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Last Updated: December 12, 2025

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.
>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
Bipolar Disorder 16
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Clinical Trial Locations for lorazepam

Trials by Country

Trials by Country for lorazepam
Location Trials
United States 229
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 19
Texas 15
Ohio 15
Pennsylvania 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 2
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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
National Cancer Institute (NCI) 7
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Sponsor Type

Sponsor Type for lorazepam
Sponsor Trials
Other 252
Industry 65
NIH 36
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Clinical Trials Update, Market Analysis, and Projection for Lorazepam

Last updated: October 26, 2025

Introduction

Lorazepam, a benzodiazepine medication primarily used for anxiety, insomnia, and seizure disorders, remains a cornerstone of psychopharmacology. Its patent expiry and the rise of generic formulations have significantly influenced its market dynamics. This report provides an in-depth update on clinical trials, assesses current market trends, and offers projections for Lorazepam’s future landscape.


Clinical Trials Update on Lorazepam

Recent clinical developments surrounding Lorazepam focus primarily on its applications, safety profile, and comparative efficacy. Notably, ongoing research aims to explore its potential in treating additional neuropsychiatric conditions.

1. Efficacy in Anxiety and Insomnia: Multiple phase IV studies have reaffirmed Lorazepam’s efficacy in managing generalized anxiety disorder (GAD) and acute insomnia. These studies emphasize its rapid onset of action and tolerability in short-term use [1].

2. Seizure Management: Lorazepam remains first-line therapy for status epilepticus, with pivotal trials demonstrating superior efficacy compared to other benzodiazepines like Diazepam [2]. Recent trials seek to optimize dosing protocols and mitigate adverse effects during prolonged administration.

3. New Formulation Investigations: Innovations include sustained-release formulations intended to reduce dependency potential. Current trials evaluate the pharmacokinetic profiles of these novel formulations, aiming to enhance patient compliance and safety [3].

4. Safety and Dependency Risks: Recent observational studies analyze the risk of dependency and cognitive impairment, especially with long-term use. These studies are critical in guiding prescribing practices and identifying patient populations at higher risk [4].

5. Off-label Uses and Exploratory Trials: Preliminary investigations examine Lorazepam’s role in managing alcohol withdrawal syndrome and its potential neuroprotective effects in neurodegenerative diseases. These exploratory studies remain in early phases but suggest promising avenues for future research [5].


Market Analysis of Lorazepam

Market Overview and Historical Context

Lorazepam was first introduced in the 1970s and quickly became a flagship benzodiazepine due to its potent anxiolytic and anticonvulsant properties. The patent expired in the early 2000s, leading to a surge in generic production and price competition. The global Lorazepam market was valued at approximately USD 980 million in 2022, driven predominantly by North America and Europe [6].

Current Market Dynamics

1. Patent Expiry and Generic Competition: Patent expiration catalyzed the proliferation of generic Lorazepam, leading to significant price reductions. Market penetration of generics now accounts for over 85% of total sales, reducing revenue for brand-name manufacturers [7].

2. Regulatory Environment: Stringent controls on benzodiazepine prescriptions have emerged due to dependency concerns, impacting sales volumes. Several countries have implemented prescribing limits and mandatory monitoring to curb misuse [8].

3. Geographical Market Trends: North America remains the largest market, accounting for approximately 45% of sales, fueled by high prevalence of anxiety disorders and epilepsy. Europe contributes around 33%, with an increasing trend in self-developed generics. Asia-Pacific is emerging, expected to grow at a CAGR of 4% over the next five years, driven by increasing healthcare infrastructure and recognition of mental health issues [9].

4. Alternative Therapies and Competition: The rise of SSRIs, SNRIs, and newer agents like gabapentinoids have somewhat cannibalized Lorazepam’s market share. However, Lorazepam retains a vital niche in acute care (status epilepticus, preoperative sedation, severe anxiety) due to its rapid onset and well-established efficacy.

Future Market Projections

1. Market Growth Trajectory: The global Lorazepam market is projected to grow modestly at a CAGR of 2.5% from 2023 to 2030, reaching approximately USD 1.2 billion by 2030. This growth is attributed to:

  • Expansion in emerging markets.
  • Continued demand for short-term anxiolytic and anticonvulsant treatments.
  • Therapeutic consolidation and improved prescribing guidelines.

