Differential Effects Of Lorazepam Dosages On Manic Symptoms In Bipolar Disorder: Observations On Agitation, Aggression, And Sedation Outcomes

Objective: This study evaluates the differential effectiveness of two lorazepam dosages (1 mg and 2 mg) on managing acute manic symptoms in patients with bipolar disorder. The research focuses on the impact of these dosages on sedation, agitation, and aggression and examines the need for emergency interventions. Methods: An observational cohort study was conducted in two inpatient psychiatric facilities, involving 284 patients with bipolar disorder in acute manic phases. Participants were divided into two groups based on prescribed lorazepam dosages: 1 mg every 6 hours (4 mg/day) and 2 mg every 8 hours (6 mg/day). Primary outcomes included sedation effectiveness (measured using the Ramsay Sedation Scale), changes in agitation and aggression (using the Modified Overt Aggression Scale), and the frequency of emergency interventions. Data were analyzed using chisquare tests and t-tests to compare outcomes between dosage groups. Results: Patients receiving 2 mg of lorazepam showed slightly higher sedation and reduced aggression compared to the 1 mg group. However, both dosages required frequent emergency interventions to manage persistent agitation and psychological restlessness. Specifically, 84.52% of females and 75.64% of males in the 1 mg group required additional emergency medication, compared to 69.23% of females and 72.29% of males in the 2 mg group. As measured by the Ramsay Sedation Scale, Sedation levels did not differ significantly between the groups (p > 0.05). Conclusions: While the 2 mg dosage offers marginally improved sedation and aggression control, neither dosage alone is sufficient to manage the comprehensive symptoms of acute mania. These findings highlight the necessity of adjunctive therapy with antipsychotics or mood stabilizers for optimal symptom management