Does CBD Interact with Ativan Or Zoloft?

In our latest question and answer, our pharmacist discusses whether or not CBD interacts with the prescription drugs Ativan (lorazepam) and Zoloft (sertraline).
Does CBD Interact with Ativan Or Zoloft?

Richard Patterson Asked

Can I take a small amount of CBD if I am using Ativan and sertroline for anxiety and depy


CBD might have additive effects if used with other CNS depressants like lorazepam, but this isn't likely at low doses.
CBD could interact with both lorazepam and sertraline by interfering with their metabolism in the liver.
Overall the risk of an interaction is low especially if you're using a low dose of CBD.


What Is Ativan (Lorazepam)?

Ativan is the brand name for lorazepam, a medication used to treat anxiety. Lorazepam belongs to a class of drugs called benzodiazepines which act on the central nervous system to produce a calming effect. Lorazepam works by increasing the effects of a neurotransmitter called γ-Aminobutyric acid or "GABA". 

What is Zoloft (Sertraline)?

Zoloft is the brand name for sertraline, an antidepressant medication. Sertraline belongs to a class of drugs known as selective serotonin reuptake inhibitors (SSRI). Serotonin is a neurotransmitter that has an important effect on mood. Sertraline works by prolonging the action of serotonin in the brain. 

Does CBD Interact With Ativan (Lorazepam)?

Technically, CBD might have additive effects if used with other CNS depressants like lorazepam. Preliminary research suggests that high doses of CBD produce sedative and hypnotic effects. Therefore, using CBD with other drugs that have sedative properties could cause additive therapeutic and adverse effects.

Some adverse effects to look out for would be: 

  • Drowsiness
  • Dizziness
  • Weakness
  • Unsteadiness

Some research suggests that CBD might inhibit UGT enzymes that are responsible for the metabolism of lorazepam. If this were to occur, the clearance of lorazepam would be reduced, and levels of the drug would increase leading to a greater likelihood of the adverse effects listed above. However, this hasn't been confirmed so the risk is relatively low. 

Does CBD Interact With Zoloft (Sertraline)?

These two medications also have the potential to interact, but again the overall risk of this happening appears quite low. Sertraline and CBD are both metabolized by enzymes in the liver. Particularly the enzymes CYP3A4, which is involved in the metabolism of 50% of all drugs, and CYP2C19. CBD could inhibit the metabolism of sertraline via CYP3A4, decreasing the clearance of the drug and increasing sertraline levels. This would increase the risk of adverse effects from sertraline such as nausea, diarrhea, tremors, sweating, and sexual dysfunction. Or the exact opposite could occur and sertraline could inhibit the metabolism of CBD via CYP3A4 or CYP2C19 increasing its effects and adverse effects. 


In Conclusion

Technically CBD could interact with lorazepam by enhancing its sedating effects or by interfering with its metabolism. CBD could also interact with sertraline by interfering with its metabolism in the liver (or vice versa). Overall the risk of CBD interacting with both of these medications is quite low, especially if you are using a low dose of CBD. 



  1. Potential Adverse Drug Events and Drug-Drug Interactions with Medical and Consumer Cannabidiol (CBD) Use. (PubMed).
  2. Exogenous cannabinoids as substrates, inhibitors, and inducers of human drug metabolizing enzymes: a systematic review. (PubMed).
  3. Cannabinoid Interactions with Cytochrome P450 Drug Metabolism: a Full-Spectrum Characterization (PubMed).
  4. CBD and other medications: Proceed with caution (Article).

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