The short answer
Not known in people. In lab tests, a standardised brahmi (Bacopa monnieri) extract slowed several liver enzymes that clear medicines, including CYP3A4. The alprazolam label forbids its use with strong CYP3A4 blockers such as ketoconazole. Nobody has measured whether brahmi acts strongly enough in the body to raise sedative levels.
We found no study that tested brahmi with alprazolam, diazepam, clonazepam or zolpidem in people. The one animal study looked at memory in mice, not at drowsiness. If you take a sleeping pill or an anti-anxiety tablet, tell your prescribing doctor before you start brahmi, and mention any new daytime sleepiness.
Sold in India as Alprax (alprazolam), Calmpose (diazepam), Clonotril (clonazepam), Lorapax (lorazepam) and Zolfresh (zolpidem).
At a glance
| What was seen | How it may work | Direction | Evidence |
|---|---|---|---|
| Extract slowed CYP2C19, CYP2C9, CYP1A2 and CYP3A4[1][3] | Enzyme inhibition by the whole extract; purified bacosides had little effect | Could raise levels of sedatives these enzymes clear | In vitro |
| Less diazepam-induced memory loss in mice[2] | Not established | Effect on drowsiness and drug levels in people unknown | Animal |
No listing is not a clearance. A missing interaction here never means a combination is safe.
The evidence, study by study
Laboratory study, 2014 In vitro
Human liver enzymes made in the lab were exposed to a standardised Bacopa extract. The whole extract slowed CYP2C19 most, then CYP2C9, CYP1A2 and CYP3A4; the purified bacosides had almost no effect. Lab findings like this show a possible route for an interaction. They do not show that one happens in people.[1]
Mouse study, 2008 Animal
Mice were given diazepam, which causes short-term memory loss, with or without an oral Bacopa extract, and then tested in a water maze. The extract lessened the memory loss. The study did not measure sleepiness or diazepam levels, so it cannot say whether the two together make people drowsier.[2]
What your doctor may watch for
- New daytime drowsiness, unsteadiness or falls.[3]
- Being unusually hard to wake, or any breathing difficulty.[3]
What to tell your prescribing doctor
You can read this out, or show them this page:
“I am taking, or planning to take, brahmi (name of product, the Latin name on the pack, dose) along with my sleeping or anti-anxiety medicine. In lab tests brahmi slowed enzymes that clear some of these medicines. Is this combination a concern for me, and what should I watch for?”
Withheld until review
Questions people ask
Related
Brahmi and antidepressants or anxiety medicines
No study has tested brahmi with SSRIs. Two adverse-event reports involve other antidepressants, and other medicines may explain them.
InteractionAshwagandha with sleeping pills and benzodiazepines
Not studied in people. Ashwagandha may have sedative effects that add to benzodiazepines and sleeping pills, based on preclinical work.
InteractionTulsi and sleeping pills or sedatives
In mice, tulsi leaf extract made a sedative work for longer. No study has tested tulsi with sleeping pills in people.
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.
Sources
- Ramasamy S, Kiew LV, Chung LY. Inhibition of human cytochrome P450 enzymes by Bacopa monnieri standardized extract and constituents. Molecules. 2014;19:2588-2601. PMID 24566323.
- Prabhakar S, Saraf MK, Pandhi P, Anand A. Bacopa monniera exerts antiamnesic effect on diazepam-induced anterograde amnesia in mice. Psychopharmacology (Berl). 2008;200:27-37. PMID 18193203.
- Alprazolam tablets, US prescribing information (DailyMed, PD-Rx Pharmaceuticals).
- Walker EA, Pellegrini MV. Bacopa monnieri. StatPearls. Updated 17 March 2023.
- LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. Bacopa monnieri. Updated 24 April 2024.
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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