Individual differences in the effects of clobazam on memory functions--clobazam and memory

Effects of lorazepam on emotional reactivity, performance, and vigilance in subjects with high or low anxiety

This study examined the hypothesis that low doses of lorazepam modify emotional response. In accord with the results of prior studies that suggest a differential effect of benzodiazepines according to the subjects' anxiety level, the authors tested the effect of lorazepam (0.5 mg twice daily) on 2 groups of 32 subjects: those with high anxiety (HA) and those with low anxiety (LA). These groups were formed a priori on the basis of their scores on the Cattell Anxiety Scale and the Hamilton Rating Scale for Anxiety. The two groups were evaluated for psychomotor function and vigilance (visual analog scales [VAS], digit-symbol substitution test [DSST], and choice reaction time [CRT]), as well as emotional reactivity. Six emotions (fear, anger, disgust, sadness, joy, and neutral state) were induced by the presentation of six movie excerpts, and subjects' emotional responses were measured using the Differential Emotions Scale. The results suggest that at the doses studied, lorazepam led to an increase in negative emotions and a decrease in positive emotions, compared with placebo. This shift of emotional reactivity toward more negative emotions was slightly stronger with the HA than with the LA subjects. However, no reliable differences in the levels of performance and vigilance (CRT, DSST, and VAS) were observed as a function of either treatment or subject group. These findings suggest a possible relationship between benzodiazepine effects and subjects' anxiety level.

Conditions under which lorazepam can facilitate retrieval

Memory is composed of three stages: acquisition, consolidation, and retrieval. By impairing acquisition processes, benzodiazepines cause anterograde amnesia while leaving intact information learned before the drug was taken. In some circumstances, retrieval of this information is even improved by benzodiazepines. It has been hypothesized that this phenomenon is not a true facilitation of retrieval processes, but is the result of reduced interference from items presented after drug administration and is thus a secondary consequence of drug-induced amnesia. Experiment 1 investigated the effect of 0.5, 1, and 2.5 mg of lorazepam on explicit episodic memory in healthy young volunteers. The 1-mg dose was found to significantly improve recall of items presented before drug administration without causing amnesia for items presented after drug administration, thus excluding an interference explanation. Experiment 2 investigated the conditions necessary to obtain facilitated retrieval with 1 mg of lorazepam. The results showed that facilitation was found only when two lists of semantically related material were presented, but that both of the lists could be presented before drug administration, thus excluding an effect of lorazepam on consolidation. Facilitation could be demonstrated in both direct (free recall) and indirect (backwards reading) retrieval tasks and when all of the material was presented after lorazepam administration. This improved retrieval could therefore be of clinical relevance, but any benefits would be reduced at higher doses that at the same time impair acquisition of new information. However, because 1 mg of lorazepam is an effective anxiolytic dose, these results suggest that it is possible to combine effective anxiety reduction with some benefits to memory.

Effects of lorazepam on film-induced differentiated emotions in healthy volunteers

We studied the effects of lorazepam, a benzodiazepine, on differentiated emotions in healthy volunteers. In order to induce differentiated emotions, film excerpts were selected on the basis of the type of emotion they induced (fear, anger and for affective tone neutral film). For 6 days (D1 to D6), ten healthy volunteers received lorazepam (1 mg bid) or placebo in a randomized cross-over double-blind trial. During each treatment period, emotional induction occurred on D4, D5 and D6. One film excerpt (fear, anger or neutral) was presented each morning after relaxation. Evaluation was performed before and after each emotional induction and included questionnaires (Differential Emotions Scale and physical activation visual analog scales), and neurophysiological parameters (systolic and diastolic blood pressure, heart rate and norepinephrine levels). Globally, the film excerpts induced the predicted emotions. An analysis of variance was undertaken and revealed a significant effect of lorazepam versus placebo. On the Differential Emotions Scale and during fear induction, lorazepam induced a significantly higher increase in fear, anxiety and disgust emotions than placebo, whereas no effect was observed after anger induction. Lorazepam also induced a significantly higher increase in diastolic and systolic blood pressure with no change in heart rate, and physical activation items ("tears" and "faster breathing") without no significant change in norepinephrine. In conclusion, our results are consistent with an overall increase in emotional reactivity with lorazepam (1 mg bid) as compared to placebo. The pertinence of film-induced differentiated emotions has to be confirmed for clinical pharmacological use.

Animal model studies of benzodiazepine-induced amnesia

The development of a mouse passive avoidance test as a model for amnesia produced by benzodiazepines is described. The model appropriately classifies the amnesic potential of a wide range of psychoactive drugs as validated by clinical findings. Control experiments indicate that the effect is best described as anterograde amnesia resulting from a failure of consolidation. gamma-Aminobutyric acid (GABA) antagonists had almost no effect on benzodiazepine-induced amnesia, whereas the benzodiazepine-receptor antagonist Ro 15-1788 completely and specifically reversed it. This clinically confirmed finding suggests that benzodiazepine-induced amnesia is mediated through the benzodiazepine-receptor. However, in vivo inhibition of benzodiazepine binding does not correlate well with amnesia in the mouse, and some benzodiazepine-receptor agonists with potent CNS effects in other in vitro models do not produce amnesia. Additional work is needed to clarify what aspects of benzodiazepine receptor occupancy mediate amnesia.

Individual differences in benzodiazepine-induced changes of memory

Antero- and retrograde amnesia are observed as side effects of most types of benzodiazepines. They have rarely been investigated with respect to physical and personality factors, or to prior experiences, present expectations, and emotional states of the subjects, all of which are well known to modify drug response. By reviewing research on benzodiazepine-induced changes of memory in preoperative, anxious, and depressed patients as well as in healthy subjects, it is demonstrated that differences in benzodiazepine-induced amnesic effects may depend on: 1. subject variables like predrug level of anxiety, depressive symptomatology, memory capacity, experiences with benzodiazepine-type drugs, and expectations of treatment outcome, and secondary factors like social environment and treatment setting 2. interactions between these subject variables and type of schedule (times of acquisition, treatment, and testing), type of learning material, and dose of drug. 3. the extent of benzodiazepine-induced changes in anxiety or depression, cortical and emotional arousal (alertness and activity) as well as physiological effects of benzodiazepines Special emphasis should be placed on the investigation of drug-induced changes of covariation between psychological measures which may provide valuable information for differential prediction and on mechanisms of drug action.

Tranquillising memories: a review of the effects of benzodiazepines on human memory

Studies from 1973 to 1985 of the effects of benzodiazepines on memory are summarised and reviewed. Anterograde amnesia appears a common effect of all benzodiazepines although its onset and duration vary with the particular benzodiazepine, its dose and route of administration. Memory impairments increase with task difficulty. There is some evidence that partial tolerance to amnesic effects develops with repeated doses of diazepam, but research with other benzodiazepines is inconclusive. Amnesia is in part a by-product of the sedative action of benzodiazepines, although these drugs may also have a specific effect of disrupting the consolidation of information in long-term memory. State-dependent effects are partial and relatively small. Methodological problems are discussed and attention is drawn to the lack of repeated dose studies, of studies with patient populations and with anxious volunteers.