Anti-Intrusion Effect of Lorazepam: An Experimental Study

다국어 초록 (Multilingual Abstract)

Objective Easy triggering of trauma-related episodic memory fragments caused by perceptual cues is tied to strong perceptual priming in the implicit memory system. And among benzodiazepines, only lorazepam has been consistently reported to have an atypical suppression effect on perceptual priming processes. The aim of this study was to investigate the effects of single doses of lorazepam, diazepam, and a placebo on intrusive memories after exposure to a distressing videotape and to explore whether the anti-intrusive effect of lorazepam is acquired as a result of the suppression of perceptual but not conceptual priming processes.
Methods Under prospective, randomized, and double-blind conditions, we compared the anti-intrusion effect of a single dose of lorazepam (n=22) with that of diazepam (n=22) and a placebo (n=21) in young healthy Korean college students following exposure to a traumatic videotape.
Results We present the first finding for an anti-intrusion effect of lorazepam. One day after the medication, lorazepam, rather than diazepam or the placebo, significantly reduced the extent of intrusion and data-driven processing of the traumatic information. There were no differences among the three conditions in state anxiety, depression, and an arousal scale throughout the experiment.
Conclusion Results from this study suggest the possibility of lorazepam as a candidate anti-intrusion drug, as well as the cautious use of diazepam in the treatment of PTSD patients. The anti-intrusive effect of lorazepam is directly related to its atypical inhibitory effect on implicit perceptual priming processes. The present study provides support for the enhanced perceptual priming hypothesis of PTSD.

참고문헌 (Reference)

1 Kožena L, "Vigilance impairment after a single dose of benzodiazepines" 119 : 39-45, 1995

2 Knopman D, "Unaware learning versus preserved learning in pharmacologic amnesia: similarities and differences" 17 : 1017-1029, 1991

3 Legrand F, "Time course of the effects of diazepam and lorazepam on perceptual priming and explicit memory" 118 : 475-479, 1995

4 Maes M, "The two-factorial symptom structure of post-traumatic stress disorder: depression- avoidance and arousal-anxiety" 81 : 195-210, 1998

5 Curran HV, "The psychopharmacology of memory, In The Oxford handbook of memory" Oxford University Press 539-556, 2000

6 Conway MA, "The construction of autobiographical memories in the self-memory system" 107 : 261-288, 2000

7 Foa E, "The Posttraumatic Diagnostic Scale (PDS) Manual" National Computer Systems 1995

8 "Structured clinical interview for DSM-IV (SCID-I) - Research version"

9 Fillmore MT, "Retrograde facilitation of memory by triazolam: effects on automatic processes" 158 : 314-321, 2001

10 Bishop KI, "Psychopharmacological analysis of implicit and explicit memory: a study with lorazepam and the benzodiazepine antagonist flumazenil" 121 : 267-278, 1995

11 Halligan SL, "Posttraumatic stress disorder following assault: the role of cognitive processing, trauma memory, and appraisals" 71 : 419-431, 2003

12 Speilberger CD, "Manual for the State-Trait Anxiety Inventory" Consulting Psychologists 1983

13 Ehlers A, "Maintenance of intrusive memories in posttraumatic stress disorder: a cognitive approach" 23 : 217-249, 1995

14 Schlagman S, "Involuntary autobiographical memories in and outside the laboratory: how different are they from voluntary autobiographical memories" 36 : 920-932, 2008

15 Krans J, "Intrusive trauma memory: a review and functional analysis" 23 : 1076-1088, 2009

16 Roediger HL 3rd, "Implicit memory. Retention without remembering" 45 : 1043-1056, 1990

17 Amir N, "Implicit memory bias for threat in posttraumatic stress disorder" 20 : 625-635, 1996

18 Horowitz M, "Impact of Event Scale: a measure of subjective stress" 41 : 209-218, 1979

19 Michael T, "Enhanced priming for trauma-related material in posttraumatic stress disorder" 5 : 103-112, 2005

20 Michael T, "Enhanced perceptual priming for neutral stimuli occuring in a traumatic context: two experimental investigations" 45 : 341-358, 2007

