© 1999 Evidence-Based Mental Health
Intravenous lorazepam reduced alcohol related seizures in patients with chronic alcohol abuse
D'Onofrio G, Rathlev NK, Ulrich AS, et al. Lorazepam for the prevention of recurrent seizures related to alcohol. N Engl J Med 1999 Mar 25;340:915–9.
Question In patients with alcohol abuse who present with a seizure, does lorazepam prevent recurrent alcohol related seizures?
Randomised, double blind, placebo controlled trial with follow up for 6 hours.
2 hospital emergency departments in Boston, Massachusetts, USA.
229 patients were enrolled but 43 met the initial exclusion criteria, including another possible cause of the seizure, currently taking drugs that caused or protected against recurrent seizures, or required treatment for symptoms of moderate to severe alcohol withdrawal other than seizures. 186 patients who were 
21 years of age (mean age 45 y, 96% men) with chronic alcohol abuse who presented after a witnessed, generalised seizure and who had had 1 drinks within the previous 72 hours were included in the intention to treat analysis.
100 patients were allocated to receive 2 mg of lorazepam in 2 ml of normal saline intravenously, and 86 were allocated to receive 4 ml of normal saline intravenously.
The primary endpoint was the occurrence of a second seizure during the 6 hour observation
Centre Hospitalier Universitaire, Clermont-Ferrand, France
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