Lorazepam Versus Diazepam in Alcohol Dependence Syndrome: Which Is Better?

Objective: To compare the efficacy of lorazepam and diazepam in managing alcohol withdrawal and associated anxiety and depressive symptoms in alcohol dependence syndrome. Methods: Sixty male patients diagnosed with alcohol dependence syndrome (International Classification of Diseases, Eleventh Revision) were randomly assigned to receive lorazepam or diazepam using a symptom-triggered oral detoxification protocol. Baseline assessments included the Severity of Alcohol Dependence Questionnaire (mean score = 22.6 ± 4.81) and the Clinical Institute Withdrawal Assessment for Alcohol-Revised (mean CIWA-Ar score= 10.98±2.45). Anxiety and depression were measured using the Hamilton Anxiety Rating Scale (HAM-A) and Hamilton Depression Rating Scale (HAM-D) at baseline, postdetoxification, and 12 weeks. Benzodiazepines were gradually tapered and stopped after detoxification. Results: Participants (mean age of 40.85 ± 8.30 years) showed comparable baseline withdrawal severity (CIWA-Ar P = .795) and similar reductions after detoxification (P = .999) and at 12 weeks (P = .321). Time to >50% symptom reduction was slightly shorter with diazepam (4.6 vs. 4.97 days; P = .241). Both groups demonstrated improvement in anxiety and depression, with slightly greater reductions in the lorazepam group, though differences were not statistically significant (HAM-A: P = .146; HAMD-D: P = .103). Conclusions: Lorazepam and diazepam are equally effective in managing alcohol withdrawal. Trial Registration: Clinical Trial Registry-India identifier: CTRI/2023/09/057998. Prim Care Companion CNS Disord 2026;28(3):25m04143.