Can Cipralex be taken with lorazepam? (+3 interactions)

In this article, we will explore whether Cipralex can be taken together with lorazepam. Additionally, the therapeutic and the adverse effects will be discussed in detail along with how to prevent them.

Can Cipralex be taken with lorazepam?

Yes, Cipralex can be taken with lorazepam but it has to be done under the careful monitoring of a professional healthcare provider.

Cipralex also known as Lexapro, contains an active ingredient escitalopram and is an antidepressant medication. Lorazepam, on the other hand, is a benzodiazepine used primarily to treat anxiety or sometimes for sedation. 

Both medications have significant effects on the central nervous system and combining them may increase the risk of side effects due to the potential additive effect of these drugs when taken together (1). The list of side effects may include drowsiness, dizziness and impaired coordination.

Although these two medications can be taken together, you are advised to never self-adjust your medication regimen or combine these two medications without consultation or guidance from your doctor. 

What does research suggest?

A study conducted in 2021 has shown that escitalopram and lorazepam can be taken together but caution should be exercised due to potential interactions as both can have depressive effects on the central nervous system (1). 

Research done in 2022, proved that this combination (lorazepam and escitalopram) is safe to use, having fewer adverse effects and a low propensity for drug interactions (2).

However, due to the interacting mechanism of action of escitalopram and lorazepam, there are chances of a few interactions. A study was done in 2022, that concluded the reports of mania being caused by escitalopram taken with alprazolam which is also a benzodiazepine.

It was proven that benzodiazepines can have an enhanced effect if taken together with selective serotonin reuptake inhibitors (SSRI) including Cipralex (escitalopram) (3).  

Therefore, it is important to monitor the patients closely when combining Cipralex with lorazepam. The combination may increase the risk of adverse effects or exacerbate symptoms. It is recommended to consult a doctor before taking the two medications together. 

How does Cipralex interact with lorazepam? 

Escitalopram, often sold under the brand name Cipralex, is used to treat anxiety and depression (4). On the other hand, lorazepam is a drug of a different class used to treat similar psychological disorders such as anxiety and depression (5). When taken together, they may have an additive therapeutic effect. However, increased adverse effects can also be observed.

These medications may react but the effects are dependent upon individual variability. Hence, this combination is to be managed by careful guidance. While they can be used together, it is important to be aware of the potential interactions.

Additive effects  

Cipralex (escitalopram) is a selective serotonin reuptake inhibitor (SSRI) that increases the level of serotonin in the brain, primarily used to manage symptoms of anxiety and depression. Lorazepam has a sedative and anxiolytic effect.

These drugs may be prescribed together to relieve the symptoms of acute anxiety cases.

When these medications are taken together, the therapeutic effects can be enhanced resulting in additive effects of these drugs. This means these may further reduce anxiety and promote relaxation. This can be beneficial in the short term for individuals experiencing acute anxiety.

Sedation and drowsiness

A potential drawback of combining these medications is an increased risk of sedation and drowsiness (6). Cipralex (escitalopram) leads to drowsiness and tiredness and lorazepam can individually cause these side effects as well. When used together, these effects may be more pronounced.

It is crucial to be cautious when operating heavy machinery or driving, as the individual’s coordination and alertness can be impaired.

Risk of overmedication

Using Cipralex with lorazepam simultaneously increases the risk of overmedication. Overmedication can lead to excessive sedation and a drop in blood pressure. It is important for healthcare professionals to carefully consider the dosages and closely monitor individuals who are prescribed both these medications. 

Potential serotonin syndrome

Though it is less common, the combination of Cipralex and lorazepam may carry a slight risk of serotonin syndrome. Serotonin syndrome is a rare but potentially life-threatening condition caused by an excessive buildup of serotonin in the brain. 

Symptoms can include (7):

• Confusion
• Agitation
• Rapid heart rate
• Elevated body temperature
• Muscle stiffness 

This is an extreme reaction and quite unusual but this underscores the importance of correct dosing and monitoring.

What conditions require a combination prescription of Cipralex and lorazepam?

A combination prescription of Cipralex and lorazepam can be prescribed for individuals with specific mental health conditions where the potential benefit outweighs the risk of the combination use. The combination is also prescribed when the monotherapy fails to provide relief. The medical conditions of the prescription are as follows:

General Anxiety Disorder (GAD): Cipralex can provide long-term anxiety management, while lorazepam may provide rapid relief during acute anxiety episodes (8). 

Panic disorder: Cipralex can help with the frequency and intensity of panic attacks over the long term while lorazepam can provide immediate relief. 

Treatment-resistant anxiety or depression: When anxiety or depression does not respond to monotherapy of SSRI including Cipralex, the healthcare providers might consider augmenting treatment with lorazepam.

Short-term anxiety management: Lorazepam is sometimes used as a short-term adjunct to SSRI treatment for anxiety, particularly during the initial weeks when SSRI therapeutic effects are gradually building.

How to prevent adverse effects of Cipralex-lorazepam combination?

Always consult with a qualified healthcare provider who can carefully evaluate your medical condition and determine the appropriateness of using the medications together. They will consider the potential benefits and risks and ensure safe and effective treatment.

If lorazepam is included in the treatment plan, healthcare providers will often aim to limit its use to the short term to taper it down as the primary SSRI  (Cipralex) take effect and begins to alleviate symptoms.

Conclusion

In my perspective, Cipralex (escitalopram) can be taken together with lorazepam. However, it has to be done after a detailed discussion and consultation with your healthcare provider.

The effects may be additive therapeutic effects or some negative effects including over-sedation and drowsiness. The combination should be carefully monitored and the dosage regimen should be followed critically.

References