21 Ehlers A, "Enhanced perceptual priming for neutral stimuli in a traumatic context: a pathway to intrusive memories" 14 : 316-328, 2006

22 Stewart SH, "Effects of oxazepam and lorazepam on implicit and explicit memory: evidence for possible influences of time course" 128 : 139-149, 1996

23 File SE, "Effects of lorazepam on psychomotor performance: a comparison of independent-groups and repeated-measures designs" 42 : 761-764, 1992

24 Martin J, "Effects of lorazepam and oxazepam on perceptual and procedural memory functions" 164 : 262-267, 2002

25 Vidailhet P, "Effects of lorazepam and diazepam on conscious and automatic memory processes" 127 : 63-72, 1996

26 Danion JM, "Effects of chlorpromazine and lorazepam on explicit memory, repetition priming and cognitive skill learning in healthy volunteers" 108 : 345-351, 1992

27 Boucart M, "Effect of benzodiazepines on structural and conceptual/lexical priming" 165 : 43-50, 2002

28 Fluck E, "Does the sedation resulting from sleep deprivation and lorazepam cause similar cognitive deficits" 59 : 909-915, 1998

29 Murray J, "Dissociation and post-traumatic stress disorder: two prospective studies of road traffic accident survivors" 180 : 363-368, 2002

30 Di Lazzaro V, "Dissociated effects of diazepam and lorazepam on short-latency afferent inhibition" 569 : 315-323, 2005

31 Curran HV, "Differential effects of lorazepam and oxazepam on priming" 8 : 37-42, 1993

32 Sellal F, "Differential effects of diazepam and lorazepam on repetition priming in healthy volunteers" 108 : 371-379, 1992

33 Danion JM, "Diazepam induces a dissociation between explicit and implicit memory" 99 : 238-243, 1989

34 Fang JC, "Diazepam and memory: evidence for spared memory function" 28 : 347-352, 1987

35 Beck AT, "Depression: clinical, experimental, and theoretical aspects" University of Pennsylvania Press 1967

36 Ehlers A, "Data-Driven Versus Conceptual Processing Questionnaire"

37 Halligan SL, "Cognitive processing, memory, and the development of PTSD symptoms: two experimental analogue studies" 33 : 73-89, 2002

38 Buffett-Jerrott SE, "Cognitive and sedative effects of benzodiazepine use" 8 : 45-58, 2002

39 Drummer OH, "Benzodiazepines- effects on human performance and Behavior" 14 : 1-14, 2002

40 Curran HV, "Benzodiazepines, memory and mood: a review" 105 : 1-8, 1991

41 Ghoneim MM, "Benzodiazepines and human memory: a review" 72 : 926-938, 1990

42 Giersch A, "Atypical behavioural effects of lorazepam: clues to the design of novel therapies" 126 : 94-108, 2010

43 Bishop KI, "An investigation of the effects of benzodiazepine receptor ligands and of scopolamine on conceptual priming" 140 : 345-353, 1998

44 Brown MW, "Absence of priming coupled with substantially preserved recognition in lorazepam-induced amnesia" 41 : 599-617, 1989

45 Yi SM, "A study of reliability and validity on the Korean version of impact of event scale" 38 : 501-513, 1999

46 Kim JT, "A study based on the standardization of the STAI for Korea" 21 : 1223-1229, 1978

47 Brewin CR, "A dual representation theory of posttraumatic stress disorder" 103 : 670-686, 1996

48 Ehlers A, "A cognitive model of posttraumatic stress disorder" 38 : 319-345, 2000

49 Lee YH, "A Study of the reliability and the validity of BDI, SDS, MMPI-D scale" 10 : 98-113, 1991