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.