The short answer
Not known in people. We found no study of ashwagandha taken with clonazepam, alprazolam, zolpidem or other sleep and anxiety medicines. Memorial Sloan Kettering's herb monograph says people on benzodiazepines should likely avoid ashwagandha, because preclinical studies suggest sedative effects that could add to theirs. It also says the clinical relevance has yet to be worked out.
Ashwagandha can cause drowsiness by itself in some people. If you take a benzodiazepine or a sleeping tablet, tell your prescribing doctor before you start ashwagandha, and mention any extra sleepiness, unsteadiness or falls.
Sold in India as Clonotril (clonazepam), Alprax (alprazolam), Calmpose (diazepam), Lorapax (lorazepam) and Zolfresh (zolpidem).
At a glance
| What was seen | How it may work | Direction | Evidence |
|---|---|---|---|
| Possible added sedation[1][2] | Sedative and GABA-related effects in preclinical studies | More drowsiness than with the medicine alone | Theoretical by mechanism |
| Moderate induction of CYP3A4 in a lab study[1][4] | Enzyme induction in vitro | Could lower levels of medicines cleared by CYP3A4, such as zolpidem; not shown in people | In vitro |
| No reversible blocking of liver enzymes by root or leaf extracts[3] | No CYP inhibition at the strengths tested | Does not rule out induction or added sedation | In vitro |
| Liver injury from ashwagandha products[5][6] | Not established | Herb safety context, not an interaction with these medicines | Case report |
No listing is not a clearance. A missing interaction here never means a combination is safe.
The evidence, study by study
Monograph, Memorial Sloan Kettering Theoretical by mechanism
The cancer centre's monograph says preclinical studies suggest ashwagandha has sedative and GABA-related properties and may add to benzodiazepines, barbiturates and anticonvulsants. It advises that people taking these should likely avoid it, and says the clinical relevance has yet to be determined. It also reports that ashwagandha moderately induced CYP3A4, a drug-clearing enzyme, in a lab study.[1]
Laboratory study, United States, 2025 In vitro
At Auburn University, four extracts of ashwagandha root and leaf were tested against seven liver enzymes, including CYP3A4/5 and CYP2B6. None blocked them in a reversible way at the strengths tested. The test did not look at enzyme induction or at added sleepiness, so it does not settle the question.[3]
Case series, India, 2023 Case report
Liver specialists at several Indian centres described 8 people with liver injury after single-herb ashwagandha products, out of 23 ashwagandha cases seen between 2019 and 2022. Five already had chronic liver disease, and three of them developed acute-on-chronic liver failure and died. This is about ashwagandha's own risk to the liver, not about sleep medicines.[5]
Case series, Iceland and the United States, 2020 Case report
Five people developed jaundice 2 to 12 weeks after starting supplements containing ashwagandha. Their liver tests returned to normal within 1 to 5 months in four of them; the fifth was lost to follow-up. Four were also taking other supplements.[6]
What your doctor may watch for
- Extra sleepiness in the day, slowed thinking, unsteadiness or falls.[1]
- Yellow eyes or skin, dark urine, itching or nausea, which can be signs of liver injury.[6]
What to tell your prescribing doctor
You can read this out, or show them this page:
“I am taking, or planning to take, ashwagandha (name of product, form and how much) along with my sleep or anxiety medicine. A cancer centre's herb monograph says ashwagandha may add to the sedation from benzodiazepines. Is that a concern for me, and what should I watch for?”
Withheld until review
Questions people ask
If ashwagandha helps me sleep, can I take less of my sleeping tablet?
That has not been tested. Any change to a sleeping tablet or benzodiazepine is for your prescribing doctor to decide, not something to try on your own.[1]
Does taking them at different times help?
We found no study that tested a time gap between ashwagandha and any sleep or anxiety medicine, so there is no evidence that spacing them helps. That is a question for your doctor.[1]
Related
Does ashwagandha improve sleep?
A 2021 review of five trials found a small improvement in sleep with ashwagandha extract. The effect looked larger in people with insomnia.
ConditionAnxiety and sleep problems: what Ayurveda offers
Ashwagandha extracts improved sleep a little and lowered stress scores in short trials. They were not trials in diagnosed anxiety disorder.
InteractionAshwagandha and antidepressants (SSRIs, SNRIs)
Doctors in Poland reported side effects they judged were caused by ashwagandha with sertraline, escitalopram or paroxetine.
InteractionBrahmi and sedatives or sleeping pills
Not tested in people. In lab tests brahmi slowed enzymes that clear some sedatives, so the effect on drowsiness is unknown.
Sources
- Memorial Sloan Kettering Cancer Center. About Herbs: Ashwagandha.
- National Center for Complementary and Integrative Health (US). Ashwagandha.
- Raichura Z, Heck K, Choi J, Yang L, Brandes M, Marney L, Mangaña AA, Neff C, Maier CS, Soumyanath A, van Breemen RB, Arnold RD, Calderón AI. Evaluation of reversible cytochrome P450 inhibition by Withania somnifera leaf and root extracts. Drug Metab Dispos. 2025;53(2):100024. PMID 40023576.
- Ambien CR (zolpidem tartrate) extended-release tablets, US prescribing information (DailyMed).
- Philips CA, Valsan A, Theruvath AH, Ravindran R, Oommen TT, Rajesh S, Bishnu S, Augustine P; Liver Research Club India. Ashwagandha-induced liver injury: a case series from India and literature review. Hepatol Commun. 2023;7(10):e0270. PMID 37756041.
- Björnsson HK, Björnsson ES, Avula B, Khan IA, Jonasson JG, Ghabril M, Hayashi PH, Navarro V. Ashwagandha-induced liver injury: a case series from Iceland and the US Drug-Induced Liver Injury Network. Liver Int. 2020;40(4):825-829. PMID 31991029.
Awaiting review by The Good Vaidya Medical Board. Prepared from the sources below and checked against each one.
Published 4 November 2026 · Last updated 4 November 2026
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