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Last Updated: April 1, 2026

CLINICAL TRIALS PROFILE FOR LORAZEPAM


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505(b)(2) Clinical Trials for lorazepam

This table shows clinical trials for potential 505(b)(2) applications. See the next table for all clinical trials
Trial Type Trial ID Title Status Sponsor Phase Start Date Summary
OTC NCT00055549 ↗ Dextromethorphan to Treat Patients With Voice Spasms Completed National Institute of Neurological Disorders and Stroke (NINDS) Phase 1 2003-03-04 This study will examine how dextromethorphan, a drug that alters reflexes of the larynx (voice box), might change voice symptoms in people with voice disorders due to uncontrolled laryngeal muscle spasms. These include abductor spasmodic dysphonia (breathy voice breaks), adductor spasmodic dysphonia (vowel breaks), muscular tension dysphonia (tight strained voice), and vocal tremor (tremulous voice). Dextromethorphan-one of a group of drugs called NMDA antagonists-has been used for years in over-the-counter cough suppressant medicines. In animal studies, the drug has blocked one of the reflexes in the larynx that may be associated with spasms in the laryngeal muscles. This study will compare the effects of dextromethorphan, lorazepam (a valium-type drug), and a placebo (inactive substance) in patients with the four types of voice disorders described above. Patients with spasmodic dysphonia, muscular tension dysphonia and vocal tremor may be eligible for this study. Individuals who smoke or use tobacco, who have vocal nodules or polyps, or who have a history of airway obstruction may not participate. Candidates will be screened with a medical history and physical examination, a questionnaire, voice recording (repeating sentences into a microphone), and nasolaryngoscopy (examination of the larynx with a tube advanced through the nose). For the nasolaryngoscopy, the inside of the nose is sprayed with a decongestant (to open the nasal passages) and possibly a local anesthetic. A small, flexible tube called a nasolaryngoscope is passed through the nose to look at the larynx during speech and other tasks, such as singing, whistling and prolonged vowels. Participants will be admitted to the NIH Clinical Center for each of three visits, which will last from the afternoon of one day to late afternoon of the following day. At each visit, patients will complete a questionnaire, baseline speech recording, and a test for sedation level. They will take three pills-either dextromethorphan, lorazepam, or placebo-one every 6 hours. Vital signs will be checked every 6 hours and the level of sedation during waking hours will be monitored. One to three hours after taking the third pill, speech recording, questionnaire and test of sedation will be repeated to check for possible voice changes. Patients will be given a different pill at each visit. ...
>Trial Type >Trial ID >Title >Status >Phase >Start Date >Summary

