In psychiatry, one of the most challenging clinical situations is this:

A patient is suffering—but cannot express what is wrong.

They may be:

• Unable to speak (mutism)
• Overwhelmed by anxiety
• Stuck in dissociative states
• Presenting with unexplained neurological symptoms

Traditionally, clinicians turned to hypnosis to access such hidden or avoided material. But hypnosis requires time, specialised training, and patient readiness.

Today, modern psychiatry offers a neurobiological alternative:

👉 Lorazepam-assisted interview (LAI)

🧠 What is a Lorazepam-Assisted Interview?

A lorazepam-assisted interview uses a carefully monitored dose of Lorazepam to:

• Reduce anxiety
• Lower psychological defenses
• Facilitate emotional expression

Unlike sedation, the goal is not to “knock out” the patient—but to create a state where they can speak more freely and access difficult emotions.

🛋️ How is this different from Hypnosis?

👉 In simple terms:

Hypnosis guides the mind
Lorazepam reduces the barriers within the brain

⚡ What Happens During the Interview?

Under the effect of lorazepam, patients often:

• Feel calmer and less guarded
• Speak more openly
• Express previously avoided thoughts
• Experience emotional release

This phenomenon resembles abreaction, a concept linked to Sigmund Freud—where suppressed emotions are released, leading to symptom relief.

But today, we understand it differently:

This is not “digging out the unconscious”—it is reducing inhibition and allowing natural expression.

🔍 When is Lorazepam-Assisted Interview Useful?

This approach can be valuable in:

• Dissociative (conversion) disorders
• Functional neurological symptoms (e.g., unexplained paralysis, mutism)
• Catatonia (diagnostic and therapeutic)
• Severe anxiety with inability to communicate
• Complex diagnostic dilemmas

👉 In some cases, the response itself becomes diagnostic.

💡 What About Other Agents?

While lorazepam is the most commonly used, other agents are being explored:

🔹 Dexmedetomidine

• Produces calm, cooperative sedation
• Preserves communication
• Useful in ICU and procedural psychiatry

These advances reflect a broader shift:

Psychiatry is increasingly integrating brain-based tools to enhance psychological care

⚠️ Important Considerations

Lorazepam-assisted interviews are:

• Not routine
• Not suitable for all patients
• Conducted in controlled clinical settings

Key points:

• The information obtained can be state-dependent
• Interpretation requires clinical expertise
• It should always be followed by structured psychotherapy

📊 How Common is This Approach?

Despite its clinical utility:

👉 Less than 10 well-documented cases are available in published literature globally

This highlights two things:

• It is a highly specialised technique
• It requires clinical judgment and experience

🧠 The Bigger Picture

We are moving beyond the old divide:

• ❌ “Psychological vs Biological”
• ✅ Toward integrated psychiatry

Lorazepam-assisted interviews represent this evolution:

Using neurobiology to unlock psychological processes

📍 Availability in Chennai

This specialised approach is now available in Chennai as part of advanced psychiatric evaluation and treatment.

It is particularly useful for:

• Patients with unexplained neurological symptoms
• Severe emotional inhibition
• Difficult-to-diagnose psychiatric conditions

🧠 One-Line Takeaway

When words are blocked, reducing the brain’s inhibition can help the mind find its voice.

📣 About the Author

Dr. Srinivas Rajkumar T, MD (AIIMS, New Delhi), DNB, MBA (BITS Pilani)
Senior Consultant Psychiatrist 
Mind & Memory Clinic, Apollo Clinic Velachery (Opp. Phoenix Mall)

With a clinical approach integrating:

• Structured diagnostic frameworks
• QEEG-based brain mapping
• AI-assisted psychiatric evaluation
• Advanced techniques like lorazepam-assisted interviews

Dr. Srinivas focuses on objective, precise, and personalised psychiatric care.

✉ srinivasaiims@gmail.com 📞 +91-8595155808