Can You Take Sertraline with Lorazepam?

Severity assessment

Moderate. The concurrent use of lorazepam and sertraline can lead to additive central nervous system (CNS) depression, increasing the risk of sedation, dizziness, and impaired coordination.

Mechanism (plain English)

Lorazepam is a benzodiazepine that works by enhancing the effect of gamma-aminobutyric acid (GABA), a natural calming chemical in the brain, which reduces brain activity. Sertraline is a selective serotonin reuptake inhibitor (SSRI) that increases the amount of serotonin in the brain, a neurotransmitter involved in mood regulation. Both medications can cause drowsiness and slow down brain function. When taken together, their combined effects on the central nervous system can be amplified, leading to increased sedation and other CNS depressant effects.

Evidence level

Guideline-supported. The British National Formulary (BNF) explicitly lists an interaction between lorazepam and sertraline, noting their additive CNS depressant effects [1, 2].

Top regulator advisories (cite verbatim or close paraphrase)

• TGA (Australia): No specific public advisory found for the lorazepam + sertraline pair. However, the ZOLOFT (sertraline hydrochloride) Product Information states that sertraline should be used with caution with other centrally acting drugs [3].
• MHRA / NICE (UK): Both Lorazepam and Sertraline have effects on the CNS and can cause sedation, which might affect the ability to perform skilled tasks. In some cases, use of two or more drugs that have effects on the CNS might also increase the risk of CNS depressant effects (which could range from sedation to unconsciousness, coma, respiratory depression, and/or cardiovascular depression) [1, 2].
• FDA / CDC (US): The FDA label for Sertraline Hydrochloride Capsules mentions that concomitant use of sertraline with other serotonergic agents (e.g., SSRIs, SNRIs, triptans) increases the risk of serotonin syndrome, and caution is advised when co-administering with other CNS depressants due to potential additive effects [4]. While a specific pharmacokinetic interaction with a single dose of lorazepam was not significant, appropriate observation is warranted when sertraline is used with other CNS depressants [5].
• EMA (Europe): No specific EMA advisory found for the lorazepam + sertraline pair.

Clinical risk factors that elevate the danger

• Age: Elderly patients may be more sensitive to the CNS depressant effects of both medications.
• Concomitant CNS depressants: Concurrent use of alcohol, opioids, other benzodiazepines, or sedating antihistamines can significantly increase the risk of severe sedation and respiratory depression.
• Underlying respiratory conditions: Patients with conditions like sleep apnea or chronic obstructive pulmonary disease (COPD) are at higher risk of respiratory compromise.
• Higher doses: Using higher doses of either lorazepam or sertraline increases the likelihood and severity of CNS depression.
• Rapid dose escalation: Quickly increasing the dosage of either medication, especially lorazepam, can heighten the risk.

What a patient should be told

• You might feel more drowsy, dizzy, or have trouble concentrating when taking lorazepam and sertraline together. Be careful when driving or doing tasks that require alertness.
• Do not stop taking either medication suddenly without talking to your doctor or pharmacist, as this can lead to withdrawal symptoms or worsening of your condition.
• Watch out for warning signs like extreme sleepiness, confusion, very slow or shallow breathing, or difficulty waking up. If these occur, seek medical attention immediately.
• Always discuss all your medications, including over-the-counter drugs and supplements, with your doctor or pharmacist to ensure your treatment plan is safe and appropriate.
• If you experience severe drowsiness, difficulty breathing, or feel like you might pass out, seek urgent medical care.

Top 3 sources (with full citation)

1. Lorazepam | Interactions - BNF - NICE. National Institute for Health and Care Excellence. Available at: https://bnf.nice.org.uk/interactions/lorazepam/ (Accessed: June 1, 2026).
2. Sertraline | Interactions - BNF - NICE. National Institute for Health and Care Excellence. Available at: https://bnf.nice.org.uk/interactions/sertraline/ (Accessed: June 1, 2026).
3. ZOLOFT (sertraline hydrochloride) Product Information. Therapeutic Goods Administration (TGA) Australia. Available at: https://www.tga.gov.au/sites/default/files/foi-204-1314-3-1.pdf (Accessed: June 1, 2026).

Notes for the reviewing pharmacist

While lorazepam and sertraline do not have a significant pharmacokinetic interaction (lorazepam is primarily metabolized by glucuronidation, not CYP enzymes significantly affected by sertraline), the primary concern is the additive pharmacodynamic effect on the CNS. Both drugs contribute to CNS depression, leading to increased sedation, psychomotor impairment, and potentially respiratory depression. It is crucial to counsel patients on avoiding other CNS depressants, including alcohol. Monitoring for excessive sedation, dizziness, and cognitive impairment is essential, especially during initiation or dose adjustments. The interaction is generally considered manageable with careful patient selection, education, and monitoring, but the potential for serious adverse events, particularly in vulnerable populations, warrants caution. There is no specific