What happens when you take lorazepam with valerian?
Lorazepam (Ativan) is an intermediate-acting benzodiazepine that works by enhancing the effects of GABA, the brain's primary inhibitory neurotransmitter, at the GABA-A receptor. Valerian root (Valeriana officinalis) is one of the most widely used herbal sleep and anxiety aids, and its mechanism is similar: valerenic acid and related compounds bind to a site on the GABA-A receptor and modulate GABA's effect, while other constituents inhibit GABA reuptake. Both substances therefore push the same lever in the same direction.
Taking them together produces additive central nervous system depression. Users typically feel deeper drowsiness, slower thinking, more impaired balance, and reduced reaction time than either substance produces alone. Healthcare references describe a meaningful risk of excessive lethargy or confusion in people who combine valerian with benzodiazepines.
Why is this important?
Valerian is widely available without a prescription and is often perceived as a gentle, side-effect-free herbal alternative to prescription sleep aids. That perception masks a real pharmacological interaction. When valerian is layered on top of lorazepam, the sedative dose effectively becomes larger than what your prescriber intended.
The most practical consequences are next-day grogginess, impaired driving ability, and a higher risk of falls, particularly in older adults. Lorazepam already accumulates more in older patients due to slower clearance, and excessive sedation in this population is associated with hip fractures and motor vehicle crashes. Adding valerian intensifies that risk.
There is also a concern around respiratory depression. Lorazepam, like other benzodiazepines, can suppress breathing, especially when combined with other CNS depressants such as alcohol, opioids, or other sedative-hypnotics. Valerian's modest CNS depressant effect can contribute to this when stacked, particularly at higher doses or in people with sleep apnea or chronic lung disease.
A subtler issue is dose unpredictability. Valerian products vary widely in the concentration of active compounds because there is no standardization across brands. Two capsules from different bottles can produce noticeably different sedation, which makes the additive effect with lorazepam harder to anticipate.
What should you do?
If you are taking lorazepam, the safest course is to avoid valerian. Skip valerian capsules, tinctures, teas, and combination sleep or stress products that list valerian, Valeriana officinalis, or valerian root extract.
If you have been using both, do not stop lorazepam abruptly; benzodiazepines should be tapered under clinician supervision. Stop the valerian and tell your prescriber so they can reassess your sleep or anxiety treatment plan.
For sleep, the strongest non-drug evidence supports cognitive behavioral therapy for insomnia, consistent sleep schedules, reducing caffeine and alcohol intake, limiting screens in the hour before bed, and keeping the bedroom dark and cool. For anxiety, cognitive behavioral therapy, mindfulness training, and regular exercise have the best long-term evidence and do not stack on top of a benzodiazepine.
If you experience excessive drowsiness, confusion, slow or shallow breathing, or trouble being woken, seek urgent medical attention. Avoid driving or operating machinery if you feel even mildly impaired.
Which specific products are affected?
Lorazepam is sold under the brand names Ativan and Loreev XR, as well as many generic immediate-release tablets, oral concentrate solutions, and injectable forms used in hospitals. The interaction applies to every formulation.
For valerian, the relevant ingredient names on labels are valerian, valerian root, Valeriana officinalis, valerian extract, and sometimes specific actives such as valerenic acid. Valerian appears in stand-alone capsules and tinctures, as a single-herb tea, and in many multi-ingredient sleep formulas that also include passionflower, hops, lemon balm, chamomile, melatonin, or magnesium. Be especially careful with night-time blends sold as natural sleep aids; they often combine several mild sedatives whose effects compound with each other and with lorazepam.
The bottom line
Lorazepam and valerian both enhance GABA-driven inhibition in the brain. Combining them increases the risk of excessive sedation, falls, and impaired daytime function in a way that is easy to underestimate because valerian is sold over the counter. The right move is to keep valerian out of the picture while you are taking lorazepam and to ask your prescriber about evidence-based alternatives that do not pile additional sedation on top of your prescription.