Valium vs. Xanax: Which is better for anxiety?

Valium (diazepam) and Xanax (alprazolam) are benzodiazepines that work by enhancing the effects of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter produced in the brain.

Both medications can reduce anxiety symptoms. Clinical trials have shown that Xanax is as effective as Valium in relieving anxiety symptoms, and sometimes even more effective.

In addition to treating anxiety, Xanax is also used to treat panic disorder, Diazepam, on the other hand, is used to treat muscle spasms, alcohol withdrawal, and epileptic seizures.

However, long-term use of these drugs is generally avoided due to potential dependence, and Xanax carries a higher risk.

This article will discuss the similarities and differences between Valium and Xanax.

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black box warning

The U.S. Food and Drug Administration (FDA) requires Xanax and Valium labels to carry a boxed warning, the agency’s highest safety warning for the drugs.

Before you start using any kind of medication, it is important to understand potential safety considerations, which include the following:

  • Taking Xanax or Valium with alcohol, opioids, or other substances that make you drowsy (including street drugs) may cause severe drowsiness, slowed breathing, coma, or death.
  • Xanax or Valium can lead to abuse, misuse, and addiction. Do not increase your dose, take it more often, or use it for longer than prescribed. Store tablets in a safe place to prevent others from taking them.
  • Do not stop taking Xanax or Valium suddenly. Doing so may cause severe and even life-threatening withdrawal symptoms, such as seizures, sudden significant changes in mood, depression, hallucinations, hyperactivity, delusions, and suicidal thoughts or behaviors. If you experience any of these symptoms, seek medical assistance immediately.

Valium and Xanax Uses

Xanax is a prescription drug used to treat anxiety, panic disorder with or without agoraphobia (anxiety disorder that causes the fear of being trapped, having a panic attack in public, or not being able to get help when something goes wrong) and for short-term treatment of anxiety symptoms.

The reasons for opening Diva are as follows:

  • Treatment of anxiety/short-term relief of anxiety symptoms
  • Ease alcohol withdrawal symptoms
  • Used with other medications to relieve muscle spasms
  • Treat epilepsy with other medicines

Xanax and Valium work by binding to receptors in the central nervous system. This combination enhances the inhibitory effects of GABA, a neurotransmitter associated with anxiety.

How long does it take for Valium and Xanax to work?

After oral administration (oral administration), diazepam concentrations in the blood peak within 1 to 2.5 hours. It starts working within 15 to 60 minutes, but it may take a week or two to feel the full effects. In addition, diazepam has a long-lasting effect, lasting more than 12 hours.

Xanax peaks in the blood within one to two hours after taking an oral dose. You may start to feel its effects within 30 minutes, and they can last for about six hours. Symptoms may resolve as early as the first week.

Which one is more effective?

Studies show that Xanax is at least as effective as Valium, and some even show that it is more effective at treating anxiety symptoms.

Specifically, three of six studies using a randomized, double-blind, placebo-controlled design found that Xanax and Valium were equally effective.

One study found no difference between the active drug and placebo due to the small number of participants. Two studies found Xanax to be more effective than Valium.

It is important to work closely with your healthcare provider to determine the treatment that is best for you.

When choosing the right medication, your provider will consider a range of factors, including:

  • potential side effects
  • cost
  • your medical history
  • Other mental illnesses you may have
  • Potential drug interactions
  • Pharmacokinetic parameters, including drug absorption, distribution, metabolism and elimination
  • your age
  • Strength of evidence supporting drug use

side effect

Valium and Xanax are both benzodiazepines and have similar side effects. However, because Valium has a longer half-life than Xanax, its side effects may last longer.

You may experience the following while taking these medications:

  • Confused
  • blurry vision
  • Dizziness
  • Drowsiness (alprazolam is used less frequently than diazepam)
  • dry mouth
  • Elevated liver enzymes
  • excessive drooling
  • Inability to completely empty your bladder
  • incontinence
  • irritability
  • changes in sexual desire
  • memory loss
  • Irregular menstruation
  • rash
  • Slow or slurred speech
  • tired

Serious reactions when taking Valium or Xanax include:

  • Dependence or substance abuse: This occurs when you develop a tolerance to a drug over time and may lead to feeling the need to use the drug in order to be effective.
  • hypotension (low blood pressure)
  • epileptic seizure
  • Slow or labored breathing
  • Increased depression
  • Having suicidal thoughts or behavior

addiction risk

Both Xanax and Valium have the potential to cause dependence, abuse, and addiction.

Three studies found that Xanax had a higher risk of dependence than Valium when the dosage (strength) was the same.

National data on emergency room visits and prescriptions also show Xanax is more likely to be abused and result in hospitalization.

Due to its properties, withdrawal potential, and potency, Xanax carries a higher risk of addiction than Valium. For example, Xanax is absorbed into the body more quickly than Valium and has a smaller distribution volume. This makes it more susceptible to abuse because it is absorbed quickly in the body and lasts shorter, causing people to take more frequent doses.

Because Xanax has a shorter half-life, withdrawal symptoms also tend to be more severe and occur earlier.

Valium, on the other hand, remains in the body longer and takes longer to be completely eliminated. This results in fewer withdrawal symptoms compared to Xanax. Additionally, Xanax is more potent than Valium, with 1 milligram (mg) of Xanax equivalent to 10 mg of Valium.

