Valium Vs. Xanax: Differences And Which To Choose - Healthline

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Valium vs. Xanax: Is There a Difference?

Medically reviewed by Alexandra Perez, PharmD, MBA, BCGP — Written by Susan York Morris — Updated on May 31, 2023

Uses
How they work
Interactions
Warnings
Side effects
Dependence
Takeaway

Diazepam (Valium) and alprazolam (Xanax) both treat anxiety disorders, but they differ in the other conditions they treat. In choosing which is best for you, a doctor will consider your age, symptoms, and medical history.

Many of us feel symptoms of anxiety from time to time. For some people, though, anxiety and its symptoms, which can be challenging, are a daily occurrence. Ongoing anxiety can affect your ability to function at home, school, and work.

Treating anxiety often involves talk therapy and antidepressant medications. Benzodiazepines are another class of medications used to help curb anxiety. Two commonly prescribed benzodiazepines are Valium and Xanax. These drugs are similar, but not exactly alike.

Why they’re prescribed

Both drugs are used to treat anxiety disorders. Xanax also treats panic disorder.

In addition, Valium treats several other conditions, including:

acute alcohol withdrawal
skeletal muscle spasm
seizure disorders

How they work

Valium and Xanax are both brand-name versions of different generic drugs. Valium is a brand name for the drug diazepam, and Xanax is a brand name for the drug alprazolam. Both of these drugs are minor tranquilizers.

They work by helping to boost the activity of gamma-aminobutyric acid (GABA). GABA is a neurotransmitter, a chemical messenger that transmits signals throughout your body. If your body doesn’t have enough GABA, you may feel anxiety.

Interactions

Dietary interaction

If you take Valium or Xanax, you should avoid large amounts of grapefruit or grapefruit juice. Grapefruit blocks the enzyme CYP3A4, which helps break down certain drugs. So having large amounts of grapefruit can increase the levels of Valium and Xanax in your body. This can increase your risk of side effects.

Drug interactions

Xanax and Valium are in the same drug class, so they have many of the same interactions with other drugs and substances. Medications that affect your central nervous system can be dangerous when combined with benzodiazepines. That’s because they can affect your respiratory system.

Several groups that interact include:

alcohol
antihistamines
other benzodiazepines or sedatives, such as sleeping pills and drugs for anxiety
pain drugs, including hydrocodone, oxycodone, methadone, codeine, and tramadol
antidepressants, mood stabilizers, and antipsychotics
antiseizure medications
tranquilizers and muscle relaxants

These are not all of the possible drug interactions. For a more complete list, see the interactions for diazepam and interactions for alprazolam.

Always tell your doctor and pharmacist about all drugs and supplements you currently take before you start taking any new drug.

Warnings for certain people

Certain people should not take one or either of these drugs. You should not take Xanax or Valium if you have acute angle-closure glaucoma (also known as narrow-angle glaucoma) or a history of allergic reaction to either drug.

You also should not take Valium if you have:

a history of drug dependence
myasthenia gravis, a neuromuscular disease
severe respiratory insufficiency
sleep apnea
severe liver insufficiency or liver failure

Side effects

Common side effects of each drug include:

drowsiness
impaired memory
impaired motor coordination or balance
lightheadedness

The effects may last for a day after you stop taking the drug. If you feel lightheaded or sleepy, do not drive or operate dangerous equipment.

Dependence and withdrawal

The most serious concerns about using Valium or Xanax are dependence and withdrawal.

You can become dependent on these drugs after a few days or weeks. People who take these drugs may build a tolerance over time, and the risk of dependence increases the longer you take the drugs.

The risk of dependence and withdrawal also increases as you age. The drugs may have longer effects in older adults and take longer to leave their bodies.

These effects can happen with both drugs, so if they’re a serious concern for you, talk with your doctor about the right treatment for your anxiety.

You should also never stop taking these drugs abruptly. Stopping these drugs too quickly can lead to withdrawal. Seek your doctor’s advice on the best way to stop taking these drugs slowly.

Differences at a glance

Alprazolam	Diazepam
slower to take effect	takes effect quickly
stays active for a shorter period	stays active for a longer period
approved for panic disorder	not approved for panic disorder
safety not established for children	may be used to treat children

Takeaway

Diazepam and alprazolam are effective in treating several conditions, including acute anxiety. However, each drug also treats different conditions.

One drug may be more appropriate for you based on the condition you’re treating and your medical history.

Talk with your doctor about your symptoms and medical history to help them determine what medication may be best for you.

»MORE:Get a refill for your medication in as little as 15 minutes with Optum Now Online Care.

Optum Now is operated by RVO Health. By clicking on this link, we may receive a commission. Learn more.

How we reviewed this article:

SourcesHistoryHealthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

Benzodiazepines and opioids. (2021).https://www.drugabuse.gov/drug-topics/opioids/benzodiazepines-opioids
FDA requiring Boxed Warning updated to improve safe use of benzodiazepine drug class. (2020).https://www.fda.gov/drugs/drug-safety-and-availability/fda-requiring-boxed-warning-updated-improve-safe-use-benzodiazepine-drug-class
Grapefruit juice and some drugs don't mix. (2021).https://www.fda.gov/consumers/consumer-updates/grapefruit-juice-and-some-drugs-dont-mix
Hepsomali P, et al. (2020). Effects of oral gamma-aminobutyric acid (gaba) administration on stress and sleep in humans: A systematic review.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7527439/
Rosenbaum JF. (2021). Benzodiazepines: A perspective.https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2020.20040376
Sake F-T-N, et al. (2019). Benzodiazepine usage and patient preference for alternative therapies: A descriptive study.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6529930/
Symptoms of angle-closure glaucoma. (2015).https://www.glaucoma.org/glaucoma/symptoms-of-angle-closure-glaucoma.php
Valium brand of diazepam tablets. (2016).https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/013263s094lbl.pdf
Xanax alprazolam tablets, USP. (2016).https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/018276s052lbl.pdf

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Medically reviewed by Alexandra Perez, PharmD, MBA, BCGP — Written by Susan York Morris — Updated on May 31, 2023

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