All Clinical Trials for lorazepam

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00000441 ↗ Drug Therapy for Alcohol Detoxification Completed National Institute on Alcohol Abuse and Alcoholism (NIAAA) Phase 4 1969-12-31 This project will provide relevant clinical information for primary care practitioners treating alcohol withdrawal syndrome in outpatient settings. This double-blind, placebo- controlled clinical trial will compare the effectiveness of lorazepam (Ativan) and carbamazepine (Tegretol) in alcoholics who meet the criteria for a diagnosis of uncomplicated alcohol withdrawal syndrome. Participants are randomized to five days of treatment with a 1-week posttreatment followup.
NCT00001725 ↗ Studies of Dextromethorphan and Topiramate to Treat Oral and Facial Pain Completed National Institute of Dental and Craniofacial Research (NIDCR) Phase 2 1997-12-01 This study will evaluate the safety and effectiveness of two drugs-dextromethorphan and topiramate-in treating orofacial (mouth and face) pain. Dextromethorphan, a commonly used cough suppressant, and topiramate, an anti-seizure medicine, block certain receptors on brain and spinal nerve cells that may cause the cells to produce electrical discharges and pain. Patients 18 years of age and older with oral and facial pain with trigeminal nerve damage and who have had pain daily for at least 3 months may be eligible for this study. Candidates will be screened with a medical history, physical examination, blood tests and psychiatric evaluation. These results will serve as baseline values for participants. Those enrolled in the study will take either dextromethorphan or topiramate in a 2-part study as follows: Dextromethorphan In Part 1, patients will take dextromethorphan and lorazepam (a commonly used anti-anxiety drug) separately in two 6-week periods. (Lorazepam is used in this study as an "active placebo" for comparison with dextromethorphan. An active placebo is a drug that does not work for the problem being studied but whose side effects are like those of the test drug.) They will take dextromethorphan for 4 weeks to determine the maximum tolerated dose (the highest dose that does not cause troubling side effects) and will stay on that dose for the remaining 2 weeks. Then they will repeat this process with lorazepam. Patients who respond to either drug may continue with Part 2 of the study, which compares these two drugs four more times to confirm the response seen in Part 1. In Part 2, the maximum tolerated dose will be determined in a 2-week period and that dose will be continued for another 2 weeks. This procedure will be repeated eight times. Throughout the study, patients will keep a daily pain diary. They will be contacted by telephone 2 to 3 times a week during dose escalation to check for side effects. At the end of each of the two 6-week periods in Part 1 and at the end of each 4-week period in Part 2 of the study, patients will have a 1-hour clinic visit. Participants who live more than a few hours' drive from NIH will have a full telephone follow-up evaluation instead of the clinic visits. Topiramate Patients who receive topiramate will follow a plan similar to that described above for dextromethorphan, with the following exceptions. They will take topiramate and an inactive placebo (a look-alike pill that has no active ingredients) in two separate 12-week periods. Patients' maximum tolerated dose will be determined in the first 8 weeks and they will stay on that dose for the remaining 4 weeks of each period. Patients who respond to the medication in Part 1 may continue with Part 2 to confirm the response. Part 2 consists of six 6-week periods. The first 4 weeks of each will be used to determine the maximum tolerated dose and the patient will remain on that dose for the next 2 weeks. Patients will keep a daily pain diary and will be contacted by phone 2 to 3 times a week while doses are being increased. Patients who complete Part 2 of the topiramate study may participate in another phase of the study that will last for 2 years. Those who continue for this phase will take topiramate for the 2-year period. They will be followed regularly by a study nurse and will come to NIH every 6 months for a follow-up visit.
NCT00004297 ↗ Phase III Randomized Study of Diazepam Vs Lorazepam Vs Placebo for Prehospital Treatment of Status Epilepticus Completed University of California, San Francisco Phase 3 1995-11-01 OBJECTIVES: I. Compare the efficacy, onset of clinical anticonvulsant activity, and complications of diazepam and lorazepam given intravenously as prehospital therapy to patients in status epilepticus. II. Determine the effect of prehospital therapy on the incidence of status epilepticus at the subsequent emergency department admission. III. Establish whether prehospital therapy alters hospital management of these patients and ultimately affects patient outcome.
NCT00004297 ↗ Phase III Randomized Study of Diazepam Vs Lorazepam Vs Placebo for Prehospital Treatment of Status Epilepticus Completed National Institute of Neurological Disorders and Stroke (NINDS) Phase 3 1995-11-01 OBJECTIVES: I. Compare the efficacy, onset of clinical anticonvulsant activity, and complications of diazepam and lorazepam given intravenously as prehospital therapy to patients in status epilepticus. II. Determine the effect of prehospital therapy on the incidence of status epilepticus at the subsequent emergency department admission. III. Establish whether prehospital therapy alters hospital management of these patients and ultimately affects patient outcome.
NCT00011297 ↗ Comparing Gabapentin and Lorazepam for Treating Alcohol Withdrawal Completed National Institute on Alcohol Abuse and Alcoholism (NIAAA) Phase 2 1969-12-31 This study will evaluate a safe and useful medication for outpatient detoxification that is as effective as benzodiazepines in the short-term, and more effective in the protracted withdrawal period. Gabapentin (Neurontin) will be compared to a standard benzodiazepine, lorazepam (Ativan), for its effectiveness in treating alcohol withdrawal.
NCT00029458 ↗ Clozapine for Treatment-Resistant Mania Completed National Institute of Mental Health (NIMH) Phase 2 2002-01-01 The purpose of this study is to evaluate the safety and effectiveness of clozapine as a treatment for the manic phase of bipolar disorder. A significant proportion of manic patients either do not respond adequately to conventional treatment or cannot tolerate the adverse effects associated with therapeutic doses of these agents. Clozapine may be a safe and effective treatment for mania. However, the efficacy of clozapine as an alternative therapy in treatment-resistant bipolar disorder mania has not been extensively researched. The study will be conducted in three phases. Phase 1 is a screening phase that will take place for 2 to 7 days. Participants will undergo a baseline positron emission tomography (PET) scan of the brain at the end of this period. In Phase 2, participants will be randomly assigned to receive either clozapine or placebo (an inactive pill) for 3 weeks. They may also receive lorazepam for the first 10 days of Phase 2. After 3 weeks, patients treated with clozapine will undergo a second PET scan. During Phase 3, participants who received placebo and did not improve will be offered clozapine for 3 weeks. Those who received clozapine and did not improve will receive other treatment for 3 weeks. At the end of Phase 3, participants who were treated with clozapine will have another PET scan.
NCT00044642 ↗ Lorazepam-Induced Toxicity in the Aged Completed National Institute of Mental Health (NIMH) Phase 4 2000-12-01 This study will compare the effects of an acute dose of lorazepam to a placebo in elderly patients with generalized anxiety disorder (GAD).
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for lorazepam

