Lorazepam (Ativan) and Ketamine Therapy | Tovani Health
Ativan (Lorazepam) — Benzodiazepine (short-acting)
Verdict at Tovani Health
Compatible; chronic daily use is the documented blunting concern.
Lorazepam and ketamine can be combined safely. The two issues we plan around: additive respiratory and CNS depression in the session window, and the well-documented effect of chronic benzodiazepine use blunting ketamine's antidepressant response. As-needed use is a smaller concern than daily standing doses.
If you take Ativan regularly and are considering at-home ketamine therapy, the combination is safe with monitoring or dose adjustment. This page covers the brief pharmacologic context and what we do at intake.
How Ativan interacts with ketamine
Lorazepam is a GABA-A positive allosteric modulator metabolized by glucuronidation (no CYP), with a half-life of 10-20 hours. Chronic benzodiazepine therapy has been associated in multiple studies with smaller and shorter antidepressant responses to ketamine.
What we do at intake
Disclose dose, frequency (daily vs as-needed), and how long you have been on it. We may ask you to hold a dose the morning of a session. We do not recommend stopping chronic benzodiazepines without your prescriber.
Bottom line
Lorazepam and ketamine can be combined safely. The two issues we plan around: additive respiratory and CNS depression in the session window, and the well-documented effect of chronic benzodiazepine use blunting ketamine's antidepressant response. As-needed use is a smaller concern than daily standing doses.
Frequently Asked Questions
How much does lorazepam reduce ketamine's effect?
Estimates vary, but multiple studies show a meaningful reduction in response magnitude with chronic daily benzo use. As-needed use for panic attacks is a smaller concern.
Should I stop lorazepam before KAP?
Not on your own. Benzodiazepine withdrawal can be dangerous. That decision belongs with your prescriber.
Ready to find out if at-home ketamine fits your situation?
We’ll note that you’re on Ativan (Lorazepam) at intake. The eligibility check takes 5 minutes and gives you an honest answer about whether at-home ketamine fits your specific situation.
FL and NJ residents only. Benjamin Soffer, DO — Tovani Health.
Sources
The verdict and clinical guidance on this page are based on the following peer-reviewed literature and FDA prescribing information.
- The Antidepressant Effect of Ketamine Is Dampened by Concomitant Benzodiazepine Medication. Andrashko V, Novak T, Brunovsky M, et al.. Frontiers in Psychiatry. 2020. PMID: 33005153
Patients on concomitant benzodiazepines showed a measurably blunted antidepressant response to ketamine.
- Pharmacodynamic Interactions Between Ketamine and Psychiatric Medications Used in the Treatment of Depression: A Systematic Review. Veraart JKE, Smith-Apeldoorn SY, Bakker IM, et al.. International Journal of Neuropsychopharmacology. 2021. PMID: 34170315
Systematic review of pharmacodynamic interactions between ketamine and psychiatric medications used in depression treatment.
Clinically reviewed
Reviewed by Benjamin Soffer, DO on May 15, 2026. Dr. Soffer is a board-certified physician (American Board of Internal Medicine) licensed in Florida and New Jersey, prescribing at-home ketamine therapy through Tovani Health.
This page is general information about how this medication interacts with at-home ketamine therapy at Tovani Health. It is not a substitute for medical advice from your prescribing physician about your specific situation. Always discuss medication changes with the doctor who prescribed them.