The painfully awkward humor of “The White Lotus” has done more than revive the career of Jennifer Coolidge and provide HBO with yet another water cooler hit. It’s offered biting commentary into privilege, mocked vapid tourism, and dissected gender roles.
For the most part it wallows in the general awfulness of Americans as ambassadors of capitalism, whether they’re traveling abroad (seasons two and three) or keeping their consumerism close to home (season one).
This year, however, features a character – Victoria Ratliff, played to the hilt by ’90s indie film darling Parker Posey – who nibbles on lorazepam like peanuts on Opening Day. Since this appears poised to become a thread that weaves its way into the wider pop culture, it seemed like a good time to look at some of the latest research into the powerful anti-anxiety drug.
Study Questions Lorazepam’s Long-Term Role in Preventing Catatonia
The most recent study – appearing in late February – questions the long-term effectiveness of lorazepam in staving off the recurrence of catatonia among bipolar disorder patients. While lorazepam has long since established itself as a reliable first-line treatment for acute catatonia, researchers found that it doesn’t really do much to mitigate the risk of future episodes.
Relying on the TriNetX database, the Drexel University researchers combed through data from 27,719 patients diagnosed with both bipolar disorder and catatonia between 2000 and 2024. The team broke the patient pool into two groups: those treated with lorazepam and those who weren’t.
The results showed that while overall recurrence rates appeared similar between the two groups, patients who didn’t receive lorazepam had fewer total episodes of catatonia.
Additionally, they had a significantly higher survival probability, defined as the time before recurrence. This, the authors write, suggests that lorazepam might not act as a lasting safeguard against future catatonia episodes.
The researchers cited a handful of possible explanations, such as differences in patient characteristics, alternative treatment strategies, and the complexity of neurotransmitter systems involved in catatonia. While lorazepam targets GABA-A receptors, other pathways – such as NMDA and dopamine receptors – could also be involved.
The research results highlight the need for personalized treatment approaches and a wider investigation into alternative therapies, such as electroconvulsive therapy (ECT) and adjunctive medications. Despite lorazepam’s effectiveness in acute management, long-term strategies for preventing recurrence remain cloudy. Future studies – and randomized controlled trials in particular – could be critical to improve catatonia treatment in bipolar patients.
Hidden Risks?
Another study – from late 2024 – looked at 20 years of pharmacovigilance data, exposing previously unreported adverse effects linked to lorazepam. The Chinese research team examined data from the FDA Adverse Event Reporting System (FAERS) and identified 174,145 reports linking lorazepam to nearly 1 million adverse events (AEs). This, the researchers insist, should galvanize regulators to take another look at the long-term safety of the drug.
The researchers found that while it remains an effective treatment, its side effects bear further scrutiny. The most reported AEs include psychiatric disorders such as drug abuse, suicide attempts, delirium, and psychotic episodes.
It’s worth noting that the study’s authors also uncovered a host of other unexpected risks, such as pneumonia aspiration, obesity, sinus tachycardia, pericarditis, duodenal ulcer perforation, and lupus vulgaris.
The data analysis revealed that older adults, particularly those between 59 and 69, reported the highest percentage of AEs, almost certainly related to physiological changes. Women also appeared to be nearly twice as likely as men to experience adverse effects, a trend the researchers attributed to gender differences in anxiety prevalence and medication response.
The study further suggests that lorazepam might contribute to abnormal fat metabolism, cardiac issues, and immune suppression. While these findings remain inconclusive, the researchers stress the importance of further clinical and laboratory studies to confirm potential causal links.
Given the severity of some of the reported AEs, the authors urged medical professionals to exercise caution when prescribing lorazepam, especially for long-term use. They add that better monitoring and patient education could help mitigate potential dangers.
Further Reading
Catatonia Associated With Post-Acute COVID-19 in a Young Child
