Anxiety and sleep disorders are among the most common health problems in the United States. Millions of people struggle with each of these issues each year. As much as a third of Americans don’t get the sleep they need for a healthy lifestyle. Anxiety disorders affect more than 18% of the population, accounting for more than 40 million people. Plus, these problems often go hand-in-hand. Sleep problems and anxiety issues can feed off of one another to worsen your physical and mental health. Drugs like Valium and Xanax may be able to help you overcome these common issues. 

Both Xanax and Valium are part of a class of drugs called benzodiazepines. Benzodiazepines were first introduced in the 1960s, and they quickly grew in popularity. In the 1970s, they grew to be the most commonly prescribed class of prescription drugs in the world. They’re in a broader category of drugs called central nervous system depressants that work with a brain chemical called gamma-aminobutyric acid (GABA). GABA is a neurotransmitter that’s responsible for sleep and relaxation. 

People with anxiety and sleep disorders often have a psychological or biochemical problem that prevents them from getting sleep or releasing anxieties, even with their natural GABA functioning. Drugs like Valium and Xanax can bind to GABA receptors on a different binding site than GABA. They don’t replace or mimic GABA; instead, they increase the effectiveness of the natural neurotransmitter. GABA opens a channel to a negative charge, which slows down nervous system functions. Benzodiazepines, like Xanax and Valium, keep that channel open for longer, making GABA more effective. 

Xanax and Valium are also used to treat panic disorders, seizures, muscle spasms, and alcohol withdrawal syndrome. Since alcohol is also a depressant, benzodiazepine can help stave off some of the withdrawal symptoms you may experience after quitting alcohol, which can be dangerous. 

Valium and Xanax are similar drugs, and they each have their advantages and disadvantages. Read more about how these two drugs compare and how which one is stronger.

What is Xanax?

Xanax is the brand name for a drug called alprazolam, that’s among the most popular benzodiazepines in the United States. Xanax is a specific type of benzodiazepine called triazolobenzodiazepine, which describes the drug’s chemical structure. It’s an intermediate-acting drug that can begin working within 20 to 60 minutes after taking it by mouth. It also has a medium duration and can last for around six hours. It’s also available in an extended-release form that can last for longer. 

Xanax is typically prescribed for the treatment of anxiety disorders, and it’s especially used to treat panic disorders and generalized anxiety disorder. It’s approved by the Food and Drug Administration (FDA) to be used to treat panic and anxiety disorders, but it may also be prescribed for other off-label purposes. It may also be used to treat nausea caused by chemotherapy. 

The drug has a few common side effects, including sleepiness, fatigue, headaches, depression, dry mouth, and memory issues. Some of these symptoms, especially drowsiness and fatigue, begin when you first start taking the drug and fade after a few days. While Xanax is a popular drug for treating anxiety disorders, some doctors are wary about using it as a first-line defense against common mental health issues. 

Xanax, like other central nervous system depressants, has some potential for misuse. If it’s used for too long or abused, it can lead to chemical dependence and addiction. Withdrawal symptoms for Xanax can be severe when you stop taking the drug suddenly. Depressants can be dangerous during withdrawal and may cause serious symptoms like seizures. 

Alprazolam was first approved for use in the United States in 1981. In 2019, 17 million prescriptions were sold in the U.S. The drug is federally controlled as a Schedule IV drug, which means that it’s considered to have some potential for abuse along with currently accepted medical uses.

What Is Valium?

Valium is a brand-name prescription for a drug called diazepam, which is a benzodiazepine like Xanax. Valium is used to treat a broad range of problems. The FDA has indicated Valium for more uses than Xanax, and it may also be used to treat other off-label uses. It’s indicated to treat anxiety, panic disorder, alcohol withdrawal, muscle spasms, reflex spasms, and compulsive disorders like OCD. It can also be used to treat restless leg syndrome and insomnia. During some medical procedures, Valium is used to promote drowsiness and memory loss to avoid the pain and trauma that can come with surgery. 

