Talk:Lorazepam

Potent Benzodiazipines

@DocJames: I had changed "Potent benzodiazepines, such as lorazepam, alprazolam, and triazolam, have the highest risk of causing a dependence" to "Potent benzodiazepines, such as lorazepam, alprazolam, and triazolam, appear to have the highest risk of causing a dependence", to make the claim that was actually made in the reference. The relevant sentence in the reference is "Potent BZDs with relatively short t1/2 (e.g. triazolam, alprazolam and lorazepam) appear to carry the highest risk of dependence". The reference does not definitivey say that they do have the highest risk, it says that they appear to have the highest risk. Should we say what the reference being used actually says, or make a stronger statement than what the reference says? (Also, I'm going to add "with a relatively short half life" after "potent benzodiazepines", since that is also what the reference says. I won't add back "appear to have" for now.) Vontheri (talk) 18:31, 19 April 2019 (UTC)

Flunitrazepam Inclusion/Facilitation of Criminal Activity

Under society and culture > recreational use, a paragraph is dedicated to discussing flunitrazepam's potential usage in facilitating criminal activity, especially date rape and robbery; however, flunitrazepam and the issue in general is not mentioned on any other pages dedicated to specific benzodiazepines, and there's little evidence that most common benzodiazpeines see appreciable usage in the above mentioned criminal activity, likely due to the fact that unlike flunitrazepam, other benzodiazepines generally possesses relatively minor polar solubility and thus will not dissolve readily in most common beverages, making it far more difficult to administer the drug without a subject's knowledge.

In essence I feel the section is out of place and potentially confusing/misleading, but as someone not especially familiar with the dos and don'ts of wiki editing I don't feel comfortable just deleting it based purely on personal judgement, so I figured I'd at least bring it up here. 100.19.116.119 (talk) 17:57, 17 August 2019 (UTC)

Respiratory Depression

DocJames and I seem to be having multiple disputes on various pages. I am a physician-pharmacologist who has been teaching at one of the largest research medical schools in the US for 26 years, but I don't get to editing Wikipedia often. When I do, it's to correct something just too absurd or troublesome to let go. The issue here is whether any benzodiazepine causes respiratory depression, and DocJames cites a Cochrane review focusing on a different subject in support of this relationship. This is not support because neither respiratory depression nor benzodiazepines was the focus of the review, and it is - indeed just a review of published work, not data in its own right. Actual primary data says something quite different, for example: G. E. Carraro, E. W. Russi, S. Buechi, and K. E. Bloch. Does oral alprazolam affect ventilation? A randomised, double-blind, placebo-controlled trial. Journal of Psychopharmacology 23 (3):322-327, 2009. Papers like this, done with modern methods, strongly deny a respiratory depressant effect of benzos, and can explain why earlier investigations were misinterpreted.

This isn't an idle discussion. The opioid overdose epidemic and its "association" with benzos is a very big deal in the US right now, with an immense amount of litigation surrounding it. In the midst of flaring accusations and repetitively-quoted misleading concepts, it is more important than ever to read the PRIMARY literature (not merely side issues mentioned in review literature). Verytas (talk) 17:04, 20 October 2019 (UTC)

The problem is reading primary research in isolation, which is why we prefer review articles, per WP:MEDRS. But anyway, your above study had the following methodology: “20 healthy men ingested 1 mg of alprazolam“. Your source then goes on to emphasise (“Oral alprazolam in a mildly sedative dose has no clinically relevant effect on ventilation in healthy, awake men.”) that the dose used is mild (I wouldn’t call 1 mg mild but the point is much higher doses are used in certain medical settings). Twenty is a very small number and since many, perhaps most, people sedated by benzodiazepines are far from “healthy” and also in medical settings, especially surgical and intensive care very high doses of benzodiazepines are more often used it means this source proves little. So really, your source is narrow and weak evidence. Your arguments really appear to be based on WP:SYN and I suggest you find reliable secondary sources, the more recently published the better, to support your position.--Literaturegeek | T@1k? 20:00, 20 October 2019 (UTC)