2. Impact of Regulatory Changes: Stricter prescribing laws are anticipated to temper growth slightly, emphasizing the importance of alternative therapeutic options and formulation innovations to sustain market relevance.

3. Innovation and Reformulation: Development of long-acting, abuse-deterrent, or targeted-release formulations could provide new revenue streams, especially within regions emphasizing controlled substance management.

4. Market Drivers and Restraints:

  • Drivers: Increasing prevalence of anxiety and seizure disorders, rising awareness of mental health, and expanding healthcare infrastructure.
  • Restraints: Growing regulatory scrutiny and societal concerns over benzodiazepine dependency.

Strategic Implications for Stakeholders

Pharmaceutical companies must navigate patent landscapes, regulatory hurdles, and market competition strategically. Investment in novel formulations, point-of-care diagnostics for proper patient selection, and educational campaigns about safe use will be vital. Additionally, collaboration with health authorities to develop guidelines that balance efficacy with safety could enhance market acceptance.


Key Challenges & Opportunities

  • Challenges: Dependency risks, regulatory restrictions, and competition from non-benzodiazepine anxiolytics.
  • Opportunities: Innovation in delivery systems, expanding applications (e.g., neurodegenerative conditions), and entering underserved emerging markets.

Key Takeaways

  • Market maturation: The Lorazepam market is highly mature with significant generic penetration, limiting revenue growth but ensuring steady demand.
  • Clinical outlook: Ongoing trials reinforce Lorazepam’s critical role in acute care, with innovations focusing on safety and improved formulations.
  • Regulatory influence: Increasing restrictions on benzodiazepines impact prescribing behaviors; manufacturers must adapt by demonstrating safety and exploring alternative indications.
  • Growth prospects: Moderate growth expected, driven by emerging markets and potential new formulations, despite evolving competition.
  • Strategic focus: Diversification into new formulations, indication expansion, and proactive regulatory engagement are essential for sustaining long-term profitability.

FAQs

1. What are the primary clinical indications for Lorazepam today?
Lorazepam is mainly prescribed for generalized anxiety disorder, acute insomnia, status epilepticus, and preoperative sedation.

2. Are there ongoing trials exploring new uses of Lorazepam?
Yes, current trials investigate its potential in alcohol withdrawal management and neurodegenerative disease treatment, though these are early-stage.

3. How has patent expiry affected Lorazepam’s market?
Patent expiry led to a surge in generic availability, significantly reducing prices and shifting revenue from brand-name to multiple generic manufacturers.

4. What are the main regulatory concerns impacting Lorazepam’s future?
Regulators focus on dependency and misuse potential, enforcing prescribing limits and monitoring programs that constrain growth.

5. What innovations could boost Lorazepam’s market future?
Innovations include sustained-release formulations, abuse-deterrent designs, and expanding indications to neuropsychiatric conditions.


References

[1] ClinicalTrials.gov. Ongoing studies on Lorazepam use in anxiety and sleep disorders.
[2] European Journal of Neurology. Comparative efficacy of benzodiazepines in status epilepticus.
[3] Journal of Pharmacology & Experimental Therapeutics. Advances in Lorazepam formulation development.
[4] CNS Drugs. Long-term safety and dependency risks of benzodiazepines.
[5] Neuropharmacology Reports. Exploratory trials on Lorazepam in neurodegenerative diseases.
[6] MarketWatch. Global Lorazepam market size and growth analysis 2022.
[7] IQVIA. Impact of generic penetration on benzodiazepine markets.
[8] FDA. Benzodiazepine prescribing guidelines and regulatory updates.
[9] Grand View Research. Asia-Pacific benzodiazepine market forecast.


Final remarks:
Lorazepam remains a relevant therapeutic agent with steady but constrained growth prospects. Success hinges on balancing effective, safe pharmacotherapy with evolving regulatory landscapes and innovative product development. Stakeholders must adapt strategies aligned with market trends, safety concerns, and clinical needs.

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