Can lorazepam and Abilify be taken together?

October 10, 2025 •

3 min read

While the combination of a benzodiazepine like lorazepam and an antipsychotic like Abilify can be clinically beneficial for some patients, it carries significant risks that necessitate careful medical supervision. It is most often used for short-term management of acute agitation or severe anxiety in a hospital setting.

Quick Summary

The combined use of lorazepam and Abilify is possible under strict medical guidance but significantly increases the risk of excessive drowsiness, sedation, and low blood pressure. Close monitoring and potential dosage adjustments are crucial to manage these enhanced side effects and ensure patient safety.

Key Points

Enhanced Sedation: Combining lorazepam and Abilify can lead to excessive drowsiness, sedation, and confusion due to their overlapping depressant effects on the central nervous system.
Orthostatic Hypotension Risk: The combination significantly increases the risk of orthostatic hypotension, a condition where blood pressure drops upon standing, which can cause dizziness and increase the risk of falls.
Expert Medical Supervision Required: This drug combination should only be used under a doctor's supervision, who will carefully monitor for adverse effects and adjust dosages as needed to ensure safety.
Special Precautions for the Elderly: Elderly patients are at a higher risk for adverse effects, including impaired thinking, judgment, and motor coordination, making close monitoring especially critical.
Avoid Alcohol and Alertness-Dependent Activities: Patients must abstain from alcohol and avoid activities like driving until they understand how the medication combination affects them.
Not for Long-Term Use: The use of lorazepam with Abilify, particularly for managing agitation, is typically a short-term strategy, and lorazepam's dose must be tapered to prevent withdrawal.

Understanding the Medications: Lorazepam and Abilify

To understand the combined effects of lorazepam and Abilify, it is important to first understand how each medication works on its own. They belong to different classes of drugs and target different aspects of the central nervous system.

Lorazepam (Ativan)

Lorazepam is a benzodiazepine that enhances the effects of the brain's primary inhibitory neurotransmitter, GABA, resulting in a calming and sedative effect. It is used for anxiety, insomnia, seizures, and alcohol withdrawal. Due to the risk of dependence, it's typically prescribed for short periods.

Abilify (aripiprazole)

Abilify (aripiprazole) is an atypical antipsychotic that helps rebalance mood and thinking by acting on dopamine and serotonin receptors. It treats conditions like schizophrenia, bipolar disorder, and major depressive disorder (as an adjunct). It's also used for agitation associated with schizophrenia or bipolar mania.

The Risks of Combining Lorazepam and Abilify

Combining lorazepam and Abilify, even when prescribed by a doctor for specific reasons like acute agitation or resistant symptoms, carries notable risks.

Increased Sedation and Drowsiness

Both medications can cause drowsiness and sedation. When taken together, these effects are amplified, leading to excessive sleepiness, confusion, and difficulty concentrating. This impaired state can be dangerous, particularly when driving or operating machinery.

Orthostatic Hypotension (Low Blood Pressure)

The combination increases the likelihood of orthostatic hypotension, a drop in blood pressure when changing positions. This can cause dizziness, lightheadedness, and fainting, raising the risk of falls. This is especially concerning for older adults.

Impaired Coordination and Cognitive Function

Enhanced sedative effects can also result in impaired thinking, judgment, and motor coordination, which is a particular concern for the elderly.

Potential for Respiratory Depression

At high doses, combining these medications can lead to respiratory depression, where breathing becomes dangerously slow or shallow. This risk is further increased by alcohol or other CNS depressants.

Pharmacodynamic vs. Pharmacokinetic Interactions

While some studies suggest that lorazepam does not significantly affect how Abilify is processed by the body (pharmacokinetics), the clinical concern lies in the pharmacodynamic interaction – the magnified sedative and blood pressure effects that require careful monitoring and potential dose adjustments.

Management and Precautions

Due to the risks, using lorazepam and Abilify together requires strict medical oversight. Healthcare providers typically implement the following precautions:

Lower Starting Doses: Doctors may begin with lower doses of one or both medications to reduce the risk of intensified side effects.
Close Monitoring: Patients are closely watched for excessive sedation, low blood pressure, and coordination problems, especially when starting treatment.
Short-Term Use: Lorazepam is usually prescribed for a limited time in this combination to manage acute symptoms.
Patient Education: Patients are informed about potential side effects and advised against activities requiring alertness, like driving.
Avoid Alcohol: Patients must avoid alcohol, which exacerbates the CNS depressant effects.

Comparison of Lorazepam and Abilify


Feature	Lorazepam (Ativan)	Abilify (aripiprazole)
Drug Class	Benzodiazepine	Atypical Antipsychotic
Mechanism of Action	Enhances GABA inhibitory neurotransmission	Partial agonist/antagonist at dopamine and serotonin receptors
Primary Uses	Anxiety, panic disorder, insomnia, seizures	Schizophrenia, bipolar disorder, major depressive disorder (adjunct)
Onset of Action	Rapid (minutes to hours)	Gradual (weeks)
Risk of Dependence	High with prolonged use	Low, but discontinuing requires medical supervision
Primary Side Effects	Drowsiness, dizziness, unsteadiness, fatigue	Weight gain, anxiety, restlessness, nausea
Interaction Effect	Increased sedation, dizziness, low blood pressure	Intensified CNS depressant effects

Conclusion

Combining lorazepam and Abilify can be effective for severe or acute mental health symptoms but is not without significant risks, primarily due to the increased sedative effects and risk of orthostatic hypotension. A healthcare professional must carefully weigh the benefits against these risks before prescribing the combination. Patients must adhere to their doctor's instructions and report any adverse effects promptly.

For more information on drug interactions, the National Institute of Health provides a comprehensive resource on medication interactions.

Frequently Asked Questions

The most common and significant side effects of combining these medications are excessive drowsiness, intense sedation, increased confusion, difficulty concentrating, and a higher risk of low blood pressure (orthostatic hypotension).

No, you should never adjust the dosage of either lorazepam or Abilify on your own. Any changes must be made under the strict guidance of your doctor to prevent serious adverse effects or withdrawal symptoms, especially from lorazepam.

Doctors may prescribe both to manage complex mental health conditions. For example, the combination can be used for the short-term treatment of acute agitation associated with schizophrenia or bipolar mania, or to manage severe anxiety that does not respond to a single medication.

Yes, it is highly dangerous. Both medications are central nervous system depressants, and combining them with alcohol can dangerously intensify sedative effects, increasing the risk of respiratory depression, coma, and even death.

This is a sign of orthostatic hypotension. You should stand up slowly from a sitting or lying position. If the symptoms persist or worsen, contact your doctor immediately, as this could indicate a need for a dosage adjustment.

The use of lorazepam, especially in combination, is often intended for short-term management of acute symptoms due to the risk of dependence. A doctor will determine the duration based on your specific clinical needs.

Yes, elderly patients should be particularly cautious. They are more susceptible to enhanced side effects like sedation, impaired coordination, and orthostatic hypotension. Anyone with pre-existing low blood pressure or respiratory issues should also be closely monitored.