dissociation is considered a defensive biological response to emergencies , a  shut - off mechanism  against severe emotional distress and excessive anxiety . dissociative disorders include dissociative amnesia , dissociative fugue , dissociative identity disorder , depersonalization disorder , and dissociative disorder not otherwise specified . dissociative amnesia is defined as an inability to recall important autobiographical information , usually of a traumatic or stressful nature , that is too extensive to be explained by normal forgetfulness . such disturbances to memory do not occur exclusively during the course of dissociative identity disorder , dissociative fugue , posttraumatic stress disorder , acute stress disorder , or somatization disorder , and do not result from the direct physiological effects of a substance , neurological disorder , or general medical conditions . there are multiple treatment methods for dissociative amnesia , such as cognitive therapy , hypnosis , somatic therapy , and group psychotherapy . however , these treatments mostly focus on memory retrieval . if these approaches fail , however , interviews using drugs such as thiopental and amobarbital are often used for therapy . interviews with these drugs can facilitate recall of memories and promote integration of dissociative materials or events . he reported six subjects experienced successful restoration of their memories during interviewed conducted with intravenous administration of amobarbital . sagant and slater widely used drug - assisted interviews in the treatment of acute war neuroses and reported that amobarbital was more effective agents or traditional hypnosis than other agents or traditional hypnosis for memory retrieval . lambert and rees reported that barbiturate - assisted interviews were an effective method of recovering memory in hysterical amnesia . it is clear that amobarbital - assisted interviews are clinically helpful in the diagnosis and treatment of dissociative disorders . however , this technique reduced use since the 1960s because of barbiturate dependence and the emergence of chlorpromazine and tricyclics in psychiatry . as safer alternatives , benzodiazepines are the preferred treatment option , because they have a wider therapeutic index compared to barbiturates , such as amobarbital , and flumazenil ( -aminobutyric acid receptor antagonist ) can reverse some symptoms of benzodiazepines . however , there have been few case reports of interviews in patients with mental illnesses that were assisted by benzodiazepines , such as diazepam , lorazepam , and midazolam . in this case report a 15-year - old , female high school student was referred to our child and adolescent psychiatric department for sudden loss of memory during a high - school extracurricular activity . there were no abnormalities in her laboratory results , including a chest x - ray , brain magnetic resonance imaging scan , hiv test , liver function test , vitamin b12 assay , and electrolyte level test . she did not exhibit cognitive problems on a mini - mental status examination , except she could not recall the other participants of her extracurricular activity , even after looking at their pictures and phone numbers . she was embarrassed at the memory loss , but she was neither worried nor agonized . she reported that she had not experienced physical or emotional trauma or severe stress . through the interviews with her family and friends , we determined that she had experienced difficult social relationships for the previous month . according to her family , she was usually timid and extremely vulnerable , and such characteristics prevented her from getting along with more than a few close friends . nevertheless , her interest in musical instruments led her to join a brass band and to enjoy playing alto saxophone in the band . according to the band members , the vice - chief wind player assigned to the baritone saxophone had complimented her performance . however , the patient felt left out and had started playing louder and trying harder in the band . the vice - chief was displeased with her behavior , and began to disparage the patient to other people . the vice - chief , however , kept disparaging her , and the patient had to endure hardships as the practice hours became longer and more frequent during a break . when the patient broke her commitment to meet the vice - chief , the vice - chief bawled at her on the phone . after 3 days , however , the patient claimed that she no longer suffered from any headaches . moreover , when her friends in the brass band called her for practice , the patient was embarrassed and could not recall anything about the band activity or the members of the band . the patient became anxious and tried to avoid conversations regarding the band activities when a supportive interview for memory retrieval was administered . she was educated about her disorder , and it was suggested that her memory could return . therefore , we decided to use drug - assisted interview for treatment of her amnesia . after 3 days of hospitalization , a lorazepam - assisted interview was planned , and the patient gave her consent . the interview with lorazepam was conducted according to a previously described protocol , described in table 1 . protocol used for the lorazepam - assisted interview before obtaining informed consent , the procedure was prepared , with a brief explanation of the means by which the procedure could help her memory recover . after 10 ml of diluted lorazepam ( 1.25 mg of lorazepam ) solution was intravenously injected , the patient became relaxed and sleepy . the interview was started with ordinary questions that gradually transitioned to the topics of her memory loss . a few minutes later , she started to report having been bullied by members of the band . she recalled that she had been insulted by a member on a phone call . when she became infuriated and tearful , an additional 5 ml of lorazepam solution ( 0.625 mg of lorazepam ) was administered . as she was too unstable emotionally to continue the interview and could not recall the details of the phone call even after half an hour , the interview was halted . the next day , the patient could recall that she had cried during the lorazepam - assisted interview . however , she could not remember any experiences with other members of the band , and she reported anxiety regarding recall of such experiences . supportive psychotherapy to provide reassurance and suggestions was performed until the second lorazepam - assisted interview . after she had been hospitalized for 10 days the same procedures were