Last updated: 29 September 2026. Informational only, not medical advice.
CBD and benzodiazepines (like alprazolam, lorazepam, or diazepam) both cause sedation, and combining them predictably produces additive drowsiness, though this combination is generally considered more manageable with careful, low-dose approaches than combinations involving opioids. Benzodiazepines also carry their own dependence and withdrawal profile, which is a separate consideration from any CBD-specific interaction.
CBD and benzodiazepines at a glance
| Benzodiazepine | Primary pathway | Interaction relevance |
|---|---|---|
| Alprazolam (Xanax) | CYP3A4 | Moderate to high |
| Diazepam (Valium) | CYP3A4, CYP2C19 | Moderate to high |
| Lorazepam (Ativan) | Minimal CYP metabolism, glucuronidation instead | Lower enzyme concern, additive sedation still applies |
| Clonazepam (Klonopin) | CYP3A4 | Moderate to high |
Why lorazepam is somewhat different from the others
Most benzodiazepines rely on CYP3A4 for metabolism, the same pathway CBD inhibits, but lorazepam is metabolized primarily through a different process called glucuronidation, which CBD doesn’t significantly affect. This means lorazepam carries somewhat lower enzyme-based interaction concern than alprazolam, diazepam, or clonazepam, though the additive sedation concern common to all benzodiazepines still applies regardless of this distinction.
What the combined effect could mean
- More pronounced drowsiness than either substance alone, relevant for driving and daily functioning
- Potentially stronger or longer-lasting benzodiazepine effects if the enzyme-dependent ones are elevated by CBD’s presence
- Increased fall risk, particularly relevant for older adults
- Some people report the combination feels manageable at low doses of each; this varies significantly by individual
The separate question of benzodiazepine dependence
Benzodiazepines carry a well-known risk of physical dependence with regular use, and abrupt discontinuation can cause significant withdrawal symptoms, including, in some cases, seizures. This is a benzodiazepine-specific consideration, unrelated to CBD, but worth noting because some people interested in CBD may be hoping it could help them reduce or come off benzodiazepine use. Any such change needs to happen gradually and under direct medical supervision, never as a self-directed substitution.
Practical guidance
- Inform your prescriber if you’re using or considering CBD alongside a benzodiazepine
- If approved, start with lower doses of CBD than you might otherwise, given the additive sedation potential
- Don’t drive or operate machinery until you understand your personal response to the combination
- Never use this combination as a self-directed strategy to taper off benzodiazepines; that process requires medical supervision given withdrawal risks
- Avoid adding alcohol, which would compound sedation risk further
Who should be most cautious
- On alprazolam, diazepam, or clonazepam specifically. Higher enzyme-pathway relevance than lorazepam.
- Older adults. Combined sedation carries higher fall and confusion risk.
- Long-term, regular benzodiazepine users. Any changes to this regimen, including adding CBD, deserve prescriber involvement given the dependence profile.
- Also on other sedating substances. Compounds risk significantly.
Frequently asked questions
Can I take CBD with Xanax or other benzodiazepines?
Often possible with medical guidance and careful, low-dose approaches, but expect additive drowsiness and discuss with your prescriber first.
Is lorazepam safer to combine with CBD?
It carries somewhat lower liver enzyme interaction concern due to its different metabolic pathway, but the additive sedation concern common to all benzodiazepines still applies.
Can CBD help me stop taking benzodiazepines?
This should only be explored under medical supervision, given benzodiazepine withdrawal can be serious. Never attempt self-directed tapering using CBD as a substitute.
What should I watch for if combining them?
Excessive drowsiness, confusion, or impaired coordination beyond what you’d expect from the benzodiazepine alone. Avoid driving until you understand your response.
