cns depression
15 interactions related to cns depression
lorazepam + valerian
Valerian root contains valerenic acid and other compounds that modulate GABA-A receptor activity. Combined with lorazepam, a benzodiazepine that also enhances GABA signaling, the effect is additive CNS depression with increased risk of severe drowsiness, confusion, and impaired coordination.
diazepam + kava
Kava's kavalactones bind GABA-A receptors and produce additive central nervous system depression when combined with diazepam, a long-acting benzodiazepine. Concurrent use is not recommended due to risk of excessive sedation, impaired coordination, and potential additive hepatotoxicity.
alprazolam + kava
Kava contains kavalactones that potentiate GABA-A receptor binding, producing additive CNS depression when combined with alprazolam, a benzodiazepine that also enhances GABA-A activity. A published case report describes a 54-year-old man who became semi-comatose after taking alprazolam with kava for three days.
zolpidem + valerian
Zolpidem is a Z-drug hypnotic that selectively binds the GABA-A receptor's alpha-1 subunit. Valerian's valerenic acid also modulates GABA-A receptors, producing additive sedation and a documented delay in next-morning psychomotor recovery when the two are combined.
alcohol + kava
Kava and alcohol both depress the central nervous system through GABAergic and other mechanisms, producing additive sedation and motor impairment. More importantly, both substances are hepatotoxic, and concurrent use significantly increases the risk of severe liver injury, including cases of fulminant liver failure requiring transplantation.
diphenhydramine + valerian
Diphenhydramine (a sedating antihistamine) and valerian root both produce CNS depression through GABAergic and histaminergic pathways. Used together, sedation, psychomotor impairment, and respiratory depression risks are additive.
alcohol + alprazolam
Alcohol and alprazolam (Xanax) both depress the central nervous system through GABA-A receptor potentiation, producing additive sedation, profound respiratory depression, and impaired psychomotor function. The combination significantly increases risk of overdose death, even at moderate doses of each substance.
alcohol + diazepam
Diazepam (Valium) and alcohol are both GABA-A receptor positive allosteric modulators, producing additive and supra-additive CNS depression with profound risk of respiratory depression, coma, and death. Diazepam's long half-life and active metabolites extend the window of dangerous interaction far beyond the dosing interval.
alcohol + zolpidem
Zolpidem (Ambien) and alcohol both potentiate GABA-A receptor activity at the alpha-1 subunit, producing additive sedation, profound impairment of psychomotor performance, and significantly elevated risk of complex sleep behaviors, falls, respiratory depression, and motor vehicle crashes. Alcohol also increases zolpidem absorption and peak concentrations.
alcohol + trazodone
Trazodone and alcohol both depress the central nervous system, producing additive sedation, dizziness, orthostatic hypotension, and impaired psychomotor performance. The combination also increases risk of falls, accidents, and rarely, dangerous arrhythmias related to QT prolongation.
alcohol + mirtazapine
Mirtazapine and alcohol both depress the central nervous system, producing additive sedation, profound drowsiness, impaired psychomotor performance, and increased risk of accidents and falls. Mirtazapine's strong H1-antihistamine activity makes the sedative interaction with alcohol particularly pronounced, especially at lower doses.
valerian tea + benzodiazepines
Valerian (Valeriana officinalis) modulates GABA-A receptors, the same target as benzodiazepines, producing additive central nervous system depression. Co-use can cause excessive sedation, impaired psychomotor performance, and prolonged drowsiness, especially with alcohol or in older adults.
alcohol + valerian
Valerian root acts on GABA-A receptors and may inhibit GABA breakdown, producing sedative effects that are additive with alcohol's CNS depressant effects. The combination produces increased drowsiness, impaired psychomotor performance, and risk of falls, particularly in older adults.
diphenhydramine + melatonin
Both diphenhydramine and melatonin cause sedation through different mechanisms (H1 antagonism and MT1/MT2 agonism). Combined use produces additive CNS depression, next-day drowsiness, impaired cognition, and increased fall risk, especially in older adults.
thc + benzodiazepines
THC and benzodiazepines are both central-nervous-system depressants and produce additive sedation, ataxia, cognitive impairment, and respiratory slowing. THC and CBD components of cannabis also inhibit CYP3A4, which metabolizes alprazolam, midazolam, and triazolam, potentially raising benzodiazepine plasma levels.