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.
The main difference between Valium and Xanax involves their onset and duration. Xanax works quicker and wears off faster.
What Are Valium and Xanax?
Quick Answer
Valium and Xanax are benzodiazepine medications used to adjust electrical activity in the brain and ease anxiety and insomnia. Experts say their addiction risks are high, so they shouldn’t be the first anxiety medications prescribed.[1],[2].
Valium is a brand name for the medication diazepam. Xanax is a brand name for the medication alprazolam.[3],[4]
Valium can help with a number of conditions Xanax would generally be inappropriate for, including these:[3]
- Cerebral palsy
- Paraplegia
- Athetosis
- Stiff-man syndrome
Xanax is generally considered to have more abuse potential than Valium.
Neither medication is necessarily “better.” It simply depends on your individual needs and your doctor’s recommendations.
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. [5]
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.
Valium & Xanax: A Comparison
Valium and Xanax are very similar, but there are important differences between them that you should understand.
Comparing Valium & Xanax
| Valium | Xanax | |
| Generic name | Diazepam | Alprazolam |
| Drug class | Benzodiazepine | Benzodiazepine |
| Dosage | A typical oral dose is 2–10 mg, given two to four times per day | A typical dose is 0.5–6 mg, given two to three times per day |
| Formulations | Oral | Oral, injectable, and gel forms exist; some people call the tablets Xanax bars |
| Prescribed for | Anxiety, alcohol withdrawal, and skeletal spasm | Anxiety and panic disorders |
| Onset, duration, and half-life | Onset: 5–60 minutes depending on formulationDuration: 12 hoursHalf-life: 60–72 hours | Onset: 30 minutesDuration: 6 hoursHalf-life: 11 hours |
| Potential for abuse | Low | Low |
| Safe for children? | May be used to treat children | Safety not established for children |
| How long does it remain in your system? | Urine: 2 weeks Saliva: 7–9 days Hair: 90 days | Urine: 7 days Saliva: 2 days Hair: 90 days |
Which Medication Is 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.
Effectiveness: Which Works Better?
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. [2]
The goal of any treatment is to improve a patient’s quality of life. With anxiety and panic symptoms especially, many patients may not react as well to one drug compared to 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.
Key Differences Between Valium & Xanax
While Xanax and Valium are very similar, important differences exist. They include the following:[3],[4]
- Pediatric use: Valium has been tested and proven effective in children. The safety of Xanax in children has not yet been proven.
- Conditions treated: Xanax can be used for anxiety and panic disorders. Valium can be used for anxiety and muscle tensing/spasm.
- Effect timeframes: Xanax takes much longer to leave the body.
- Abuse potential: Xanax is typically considered more pleasurable or addictive than Valium.
Side Effects & Warnings
Benzodiazepines like Valium and Xanax are powerful drugs that often cause significant side effects. They include the following:[3[,[4]
- Changes in appetite
- Changes in sex drive and ability
- Constipation
- Difficulty urinating
- Dizziness
- Drowsiness
- Dry mouth
- Irritability
- Joint pain
- Lightheadedness
- Mild confusion
- Mild muscle weakness
- Weight changes
People who abuse benzodiazepines sometimes crush the pills and snort them. Dangers of snorting these drugs include loss of smell, infection, and breathing difficulties. Crushing pills can also lead to a higher risk of overdose.
Signs of a Benzodiazepine Overdose
Signs of an overdose or serious negative reaction include the following:[3],[4]
- Moderate or severe problems with coordination and balance
- Partial or total loss of bodily control
- Seizures
- Severe rash
- Shortness of breath or difficulty breathing
- Significant confusion, like forgetting where or who one is
- Slurred speech or the inability to speak
- Yellowing skin or eyes
In one study, a small number of patients who took Valium experienced suicidal thoughts[6] 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.
Drug Interactions
Benzodiazepines are meant to be taken alone, with no other types of medications. But combining the drug with other substances is common among people who abuse the drug.
Benzodiazepines can cause life-threatening reactions if taken with opioids, such as the following:
- Fentanyl: This powerful drug can cause an overdose at even tiny levels.
- Codeine: This medication is sometimes used for pain, and it can be added to cough syrup too.
- Hydrocodone: Hydrocodone is a prescription painkiller that often moves from pharmacies into the illicit drug supply.
- Heroin: Heroin is an illicit drug often injected by people addicted to it.
- Methadone: Methadone is a prescription medication often used in medication-assisted treatment (MAT) programs.
- Tramadol: Tramadol is a painkiller people often (wrongfully) believe is not an opioid.
Opioids aren’t the only cause for concern. Benzodiazepines can interact with other drugs, including the following:
- Alcohol
- Antihistamines
- Anti-seizure medications
- Muscle relaxants
- Other benzodiazepines or sedatives
Benzodiazepine Detox and Addiction Treatment
Benzodiazepines change chemical levels within the brain, and those alterations can make quitting very difficult. In some cases, quitting can even be dangerous due to the risk of life-threatening withdrawal symptoms like seizures. The safest way to quit benzos like Valium or Xanax is to seek professional treatment.
Benzodiazepine detox typically involves switching to another drug and then reducing the dose slowly over long periods. A controlled taper is a safe and effective way to help you get sober safely. Although detox is an important first step on the road to recovery, it is just the beginning—once you are medically stabilized, it’s important to transition into an addiction treatment program where you can begin doing the work to understand your drug misuse.
If you’re using benzodiazepines, talk with your doctor about how to quit safely.
Valium vs. Xanax FAQs
We have compiled some of the most common questions about how Valium and Xanax compare.
What is the difference between Valium and Xanax?
These drugs are both benzodiazepines, but Xanax is stronger and comes with a higher abuse potential.
Which drug is stronger?
Xanax persists within the body for longer, but therapeutic doses are similar for both drugs.
Can you quit benzos cold turkey?
No. It is not safe to quit benzos abruptly. Doing so can lead to seizures.
Does Xanax cause weight gain?
Yes. Benzodiazepines can cause weight gain in some people.
What are Xanax withdrawal symptoms like?
Quitting benzodiazepines abruptly can lead to serious withdrawal symptoms, including deep anxiety and seizures. This approach is never safe.
Is Xanax safe for children?
Xanax has not been proven safe in children.
Dr. Alison Tarlow is a Licensed Clinical Psychologist in the States of Florida and Pennsylvania, and a Certified Addictions Professional (CAP). She has been a practicing psychologist for over 15 years. Sh... Read More
- 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.
