Which injectable benzodiazepine can help relieve emotional distress and insomnia secondary to psychosis?

The injectable benzodiazepine that is most effective for relieving emotional distress and insomnia secondary to psychosis is Lorazepam. This medication is favored in emergency settings for its rapid onset of action and effectiveness in managing acute agitation and anxiety, commonly seen in psychotic patients. Lorazepam's sedative properties make it particularly useful in addressing insomnia that can accompany acute psychotic episodes.

In addition to its anxiolytic effects, Lorazepam has a relatively predictable pharmacokinetic profile, allowing for more accurate dosing and management of symptoms. Its ability to help with sleep while also providing calming effects supports its role in treating distress associated with psychosis.

The other options have specific uses but may not be as appropriate for this context. Clonazepam and Alprazolam are typically used for anxiety disorders but do not have the same rapid sedative effects when injected. Midazolam, while it does have sedative properties, is more commonly used for procedural sedation rather than for managing emotional distress and insomnia in psychosis. Thus, Lorazepam stands out for its relevance in this clinical scenario.