefits more patients.

The trial requires that you are not taking chronic narcotics, barbiturates, or benzodiazepines. You should not have increased your psychotropic medication in the last 4 weeks. You can take benzodiazepines as needed, but not within 5 half-lives of an MRI session. Healthy controls cannot take any medication with psychotropic effects.

Research shows that lorazepam is usually safe and effective for treating anxiety. The FDA has approved it, indicating that its safety has been thoroughly studied. However, lorazepam can cause side effects, including unusual movements, seizures, and sudden changes in mental state.

Previous studies on lorazepam tablets have reported these side effects, but they are uncommon. Many people take lorazepam without major issues. It is not recommended for individuals with primary depression or psychosis, as it might worsen these conditions.

Lorazepam is unique because it offers a potentially quicker relief of psychotic symptoms compared to standard treatments like antipsychotics, which often take weeks to become fully effective. Unlike typical antipsychotic drugs that primarily target dopamine receptors, Lorazepam, a benzodiazepine, acts on GABA receptors, which might help in rapidly calming acute episodes of psychosis. Researchers are excited about this treatment because it could provide immediate symptom relief, which is critical during severe psychotic episodes, offering a promising alternative or adjunct to current therapies.

Research shows that lorazepam, a medication often used to treat anxiety, can also help manage symptoms of psychosis. Known for its calming effects, it can reduce agitation and distress in people with conditions like schizophrenia and bipolar disorder. In this trial, participants with schizophrenia, schizoaffective disorder, bipolar disorder, or early psychosis will receive lorazepam to evaluate its effectiveness in managing psychosis symptoms. Studies have found that lorazepam can quickly ease severe anxiety and agitation, making it useful in emergencies for those with serious mental health issues. Additionally, its ability to affect mood disorders supports its use in managing psychosis symptoms related to these disorders. Lorazepam boosts the activity of certain chemicals in the brain, calming the nervous system. This mechanism explains its expected effectiveness in treating psychotic symptoms.⁴⁶⁷⁸⁹