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Valium vs. Xanax for Anxiety Disorders : Differences Worth Knowing

With so much stress in our lives these days, it is normal that all of us feel anxious from time to time. However, for some people, anxiety becomes a daily occurrence. Ongoing anxiety and all the symptoms it brings can eventually begin to affect your daily life and your ability to function properly at work, school, or even at home. Anxiety is recognized as an actual mental condition and it needs to be treated either with antidepressants or through therapy. If your doctor suggests medications for treating anxiety, then benzodiazepines are generally suggested. These are a class of drugs that are used for curbing anxiety. The two most commonly prescribed benzodiazepines are Xanax and Valium. While these two drugs are very similar, they are not exactly alike and have some differences in the way they function and treat anxiety.

Valium vs. Xanax for Anxiety Disorders

Valium vs. Xanax: What Are They & How Do They Work in the Treatment for Anxiety Disorders?

Valium is a brand name for benzodiazepine group medicine known as “diazepam,” while Xanax is a brand name for benzodiazepine group medicine “alprazolam.” Both Valium and Xanax are anti-anxiety medications belonging to the benzodiazepine family of drugs.

Benzodiazepines work by boosting the effects of gamma-aminobutyric acid (GABA) in the brain. The neurotransmitter GABA inhibits certain brain activities. Researchers believe that excessive activity in the brain is the reason behind anxiety or many other psychiatric disorders. If your body does not have sufficient amounts of GABA, then you may begin to feel anxious. So, both Xanax and Valium affect the unbalanced chemicals in the brain in people suffering from anxiety. In other words, these drugs can be considered to be minor tranquilizers. Both these drugs are used for the treatment of not just anxiety disorders, but also panic disorders and anxiety that is caused by depression.

Valium vs. Xanax: Major Differences

Valium is available in both tablet and liquid forms while Xanax is only available in a tablet form. Xanax is also considered to be extremely habit-forming in nature and people who are prescribed Xanax, have a much higher risk of addiction or substance abuse compared to Valium, which is less addictive in nature. Valium also takes time to work and show its effectiveness on anxiety symptoms. However, once Valium becomes active, it has a biological half-life of nearly 20 to 100 hours. Xanax, on the other hand, is only active for 11 hours and will provide you relief only for that much time. Valium is known to help a person suffering from anxiety overcome the situation easily when it is used in the right dosage. If you are taking Valium in small doses, then it is unlikely that you will become addicted or face any sort of withdrawal symptoms.

While Valium works by modifying the very cause of anxiety disorder, Xanax works by suppressing the brain to affect the brain’s ability to send neurons. When this process is slowed, the person feels calm and more relaxed. Xanax should not be taken with other drugs as it can have potentially dangerous side effects. Valium, though, can be combined with other medications if your doctor advises.

Valium vs. Xanax: Differences Based on Side Effects

Let us look at the various side effects of both these medications.

Side Effects of Valium

The most common side effects of using Valium include:

Some of the serious side effects of Valium may include:

Side Effects of Xanax

The most common side effects of using Xanax include:

Addiction – more likely to occur at high doses taken over a prolonged period of time. Abrupt discontinuation after a prolonged use can also lead to withdrawal symptoms.
Withdrawal symptoms of Xanax include:

Valium vs. Xanax: Differences Based on Dosage

Dosage of Valium

Valium can be taken with or without food. Valium is disposed of by the liver and excreted out by the kidneys. Therefore, in patients who have abnormal kidney function, the dosage of Valium needs to be lower. The starting dose of Valium (taken orally) for anxiety patients is 2 to 10 mg per day, to be taken two to four times daily. If given rectally, the normal rectal dose is between 0.2-0.5mg/kg, depending also on the age of the patient.

Dosage of Xanax

For treatment of anxiety disorder, the starting dose of Xanax is 0.25 to 0.5 mg three to four times a day using the immediate release tablets of Xanax. This Xanax dose can be increased in every three to four days to reach a maximum dosage of 4 mg daily. If you suffer from panic attacks along with anxiety disorders, then the starting dosage is 0.5 mg taken three times a day. This Xanax dosage can also be increased after three to four days but not beyond 1 mg per day. Xanax can be taken with or without food.

Valium vs. Xanax: Drug Interactions

Drug Interactions of Valium

Alcohol and certain medications add to the sedative effects of Valium. Patients who are already taking some form of benzodiazepines must avoid any such combinations. Drugs that prolong the effects of Valium include:

  • Ketoconazole
  • Itraconazole
  • Cimetidine
  • Omeprazole
  • Erythromycin
  • Darunavir
  • Clarithromycin
  • Fluvoxamine
  • Fluoxetine

If you are taking any of these above drugs, then the dosage of Valium needs to be adjusted and decreased accordingly.

Drug Interactions of Xanax

Xanax is known to interact with alcohol and medications (such as barbiturates and narcotics) that repress brain activity by causing sedation.

The side effects of Xanax is increased as medications such as ketoconazole, nefazodone, cimetidine, fluvoxamine, and itraconazole, further increase the blood concentration levels of Xanax. Xanax also interacts with other benzodiazepines or sedatives such as sleeping pills. Even pain drugs, antidepressants, mood stabilizers, antiseizure medications, tranquilizers, etc., all tend to interact with Xanax. Therefore, always inform your doctor about all the supplements and drugs that you are currently taking before you start to take Xanax.

Valium vs. Xanax: Which Is Ideal For Treating Anxiety Disorder?

The answer to this really depends on the prescribing doctor. Your doctor will evaluate the severity of your condition and based on the level of your anxiety disorder and your overall health, the medication is prescribed. Valium is usually given to patients to manage the treatment safely. If Valium is not found to be effective, then doctors will prescribe Xanax. Never treat yourself and always ask your doctor for help. You should continue the medication for the time period your doctor has prescribed to treat your anxiety disorder and never stop any of these medications on your own without consulting the doctor first.


Both Xanax and Valium are used for the treatment of anxiety disorders and also for helping with panic attacks, Valium is further used for treating tremors, agitation, seizures, delirium, and hallucinations occurring from alcohol or drug withdrawal. Side effects of both the drugs are more or less the same and can result in drowsiness, speech issues, and fatigue. Take these anti-anxiety medications exactly as prescribed by your doctor and follow all the directions on the prescription label in order to avoid any complications. Which drug is better, will ultimately depend on which one suits your condition the best and helps treat your anxiety disorder.


  1. National Institute of Mental Health. (2021). Anxiety Disorders. Retrieved from https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml
  2. MedlinePlus. (2021). Alprazolam. Retrieved from https://medlineplus.gov/druginfo/meds/a684001.html
  3. MedlinePlus. (2021). Diazepam. Retrieved from https://medlineplus.gov/druginfo/meds/a682047.html
Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:July 17, 2023

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