Compare Valium to Xanax

Vilma Ruddock
woman looking at pill bottles

Valium and Xanax belong to the same class of drugs, the benzodiazepines. They have similar therapeutic benefits, side effects, risks, and potential for abuse and addiction. The two drugs differ mainly in their potency and the duration of their effects.

Common Uses of Valium and Xanax

Doctors prescribe Valium and Xanax for anxiety, panic, and seizure disorders, and as a muscle relaxant and sleep sedative. Valium is often given for the following:

  • Acute or chronic anxiety
  • Acute panic attacks
  • Insomnia or other sleep disturbances
  • Muscle spasms
  • Restless leg syndrome
  • Acute seizures and short-term treatment of epilepsy
  • To manage alcohol, opioid, and benzodiazepine withdrawal symptoms
  • To provide relaxation and decrease anxiety before diagnostic or surgical procedures

Xanax is most often prescribed for:

  • Symptoms of acute anxiety and generalized anxiety disorder
  • Panic disorder, which involves recurrent panic attacks
  • Symptoms of premenstrual syndrome (PMS)

Valium and Xanax Similarities

Because Valium (a brand of diazepam) and Xanax (a brand of alprazolam) are both benzodiazepines, they share similar characteristics and exert the same effects on the body.

  • In therapeutic doses, both drugs make you feel calm, less anxious, relaxed, tranquil, and sleepy, and they can give you a euphoric feeling.
  • The drugs have a quick onset of effect so you will start to feel the full effects within half hour to one hour after taking an oral dose.
  • For the treatment of certain problems, you might be prescribed repeated doses throughout the day to maintain the required level of effect.
  • The drugs are safe when taken by mouth as prescribed but have a potential to be misused and abused, which can lead to dependence and addiction.

How the Drugs Work

Valium and Xanax have the same mechanism of action. According to the University of Maryland, all benzodiazepines (benzos) increase the activity of the inhibitory neurotransmitter gamma-amino butyric acid (GABA) in the brain.

GABA inhibits nerve activity in the central nervous system (CNS). This results in the anti-anxiety, sedative, and anti-seizure effects of Valium, Xanax, and other benzos. The CNS effects can last even after the drug is no longer detectable in the blood.

Absorption, Distribution, and Excretion

When you take oral Valium or Xanax, your body handles either drug in the same way.

  • The benzo is well absorbed by the gut and quickly gets into the bloodstream.
  • From your blood, the drug distributes to your brain and other tissues, including your liver, muscles, and body fat where it can accumulate after repeated doses.
  • Both drugs can cross the placenta and get into a fetus and also be secreted in breast milk.
  • Your liver metabolizes a benzodiazepine, and it is excreted mainly by your kidneys.
  • How long Valium or Xanax stay in your body depends on the dose, how frequently you take them, and other factors, such as the amount of body fat you have.
  • With short-term use, the drugs and any metabolic products can be detected in your blood, urine, and saliva up to four days after the last dose and in your hair for up to 90 days.
  • Heavy use of high or frequent doses might take a few weeks for the drug to clear from your body fluids compared to a few days for regular users.

Short-Term Side Effects

During a short course of Valium or Xanax, the temporary unwanted side effects include the following, which are more severe the higher the dose you take.

  • v
    Drowsiness, fatigue, dizziness, and slurred speech similar to drinking too much alcohol can start as soon as the drug takes effect.
  • You can experience confusion, disorientation, poor concentration, focus, and attention, and short-term difficulty with memory.
  • Impaired thinking, judgement and perception, reaction time, coordination, and memory interferes with ability to drive or operate other heavy equipment. Don't drive for at least six hours after a dose of Valium or Xanax or longer if you are still feeling the effects.
  • Physical symptoms such as constipation because of decreased bowel motility, headaches, shortness of breath, dry mouth, and change in appetite may occur.
  • Decreased sex drive and sexual function is possible.
  • Although used to promote sleep, Valium and Xanax can cause sleep disturbance including insomnia.
  • Hangover for up to 12 hours can happen the next day after taking the previous night for sleep.

These short-term side effects will disappear after you stop taking the benzodiazepine. Combining Valium or Xanax with another depressant substance, such as alcohol or an opioid, can increase and prolong the effects of the two drugs.