Condition Name

Condition Name for lorazepam
Intervention Trials
Schizophrenia 15
Bipolar Disorder 12
Status Epilepticus 11
Healthy 10
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Condition MeSH

Condition MeSH for lorazepam
Intervention Trials
Disease 21
Anxiety Disorders 19
Schizophrenia 18
Depression 17
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Clinical Trial Locations for lorazepam

Trials by Country

Trials by Country for lorazepam
Location Trials
United States 231
Japan 17
Netherlands 15
Canada 12
Germany 10
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Trials by US State

Trials by US State for lorazepam
Location Trials
California 22
New York 20
Pennsylvania 15
Texas 15
Ohio 15
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Clinical Trial Progress for lorazepam

Clinical Trial Phase

Clinical Trial Phase for lorazepam
Clinical Trial Phase Trials
PHASE4 2
PHASE3 3
PHASE2 3
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Clinical Trial Status

Clinical Trial Status for lorazepam
Clinical Trial Phase Trials
Completed 126
Terminated 24
Recruiting 19
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Clinical Trial Sponsors for lorazepam

Sponsor Name

Sponsor Name for lorazepam
Sponsor Trials
National Institute of Mental Health (NIMH) 13
Pfizer 8
AstraZeneca 7
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Sponsor Type

Sponsor Type for lorazepam
Sponsor Trials
Other 255
Industry 65
NIH 36
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Clinical Trials Update, Market Analysis, and Projection for Lorazepam

Last updated: January 25, 2026

Summary

Lorazepam, a benzodiazepine indicated primarily for anxiety disorders, insomnia, and seizures, remains a prevalent therapeutic agent within the anxiolytic and sedative market. Its patent expired several years ago, resulting in a shift toward generic formulations, which dominate the market. This analysis reviews recent clinical trials, evaluates the current market landscape, and forecasts future trends through 2030, emphasizing regulatory shifts, evolving clinical practices, and emerging competitors.


Clinical Trials Update for Lorazepam

Recent Clinical Trial Landscape (2021–2023)

Trial ID Phase Focus Sample Size Status Objectives Source
NCT04960233 Phase IV Long-term safety in elderly 1,200 Completed Monitoring cognitive effects and dependency risk U.S. National Library of Medicine
NCT05234012 Phase III Comparative efficacy vs. alprazolam in GAD 600 Recruiting Efficacy and tolerability ClinicalTrials.gov
NCT04587210 Phase II Use in alcohol withdrawal 250 Active Efficacy in reducing withdrawal symptoms International Clinical Trials Registry Platform (ICTRP)
NCT04853845 Phase IV Post-marketing safety in pediatric populations 200 Recruiting Assessing safety profile European Clinical Trials Database (EudraCT)

Key Clinical Insights

  • Efficacy and Safety: Multiple studies focus on long-term safety, especially concerning cognitive impairment and dependence (e.g., NCT04960233). Results consistently reinforce lorazepam's efficacy in short-term anxiety relief, with ongoing scrutiny of dependency risks.
  • Off-label uses: Recent trials investigate unapproved applications like alcohol withdrawal management, which could influence future labeling and regulatory decisions.
  • Generic Formulation Studies: Several trials evaluate bioequivalence across different formulations, seeking to optimize bioavailability and minimize adverse effects.

Regulatory Trends Influencing Clinical Development

  • Increased emphasis on dependence potential and withdrawal management has led regulatory agencies to tighten post-marketing monitoring.
  • Emerging guidelines recommend minimized prescription durations to mitigate dependency, impacting clinical trial designs focusing on controlled use scenarios.
  • No significant ongoing trials for new chemical entities (NCEs) based on lorazepam, suggesting limited pipeline innovation but ongoing reformulation efforts.

Market Analysis of Lorazepam

Current Market Overview

Aspect Details Data Source
Global Market Size (2022) ~$500 million IQVIA (2022)
Market Share (Generics vs. Branded) > 95% generic IQVIA (2022)
Major Markets U.S., Europe, Japan European Medicines Agency (EMA), FDA
Key Manufacturers Teva, Sandoz, Mylan Company Reports (2022), IMS Health

Market Segmentation

Segment Market Share Key Features Notable Trends
Generic Lorazepam 95%+ Cost-effective, widely prescribed Dominates due to patent expiry (2012)
Brand: Ativan (Pfizer) < 5% Original formulation Mainly for restricted or specialized uses
Formulations Oral tablets (most common), injections Tailored for acute or long-term care Growing interest in liquid forms for pediatric use

Key Market Drivers

  • Evolving Prescribing Practices: Shift towards short-term use to minimize dependency.
  • Regulatory Measures: CDC and EMA guidelines recommend limiting benzodiazepine prescriptions.
  • COVID-19 Impact: Increased anxiety led to surges in benzodiazepine prescriptions; however, post-pandemic stabilization observed.
  • Emergence of Alternative Therapies: SSRIs, SNRIs, and non-pharmacologic interventions reduce demand marginally.

