Can You Take Passionflower With Lorazepam?

Hello and thanks for reaching out!

Passionflower and lorazepam aren't a combination I'd put together without a quick conversation with your pharmacist or prescriber first as there is an interaction between the two.

The two aren't dangerous together in the way some drug pairings are, but they calm the brain through the same pathway, so their sedating effects tend to add up rather than sit side by side. That's why this pairing is classified as a moderate interaction, and you can read the details on our Passion Flower with Lorazepam interaction page:  Passion Flower with Lorazepam.

Why the Two Effects Stack

Lorazepam (Ativan) is a benzodiazepine, and it works by boosting the activity of GABA, the brain's main calming neurotransmitter. That's what makes it effective for anxiety and occasionally for sleep, and it's also the source of its familiar side effects, including drowsiness, dizziness, slowed reaction time, and trouble with balance or memory.

Passionflower (Passiflora incarnata) is a climbing vine whose extracts are taken for very similar reasons, mainly anxiety and restless sleep. It's thought to work by increasing GABA signaling as well, and it has mild sedative and muscle-relaxing effects of its own.

So, rather than one product doing something the other doesn't, you have two things pushing in the same direction, and the result can be more sleepiness and impairment than you'd get from lorazepam alone.

What the Research and Case Reports Show

Passionflower is not a weak or purely placebo herb in this respect.

In a small four-week trial in people with generalized anxiety disorder, a passionflower extract performed about as well as oxazepam, a benzodiazepine closely related to lorazepam, with no significant difference between the two by the end of the study.

A larger trial in 200 patients having wisdom teeth removed found that a single 500 mg dose of passionflower eased pre-surgery anxiety to a similar degree as 15 mg of midazolam, another benzodiazepine.

Those studies were designed to test passionflower as an alternative to a benzodiazepine, not as an add-on, but they make the point clearly. If passionflower can stand in for a benzodiazepine, it's reasonable to expect it to amplify one.

There is also a published case report of a patient taking lorazepam who added valerian and passionflower and developed hand tremor, dizziness, and muscle fatigue, symptoms that resolved once the herbs were stopped.

It's a single report, and valerian was part of the mix, so it doesn't prove passionflower alone was responsible. Still, it fits with what you'd predict from the pharmacology.

Lorazepam's own prescribing information lists other central nervous system depressants among its clinically significant interactions, and sedating herbs belong in that same general category even though the label doesn't name them.

Points to Talk Over With Your Pharmacist

If your prescriber is comfortable with you using both, the practical concerns are the ordinary ones that come with extra sedation. Avoid driving or anything requiring alertness until you know how the combination affects you, skip alcohol, and be especially careful if you also take other sedating medicines such as opioids, sleep aids, muscle relaxants, or older antihistamines like diphenhydramine, since each of those adds another layer.

Older adults and anyone with breathing problems or a history of falls should be more cautious still. It's also worth knowing that supplement doses vary quite a bit between brands, so the amount of active extract in one passionflower capsule or tea can be very different from another.

Final Words

In summary, passionflower and lorazepam can be combined in some situations, but only with your prescriber or pharmacist aware of it, because the two reinforce each other's sedating effects.