Valium vs. Xanax: What Are the Differences?

Valium and Xanax are benzodiazepines that can both treat anxiety and panic disorders. Valium is also able to treat a number of other neurological disorders, such as cerebral palsy. 

The major difference between Valium and Xanax is in regard to their half-life, with Xanax having a short half-life and more intense effect on its users. 

Valium vs. Xanax 

Valium and Xanax are two commonly prescribed benzodiazepines, a class of medications used to calm abnormal overactivity in the brain. They are most commonly prescribed for anxiety or panic disorders as well as certain other neurological disorders.

Valium is a brand name for the medication diazepam. Xanax is a brand name for the medication alprazolam. 

While the differences will be discussed further in the sections below, both have the potential to be addictive and to cause harm if not taken as prescribed. If you feel drawn to abuse a medication or feel the amount prescribed isn’t helping, always talk to your doctor before changing the way you take your medicine.

How Do These Drugs Work?

Since both medications are benzodiazepines, Valium and Xanax work in similar ways. 

Benzodiazepines work as positive allosteric modulators on an important receptor for neurotransmissions. 

By modulating the body’s gamma-aminobutyric acid (GABA)-A receptor, the excitability of neurons can be reduced due to GABA’s ability to inhibit activity. This helps to create the characteristic calming effect of benzodiazepines.

Key Differences Between Xanax & Valium

Diazepam (Valium) has a half-life range of 20 to 80 hours. Alprazolam (Xanax) has a half-life range of between 6.4 to 26.9 hours. This means the drugs act significantly differently within the body.

Valium can help with a number of conditions Xanax would generally be inappropriate for, including these:

• Cerebral palsy
• Paraplegia
• Athetosis
• Stiff-man syndrome

Valium can also be combined with other medications to help control seizures. 

Because of its more intense effects and shorter half-life, Xanax is generally considered to have more addiction potential than Valium (discussed in more detail below). However, this same intensity may help to treat anxiety and panic symptoms in patients for whom Valium doesn’t work or is less effective.

Is One Drug More Effective?

Both medications remain in use for a reason, with neither being universally “more effective” than another. 

For anxiety and panic, Xanax generally has a stronger effect, which also means it can be prescribed in smaller doses. Valium, meanwhile, will last longer per dose taken. 

The goal of any treatment is to improve a patient’s quality of life. With anxiety and panic symptoms especially, many patients may react less well to one drug than the other. 

Valium is generally more effective for the treatment of the other neurological problems noted in the section above. Xanax’s short half-life and different pharmacological properties mean it may not be a helpful long-term treatment for those same problems. 

Is Xanax or Valium More Addictive?

Both of the medications have the potential to be addictive. As a class of drugs, benzodiazepines can be abused, cause dependence, and have long-term negative health consequences when taken without a doctor’s oversight. 

Never suddenly stop taking either medication on your own. Total cessation of use suddenly can cause long-lasting withdrawal and potentially life-threatening symptoms. Instead, create a treatment plan with your doctor to slowly reduce your dependence.

Xanax is generally considered to have more abuse potential than Valium. Xanax has a more intense calming effect on the body and a shorter half-life, which can lend itself to greater levels of abuse.  

Warnings & Side Effects

Benzodiazepines can be life-threatening if taken with opioids, such as these:

• Fentanyl
• Codeine
• Hydrocodone
• Heroine
• Methadone
• Tramadol
  

Note that this list of opioids is not all-inclusive. There are also other non-opioid medications that may have dangerous interactions with benzodiazepines.

Always tell your doctor you’re taking benzodiazepines, even if you are doing so without a prescription before they prescribe you any medication. A reputable medical professional only wants to provide you with the best possible care, and this will help them adjust their recommendations so your life is not endangered.

A small number of patients who took Valium in a study experienced suicidal thoughts. If you experience suicidal thoughts, especially those you consider acting on, talk to your doctor immediately. This is likely a side effect of your medication. Your doctor can alter your treatment and get you the care you need.

Common, less serious side effects of both medications include the following:

• Mild confusion
• Constipation
• Mild muscle weakness
• Changes in sex drive and ability
• Drowsiness
• Difficulty urinating
• Dizziness
• Dry mouth
• Weight changes
• Changes in appetite
• Joint pain
• Irritability
• Lightheadedness

Signs of an overdose or serious negative reaction include the following:

• Significant confusion, like forgetting where or who one is
• Slurred speech or the inability to speak
• Moderate or severe problems with coordination and balance
• Shortness of breath or difficulty breathing
• Seizures
• Severe rash
• Yellowing skin or eyes
• Partial or total loss of bodily control

Which Is Better: Valium or Xanax?

Neither medication is necessarily “better.” It simply depends on your individual needs and your doctor’s recommendations. 

Talk to your doctor about the best choice for your specific situation.

References

Alprazolam. (May 2021). MedlinePlus.

Alprazolam and Diazepam in the Treatment of Generalized Anxiety. (June 1984). Journal of Clinical Psychopharmacology. 

Benzodiazepine Pharmacology and Central Nervous System–Mediated Effects. (Summer 2013). The Ochsner Journal.

Diazepam. (May 2021). MedlinePlus.

Risks Associated With Long-Term Benzodiazepine Use. (August 2013). American Family Physician. 

Stiff-Person Syndrome: A Treatment Update and New Directions. (December 2020). Cureus.

Benzodiazepines Versus Placebo for Panic Disorder in Adults. (March 2019). Cochrane Library.

A Review of Alprazolam Use, Misuse, and Withdrawal. (March 2018). Journal of Addiction Medicine.