Prescription ·Strong evidence ·Reviewed May 2026
Prescription benzodiazepine (Schedule IV controlled substance) approved for anxiety disorders, insomnia due to anxiety, and as a preanesthetic agent. Also widely used for acute seizure management, alcohol withdrawal, and chemotherapy-induced nausea. Preferred in patients with hepatic impairment because it undergoes glucuronidation (Phase II metabolism) rather than CYP450-dependent oxidation, with no active metabolites. Dosage must be determined by your prescribing physician.
The bottom line
Evidence rating strong. Most-documented uses: anxiety relief, acute seizure management, alcohol withdrawal management. 10 sources indexed (2004–2025), with 5 interaction records on file.
Core mechanism
Binds to the benzodiazepine site on GABA-A receptors, enhancing GABA-mediated chloride ion influx. This increases inhibitory neurotransmission throughout the central nervous system, producing anxiolytic, sedative, amnestic, anticonvulsant, and muscle relaxant effects.3,8
Well absorbed orally. Can be taken with or without food. Available in IM/IV formulations for acute settings.
Valerian root enhances GABAergic activity, which adds to lorazepam's CNS depressant effects. This combination can lead to excessive sedation, psychomotor impairment, and potentially dangerous respiratory depression.
Recommendation: Avoid combining valerian root with lorazepam. The additive sedative effects can be dangerous. If you need sleep support while on lorazepam, discuss alternatives with your prescriber.
Melatonin's sedative effects can compound lorazepam's CNS depression. While some research suggests melatonin may help facilitate benzodiazepine tapering, combining both at full doses may cause excessive sedation and next-day drowsiness.
Recommendation: If using melatonin with lorazepam, start with a low melatonin dose (0.5-1mg) and monitor for excessive sedation. Melatonin may be useful as part of a supervised benzodiazepine tapering strategy but should not be added without medical guidance.
Supplemental GABA may have sedative effects that could add to lorazepam's CNS depression. Although the extent of oral GABA's blood-brain barrier penetration is uncertain, the potential for additive GABAergic effects warrants caution with this combination.
Recommendation: Exercise caution when combining GABA supplements with lorazepam. Monitor for excessive sedation, drowsiness, or impaired coordination.
Passionflower has anxiolytic and GABA-related activity that may stack with lorazepam's benzodiazepine effect. The result can be more sedation, slowed thinking, poor coordination, or falls. Risk rises with alcohol, opioids, sleep medicines, respiratory disease, older age, or taking lorazepam more often than prescribed.
Recommendation: Avoid passionflower with lorazepam unless your prescriber has reviewed the combination. If used, avoid alcohol and other sedatives, use caution with driving, and stop passionflower if you feel unusually sleepy, confused, or unsteady. Get urgent help for severe sedation or slowed breathing.
Alcohol compounds lorazepam's sedating, amnestic, and coordination-impairing effects. Even if lorazepam is not strongly CYP-metabolized, the interaction is pharmacodynamic and can still cause dangerous impairment. Combining them raises the risk of falls, blackouts, aspiration, and respiratory depression.
Recommendation: Avoid alcohol while taking lorazepam. If alcohol was used, do not take extra lorazepam for anxiety or sleep without medical guidance. Seek urgent care for severe sedation, slow breathing, or inability to stay awake.
Numbered references. Citations throughout the page link here.
Chen A, Bae M. Lorazepam in Managing Atypical Neuroleptic Malignant Syndrome: A Systematic Review of Case Reports. The western journal of emergency medicine. 2025
Amore M, D'Andrea M, Fagiolini A. Treatment of Agitation With Lorazepam in Clinical Practice: A Systematic Review. Frontiers in psychiatry. 2021
Systematic review found benzodiazepines including lorazepam commonly prescribed during pregnancy (prevalence 1.1-10.9%), highlighting the need for careful risk-benefit assessment given potential neonatal complications.
Meta-analysis found lorazepam had comparable efficacy to diazepam for terminating convulsive status epilepticus, with a trend toward fewer recurrences and less respiratory depression, supporting its role as a first-line agent.
Curtin F, Schulz P. Clonazepam and lorazepam in acute mania: a Bayesian meta-analysis. Journal of affective disorders. 2004
Yang WY, Huang K, Lin ZJ et al.. Intranasal Dexmedetomidine for the Management of Preoperative Anxiety-Related Insomnia: A Randomized, Three-Blinded, Clinical Trial Compared with Lorazepam and Placebo. Drug design, development and therapy. 2024
Hui D, Frisbee-Hume S, Wilson A et al.. Effect of Lorazepam With Haloperidol vs Haloperidol Alone on Agitated Delirium in Patients With Advanced Cancer Receiving Palliative Care: A Randomized Clinical Trial. JAMA. 2017
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