Ativan and Drug-Assisted Interviews

January 19th, 2012
By Dr. James Pendleton, Psychotropic News Contributor

Episodes of amnesia are common with many psychiatric disorders. Intense anxiety or guilt can generate mental blockages, protecting the individual from stressful memories or ideas. Traumatic events, such as physical assaults or accidents, may also lead to periods of seemingly complete amnesia. The technical name for this repressed memory condition is dissociative amnesia. Several methods have been developed for unblocking repressed memories. Once memories are unblocked, patients can more effectively deal with troubling emotions or thoughts. Hypnosis, cognitive behavioral therapy, and drug-assisted interviews are all useful approaches for recovering lost memory.

Drug-assisted interviews have typically been conducted with Amytal (amobarbital), a kind of drug known as a barbiturate. However, barbiturates have been known to cause excessive respiratory depression and deep sedation. Should these effects of the drug be too intense, there’s no reliably safe way to reverse the effects quickly. A dangerous, even life-threatening reaction is possible with barbiturates. For these reasons and more, therapists have looked to Ativan (lorazepam) as an alternative for drug-assisted interviews.

Belonging to the class of drugs known as anti-anxiety agents, Ativan induces relaxation without the profound sedation of a drug like Amytal. Rather than suppressing the entire central nervous system, this medication targets specific neurotransmitter sites. There is a relatively low risk of serious side effects or excess sedation. More importantly, there is an effective reversal agent for Ativan in the event of an emergency. Research indicates that dissociative amnesia is the result of a physical and chemical mechanism in the brain. Ativan interrupts this process, while a skilled interviewer helps the patient gradually uncover the repressed memory fragments. The process requires time and patience but is often beneficial from a therapeutic standpoint. Once the amnesia is cleared, the patient can work through the disturbing or traumatic memories and experience an improved quality of life.

Dissociative amnesia is often a symptom of a debilitating psychiatric condition. Drug-assisted interviews, when conducted by an expert therapist, can begin releasing blocked memories and feelings. Ativan, typically prescribed for anxiety disorders, facilitates the process of unblocking buried memories. With relatively few side effects and high tolerability with a variety of patients, Ativan may one day become the psychotropic medication of choice for drug-assisted interviews.

References

Lee, S., Park, S., & Park, S. (2011). Use of lorazepam in drug-assisted interviews: two cases of dissociative amnesia. Psychiatric Investigations, 8, 377-380.
MedlinePlus Drug Information. (n.d.). National Library of Medicine – National Institutes of Health. Lorazepam. Retrieved April 1, 2012, from http://www.nlm.nih.gov/medlineplus/druginfo/meds/a682053.html

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