used . during the second interview , she successfully recalled a phone conversation with three friends in which she blamed herself for not reporting the bullying . the day after , she could recall that her relationships with peers and more senior members of the band had been stressful . as soon as she remembered that her best friend had blamed her , she was disappointed and angry because she could not resolve the misunderstanding . she then recalled most of the events related to her memory loss and decided to accept further psychotherapy . a final diagnosis of dissociative amnesia was made , and she was discharged after 14 days of hospitalization . one week later , she was getting along well without any memory or cognitive problems . barbiturate - assisted interviews have been used for more than 70 years in psychology as both diagnostic and therapeutic tools . amobarbital - assisted interviews were first introduced in 1930 by bleckwenn , as a treatment for catatonic schizophrenia . amobarbital - assisted interview were applied to non - psychiatric patients by lindermann in 1932 . in the early 1950s , extensive studies on amobarbital - assisted interviews were performed using the terms narcoanalysis , narcosynthesis , narcosuggestion , and narcocatharsis . in korea , amobarbital - assisted interviews were used to treat neurosis patients following the korean war in 1952 . although amobarbital - assisted interviews gave problems , the clinical application of these interviews is warranted in patients with psychiatric emergencies . according to previous studies of drug - assisted interviews , the patient - physician relationship greatly affects the prognosis . in addition , improvements in the patient 's symptoms are not completely determined by negative affect and depression during the drug - assisted interview . it allows the patients to talk about unpleasant or stressful experiences , and helps to relate current symptoms to psychological stressors and conflicts . amobarbital - assisted interviews can be clinically used in the diagnosis of mute patient or patients with a stupor , such as those with catatonia , hysterical stupor , unexplained muteness , and differentiating depressive , schizophrenic , and organic stupors . it can also be used in therapeutic interviews for dissociative disorders , such as abreaction of post - traumatic stress disorder , recovery of memory in psychogenic amnesia and fugue , and recovery of function in conversion . however , if the patient strongly refuses the treatment or is afraid of revealing relevant information , the drug - assisted interview should not be applied . also , clinical contraindications include upper respiratory disorders , severe liver or kidney disease , history of hypotension or porphyria , and barbiturate addiction . before the drug - assisted interview begins , the objectives and procedures of the interview should be explained to the patient and accompanying family members . they should neither anticipate an unreasonably robust response nor be afraid of the treatment . to start the interview , the patient is typically asked to lie down and reassured by receiving an explanation of the procedure . a 5% sodium amobarbital solution ( 500 mg of amobarbital diluted in 100 ml of normal saline ) the interview starts with ordinary matters and slowly transitions to the questions regarding the trauma , a guilty conscience , and suppressed events . for a mute patient , subjects related with the patient 's life are already known can be chosen with the prediction that the patient will be able to talk soon . amobarbital interview is not much different from other psychiatric interviews , but it should proceed slowly , especially when the questions begin to elicit memories of emotionally traumatic or stressful events . for most cases , these interviews require 30 minutes and should be end sufficient information has been obtained . for at least 15 minutes after termination of the amobarbital administration , the patient is kept in a lying position and monitored until he or she can walk alone . in recent years , benzodiazepines have been begun to replace amobarbital for drug - assisted interviews . however , to the best of our knowledge , there are only two reports on the use of lorazepam - assisted interviews in psychiatry . ilechukwu et al described a modified amobarbital interview used in middle - aged white women with dissociative amnesia . in this report , 6 mg lorazepam diluted with normal saline was administered until the subjects showed relaxation and sedation . they recommended that lorazepam should not administered over 2 mg / min , no more than 4 mg lorazepam should be used in the preparation stage of the interview , and up to a total dose of 4 mg can be additionally given after 1015 minutes if sedation does not occur . lee et al administered lorazepam solution ( 10 mg of lorazepam diluted in 300 ml of normal saline ) for 60 minutes ( 0.050.1 mg / min ) in individuals with dissociative amnesia who were 1718 years of age . however , in that report , the lorazepam - assisted interview was used after failed treatments with antidepressants ( paroxetine 20 mg / day or fluoxetine 20 mg per day ) and an anxiolytic ( alprazolam 0.51.5 mg per day ) , which were also used during drug - assisted interview . in the present case report , we used lorazepam - assisted interviews to treat a 15-year - old girl with dissociative amnesia successfully . to the best of our knowledge , this report describes the youngest person reported to have undergone lorazepam - assisted interviews and the smallest amount of lorazepam ( 2.125 mg of lorazepam ) used in such interviews without concurrent treatment with other psychiatric drugs . a limitation of this case study is that the interviews were conducted by two different examiners with different interview styles . future studies should consider this issue and whether interview gains can be consolidated , particularly through video - recording the interview .
to facilitate gathering information during a psychiatric interview , some psychiatrists advocate augmenting the interview using drugs . rather than barbiturates 
 , benzodiazepines have been used for drug - assisted interviews . 
 dissociative amnesia is one of the indications for these interviews . 
 herein , we present the case of a 15-year - old female who was diagnosed as having dissociative amnesia because of conflicts with her friends . 
 she was administered a lorazepam - assisted interview to aid recovery of her memories . in this case , 
 a small dose of lorazepam was sufficient to recover her memories without any adverse effects .