Taking Melatonin With Lorazepam
In our latest question and answer, the pharmacist discusses whether or not it is safe to take melatonin and lorazepam together.
Is it OK to take half of 5 mg melatonin with a small dose of lorazepam for sleep once or twice a week? Thank you!
Jul 08, 2022- Taking melatonin and lorazepam together may increase drowsiness, but this combination is not expected to cause significant problems for most people. Melatonin may be helpful for people taking lorazepam since the benzodiazepine can reduce the body's natural melatonin production. If you use both medications together, use them cautiously and at low doses if needed.
Thanks for reaching out! Lorazepam and melatonin should be used cautiously together.
Using both together increases the risk of additive sedation, although this isn't thought to be clinically significant for most individuals as melatonin doesn't have strong sedating properties. Melatonin is more commonly used to aid in normalizing your sleep-wake cycle after disruption (e.g. jet lag).
Interestingly enough, the use of melatonin supplements may have a place in therapy for many individuals that take benzodiazepines, such as lorazepam. Preliminary studies in animals have shown that benzodiazepines can reduce endogenous melatonin production. Melatonin supplementation may help restore melatonin levels to more normal levels, increasing sleep quality. although more studies are needed.
Melatonin Information
Melatonin is an endogenous (i.e. naturally produced in our bodies) hormone that is produced in the pineal gland and is necessary for the normal functioning of our circadian rhythm and sleep cycle. The release of melatonin in our bodies is stimulated by darkness and suppressed by light and has a major role in our sleep-wake cycle and circadian rhythm.
To generalize, when we get ready to sleep, melatonin levels increase. When we are ready to get up, melatonin levels decrease. Many studies show that melatonin supplementation is effective for certain situations that can lead to disruptions of the sleep-wake cycle such as in jet lag or in night shift workers. There is less evidence for benefit when used for short-term treatment of insomnia.
Nevertheless, there are studies that do show that melatonin can decrease sleep latency (i.e. time to fall asleep) and increase total sleep time, although the effects don't appear to be that profound. The most evidence of the benefit for use of melatonin may be in the elderly, or in those that have diminished melatonin levels or are taking drugs that can reduce melatonin levels.
Lorazepam Information
Lorazepam, brand name Ativan, is a fast acting benzodiazepine. It is often used for the treatment of anxiety as well as insomnia. After taking by mouth, lorazepam will begin to work quickly, in about 30 minutes. Each dose lasts around 8 to 12 hours. When used long-term, lorazepam can cause physical dependence and needs to be slowly tapered to avoid withdrawal symptoms.
Taking Melatonin And Lorazepam Together
As mentioned above, taking melatonin and lorazepam together can theoretically increase the risk of excess sedation but there isn't much evidence that this interaction is major and most individuals will tolerate the combination well. Nevertheless, be sure to use both cautiously, at low doses if necessary.
Final Words
Thanks again for your question and please reach out again in the future with any additional questions!
Glossary — Terms in This Answer
- Additive sedation
- A combined drowsy or sleep-inducing effect that occurs when two medications that cause sedation are used together.
- Sleep-wake cycle
- The body's natural daily pattern of sleeping and waking.
- Benzodiazepines
- A class of prescription medications that reduce anxiety and promote sleep by affecting the central nervous system.
- Endogenous
- Something that is naturally produced inside the body rather than coming from an external source.
- Pineal gland
- A small gland in the brain that produces melatonin to regulate sleep.
- Circadian rhythm
- The body's internal 24-hour cycle that regulates sleep, wake times, and other biological processes.
- Sleep latency
- The amount of time it takes to fall asleep after getting into bed.
- Physical dependence
- A condition where the body adapts to a medication and experiences withdrawal symptoms if it is stopped suddenly.
Dr. Brian Staiger, PharmD
Doctor of Pharmacy, board certified clinical pharmacist (BCPS), American Herbalist Guild, Medication Therapy Management certified
Brian Staiger, PharmD, BCPS, is a licensed pharmacist with more than 13 years of experience across retail pharmacy, clinical pharmacy, medication safety, pharmacy program development, and healthcare administration. He is the founder of HelloPharmacist.com, where he helps patients...
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