Lorazepam-Assisted Interview in Clinical Psychiatry: A Narrative Review of Current Evidence and Research Gaps

Introduction: Drug-assisted interviews have been used in psychiatry for about a century. The use of barbiturates for this purpose has declined, and the use of lorazepam has gained popularity over time for conducting drug-assisted interviews, given a better safety profile. However, the evidence for the use of lorazepam for drug-assisted interviews is fragmented and anecdotal, and mostly in the form of case reports. The current review aims to synthesize available evidence on the use of lorazepam-assisted interviews in psychiatry. Methods: For this narrative review, a literature search was conducted using PubMed, Scopus, and Google Scholar. Peer-reviewed articles on the use of lorazepam for drug-assisted interviews for psychiatric patients were identified, and data were manually extracted and synthesized. Results: Eleven case reports and one case series on lorazepam-assisted interviews were identified. Dissociative disorder was the common diagnosis where it was used, with most studies reporting significant improvement after the interviews. Adverse events, though rare, included excessive sedation, disinhibition, agitation, and emotional lability. Interview protocols varied among the studies, with doses ranging from 2 to 18 mg, administered through intravenous routes either as boluses or infusion (rates ranging from 0.05 mg/min to 0.1 mg/min). Most studies involved single sessions, with a maximum of 12 sessions in one case report. Conclusion: Lorazepam-assisted interview may hold potential clinical utility in appropriate cases. Future studies are needed to establish efficacy and safety and to evaluate interview protocols.