Long-Term Side Effects

With prolonged use or abuse of Valium or Xanax, short-term side effects can persist. The long-term side effects of either drug include:

  • Ongoing drowsiness and sedation
  • Prolonged impaired judgement, decision-making, and short-term memory
  • Difficulty with attention, perception, focus, and coordination
  • Persistent depression, irritability, blunt emotions, and other mood changes
  • Persistent physical symptoms such as chronic headaches, constipation, and changes in appetite
  • Heightened anxiety when not on the drug

These long-term effects can last for months or longer for habitual users and abusers.

Risks

Prolonged use of Valium or Xanax, or any benzodiazepine, has the same risks.

  • Physical dependence: Long-term use of either drug, even in normal prescribed doses, can cause physical dependence. This means when you stop the drug abruptly, your body can have abnormal function. You can have unpleasant withdrawal symptoms including rebound anxiety, tremulousness, seizures, and convulsions depending on the dose and frequency of use.
  • Psychological dependence: The user feels she/he cannot function without the drug.
  • Tolerance: This means the user needs higher and higher doses or needs to take the benzodiazepine more often to maintain the same tranquilizing and sedative effects.
  • Potential for abuse: The National Institute on Drug Abuse lists Valium and Xanax among the most abused prescription drugs. Abusers misuse the drugs by:
    • Using higher doses to get a better relaxed effect or feel euphoric, then need increased doses to compensate for tolerance
    • Taking more frequent doses than usually prescribed
    • Using the drugs when not prescribed for their use
    • Taking the benzos with other classes of psychoactive drugs such as opioid drugs
    • Using the drug by alternate routes rather than by mouth, such as crushing and snorting or by injecting a solution of the drug
  • Risk of addiction: Frequent, long-term use of high doses of either drug or in unintended ways has the potential to cause addiction with craving for the drug.

In addition, high doses Valium or Xanax can severely depress the brain and respiratory center and slow breathing and heart rate. This risk is even greater if the benzo is combined with alcohol or other depressant drugs such as opioids. Extreme abuse of either drug can lead to overdose and cause accidental respiratory and cardiac arrest, coma, and death.

Differences Between Valium and Xanax

Although Valium and Xanax have many similarities, they differ in a few characteristics including, their potency, how long they stay in the body, and therefore the duration of their effects.

  • Xanax is more potent than Valium according to a comparison of benzodiazepines by a Johns Hopkins guide sheet. This means it takes a smaller milligram dose of Xanax to cause the same effect as Valium.
  • Valium is has a longer duration of action than Xanax, according to a 2013 review of benzodiazepines in the Ochsner Journal. This is because it takes longer for the body to eliminate Valium and its metabolic products from the liver than it does for Xanax.

A Comparison Table of the Differences

The following table summarizes some of the differences between Valium and Xanax, including their generics.

VALIUM XANAX
Routes of administration
  • Oral
  • Injection
  • Suppository
  • Oral
Forms of the brand drug and their generics
  • Tablet
  • Extended-release tablet
  • Liquid concentrate
  • Intravenous solution
  • Intra-muscular injection
  • Rectal gel
  • Tablet
  • Extended-release table
  • Oral disintegrating tablets (ODT)
  • Liquid concentrate
Usual oral dose 2 to 10 milligrams 0.25 to 2 milligrams
Frequency of oral dosing 1 to 4 times per day 2 to 3 times per day
Onset of effects after an oral dose About 15 to 30 minutes 30 to 60 minutes
Peak blood level after an oral dose 1 to 2 hours 1 to 2 hours
Duration of effects 12 to 24 hours 6 to 12 hours
Elimination half life of the drug and active metabolic products 20 to 80 hours 6 to 27 hours (has no active metabolic products)

Recommended for Short-Term Use

Valium and Xanax are two of the most common benzodiazepines doctors prescribe for specific indications. They are recommended for short-term use to decrease the risk for long-term side effects, abuse, and addiction. If you need long-term treatment for your condition, talk to your doctor about how to reduce or manage these risks.

Was this page useful?
Compare Valium to Xanax