How to take Valium and Xanax

stable Alprazolam
Available advantages pill: 2 mg, 5 mg, 10 mg; solution: 5 mg per 5 milliliters (mL), 5 mg per mL (concentrate) pill: 0.25 mg, 0.5 mg, 1 mg, 2 mg
Recommended dosage anxiety: 210 mg, 2 to 4 times daily, or 210 mg injected every three or four hours as needed; alcohol withdrawal: 10 mg, 3 or 4 times within the first 24 hours, reduce to 5 mg, 3 or 4 times daily as needed; Relieve muscle spasms: 210 mg, three to four times daily, or Every three to four hours as needed; higher doses may be needed tetanus; epilepsy: 210 mg, 2 to 4 times daily generalized anxiety disorder: 0.250.5 mg 3 times daily; dose may be adjusted every three to four days based on response, up to 4 mg daily Panic Disorder: 0.5 mg three times daily; depending on response, dose may be increased every three to four days, up to 1 mg daily
Universal availability Yes Yes
Dosage for Children and Adolescents The recommended starting dose for children is 12.5 mg 3 to 4 times daily. Dosage may be increased gradually as needed and tolerated. Not approved for use in children or adolescents
Dosage for the Elderly (65 years and older) The recommended starting dose for older adults is 22.5 mg once or twice daily. Dosage may be increased gradually as needed and tolerated. The recommended starting dose for older adults is 0.25 mg, taken 2 to 3 times daily. Increase gradually if necessary and tolerated.

Who shouldn’t take them?

You should not take diazepam if:

  • You are allergic to it or any of its ingredients.
  • You have severe liver damage.
  • You have myasthenia gravis, respiratory failure, or sleep apnea.

People who have the following conditions should use diazepam with caution:

  • drinking at the same time
  • frustrated
  • Older or frail adults
  • History of alcohol or drug abuse
  • kidney damage
  • Mild to moderate liver damage
  • Porphyria (accumulation of natural chemicals called porphyrins in the body)
  • Respiratory diseases
  • History of epilepsy
  • central nervous system slowdown

You should not take Xanax if:

  • You are allergic to it or any of its ingredients.
  • You are breastfeeding.

People with the following conditions should use Xanax with caution:

  • drinking at the same time
  • frustrated
  • Older or frail adults
  • History of alcohol or drug abuse
  • liver damage
  • Respiratory diseases
  • History of epilepsy
  • sleep apnea
  • central nervous system slowdown
  • Have smoking habit
  • Increased stomach pH (soluble form)
  • Decreased salivary flow (dissolvable form)
  • Phenylketonuria (phenylalanine-containing form)


Valium and Xanax are both benzodiazepines, which work by enhancing the effects of GABA in the brain, reducing symptoms of anxiety. However, due to the risk of dependence, these drugs should be used with caution and long-term use should be avoided.

Both drugs come with boxed warnings about the risks of abuse, misuse and addiction, as well as warnings about potentially fatal side effects when combined with other substances. Abrupt discontinuation of the drug may also cause severe and life-threatening withdrawal reactions. You may experience similar side effects when taking either medication, such as confusion, dizziness, drowsiness, and dry mouth.

Clinical trials have shown that Xanax is as effective as Valium in reducing anxiety symptoms, and sometimes even more effective. Although diazepam lasts longer in the body, the risk of addiction to alprazolam is higher.

It is important to work with your healthcare provider to determine the most appropriate treatment plan and to avoid drug interactions.

Frequently asked questions

  • Does Xanax or Valium last longer?

    The effect of oral diazepam lasts for more than 12 hours. And Xanax only lasts about six hours. Additionally, Valium has a longer half-life than Xanax, which means it remains in the body longer and is not metabolized as quickly as Xanax.

    Additionally, diazepam has an active metabolite called desmethyldiazepam, which can accumulate in the body, further prolonging its effects. Xanax does not accumulate any metabolites.

  • What other options are there for treating anxiety?

    Other treatment options for anxiety disorders include:

    • Psychotherapy, such as cognitive behavioral therapy (CBT), cognitive therapy, and applied relaxation therapy
    • Medications such as selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), and other benzodiazepines such as Ativan (lorazepam) or Klonopin (chlorazepam) Nitrazepam)
    • Combination of psychotherapy and medication

Verywell Health uses only high-quality sources, including peer-reviewed research, to support the facts in our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

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  7. Verster JC, Volkerts ER. Clinical pharmacology, clinical efficacy, and behavioral toxicity of alprazolam: a review of the literature. Central Nervous System Drugs Revised. Spring 2004;10(1):45-76. doi:10.1111/j.1527-3458.2004.tb00003.x.

  8. American Academy of Family Physicians.Addiction: Part 1: Benzodiazepine Side Effects, Abuse Risks, and Alternatives

  9. Ait-Daoud N, Hamby AS, Sharma S, Blevins D. Review of alprazolam use, misuse, and withdrawal. J Addiction Med. 2018;12(1):4-10. doi:10.1097/ADM.0000000000000350

  10. Daily Medical Journal. Niravam – alprazolam tablets, orally disintegrating.

  11. Anxiety and Depression Association of America. Review of clinical practice in GAD.

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