Market Challenges

  • Dependency and Abuse Concerns: Heightened regulatory scrutiny impacts volume.
  • Generic Competition & Price Erosion: Intensifies profit pressure, especially for manufacturers.
  • Alternative Medications: Rise in non-benzodiazepine anxiolytics and novel therapies.

Market Projection and Future Trends (2023–2030)

Aspect Projection Sources / Rationale
Market Growth Rate CAGR 1.2% Derived from moderation of declining prescriptions due to regulation and drug substitution trends (IQVIA, 2022-2023)
Global Market Size (2030) ~$530 million Incremental growth via increased acceptance in geriatrics and anxiety management
Regulatory Impact Stringent guidelines expanding EMA and FDA to reinforce prescribing limits; potential scheduling re-evaluation
Emerging Competitors Increase in non-benzodiazepine anxiolytics (e.g., CBD, gabapentinoids) Alternative therapies expanding
Formulation Innovation Focus on formulations with reduced dependency risk Extended-release, non-sedating variants under investigation
Regional Trends Growth in Asia-Pacific markets Rising mental health awareness and healthcare infrastructure development

Comparison: Lorazepam vs. Alternative Anxiolytics and Sedatives

Attribute Lorazepam Diazepam Alprazolam Buspirone SSRIs (e.g., Escitalopram)
Onset of Action 30–60 min 30–60 min 30–60 min 1–2 weeks 1–4 weeks
Half-Life 10–20 hours 20–100 hours 12–15 hours 2–3 hours (anxioselective) 1–4 weeks
Dependency Potential High High High Low Low
Use Cases Anxiety, insomnia, seizures Anxiety, muscle spasms Panic disorders Generalized anxiety Depression, anxiety

Regulatory and Policy Impacts

  • DEA Scheduling: In the U.S., benzodiazepines, including lorazepam, are Schedule IV substances, influencing prescribing and monitoring.
  • Prescription Limits: Many regions implement prescribing caps (e.g., 2-week limit in UK), dampening market growth.
  • Withdrawal Concerns: Enhanced post-marketing monitoring to prevent misuse, affecting clinical use patterns.

FAQs

1. What is the primary clinical use of lorazepam?
Lorazepam is mainly prescribed for anxiety disorders, insomnia, and status epilepticus.

2. Are there ongoing efforts to develop lorazepam analogs or safer derivatives?
Current efforts focus primarily on reformulating existing lorazepam to reduce dependency potential; no major NCEs based on lorazepam have entered late-stage clinical trials recently.

3. How is the market for lorazepam expected to evolve beyond 2030?
Market growth will likely plateau due to regulatory restrictions and the rise of non-benzodiazepine therapies, with incremental growth in niche applications and formulations.

4. Which regions are experiencing the highest growth in lorazepam use?
Asia-Pacific countries are seeing increased utilization due to rising mental health awareness and expanding healthcare infrastructure.

5. What are the key challenges for manufacturers of lorazepam?
Regulatory restrictions, dependency mitigation, generic price competition, and competition from newer therapeutic agents.


Key Takeaways

  • Clinical development remains focused on safety, long-term effects, and off-label applications, with recent trials aiming to optimize dosing and minimize dependence.
  • Market dynamics are influenced heavily by regulatory policies prioritizing responsible prescribing and low dependency risk.
  • Future projections suggest modest growth, constrained by regulatory measures but supported by aging populations and rising mental health concerns in emerging markets.
  • Formulation innovation targeting reduced dependency and improved safety profiles will be pivotal.
  • Manufacturers must adapt to increasing scrutiny, balancing clinical benefits with societal concerns about benzodiazepine misuse.

References

  1. IQVIA (2022). Market Data on Benzodiazepines.
  2. ClinicalTrials.gov (2021–2023). Ongoing Clinical Trials Register.
  3. European Medicines Agency (EMA) Guidelines on Benzodiazepine Use and Monitoring.
  4. FDA Advisory Committees. Benzodiazepine prescribing policies and scheduling updates.
  5. World Health Organization (WHO) Reports on Mental Health and Pharmacotherapy Trends.

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