Valium is typically taken by mouth, but it can also be taken as a suppository, injected into the muscle, injected into the vein, or intranasally. Valium is a fast-acting drug, and it can begin working within 15 to 60 minutes after taking an oral dose. If it’s injected into the vein, it can begin working within 15 minutes. 

Like Xanax, Valium can have a few common side effects, including sleepiness and impaired coordination. Xanax and Valium can both increase your risk of suicidal thoughts or actions, but those side effects are less common. Other rare but serious side effects can include respiratory depression and seizures. Respiratory depression is common among people that misuse the drug, take it in high doses, or mix it with other depressants. Seizures are common among people that have epilepsy, but they may also occur if you stop using the drug abruptly. 

Valium has a moderate abuse potential, and it’s federally controlled as a Schedule IV drug, like Xanax. Long-term use and abuse can lead to chemical dependence and addiction. 

After chlordiazepoxide was developed in 1955, diazepam was the second benzodiazepine to be developed in 1959. After its release in the United States, it was the highest-selling medication between 1968 and 1982. Today, Xanax is prescribed more frequently, but there were five million Valium prescriptions sold in 2019.

What are Xanax’s Side Effects?

Xanax is usually safe to use as long as you take it as prescribed. There are a few common side effects and other side effects that are more severe but less common. Benzodiazepines can cause some common side effects when you first start using one, but they often wear off as your body adjusts to the medication. For Xanax, the most common side effects that appear when you first start using it include dizziness and lightheadedness. You should let your doctor know if these symptoms are severe or if they continue past the first few days of use. 

Xanax can also cause some other side effects that are consistent with other central nervous system depressants. When you start taking a prescription like Xanax, it’s important to make a note of any symptoms you experience and let your doctor know. Xanax side effects can include:

  • Depression
  • Headache
  • Confusion
  • Insomnia 
  • Nervousness 
  • Low blood pressure
  • Dizziness
  • Restlessness
  • Fatigue
  • Sleepiness 
  • Dry mouth 
  • Constipation 
  • Nausea and Vomiting 
  • Diarrhea
  • Increased salivation
  • Cardiovascular 
  • Tachycardia/palpitations 
  • Hypotension
  • Sensory
  • Blurred vision
  • Musculoskeletal rigidity
  • Tremors
  • Weight changes

The FDA also notes that there were some rare symptoms reported, including problems with menstruation, urinary retention, musculoskeletal weakness, and changes in libido. 

What are Valium’s Side Effects?

Valium is generally safe to use when it’s prescribed by a doctor, but it can come with some adverse effects. Some of the side effects that can occur when you first start taking Valium include drowsiness and fatigue. You may need to avoid driving or operating heavy machinery until you know how the medication will affect you. Speak to your doctor if you feel extremely fatigued and your drowsiness doesn’t go away as you get used to the drug. Muscle weakness and poor coordination have also been reported. 

According to the FDA, there have also been several other side effects reported, including:

  • Confusion
  • Depression
  • Dysarthria
  • Headache
  • Slurred speech
  • Tremors
  • Vertigo
  • Nausea
  • Constipation 
  • Gastrointestinal issues
  • Blurred vision
  • Dizziness
  • Low blood pressure
  • Changes in libido
  • Skin reactions
  • Dry mouth

Valium can also cause what’s known as paradoxical reactions, which are side effects that are the opposite of the drug’s expected effects. These reactions can include overstimulation, restlessness, irritability, rage, hallucinations, delusions, and nightmares. While these symptoms can be severe, they aren’t very common. Still, it’s important to keep your doctor informed about any new or worsening symptoms you experience. 

High doses of Valium can be potentially dangerous, causing severe hypnosis, dizziness, and loss of consciousness. Your breathing may slow, which can lead to oxygen deprivation. Severe overdose can be fatal. However, a life-threatening accidental overdose on Valium isn’t common unless the drug is mixed with other substances like opioids, alcohol, or other depressants. 

Xanax and Valium: Which Drug is Stronger?

Xanax and Valium have similar effects, but they are prescribed in different doses, and one is generally more potent than the other. You can compare the potency for certain drugs by looking at their standard effective doses. However, it’s important to note that not all of the drug’s effects will be more potent. Just because one medication is generally stronger doesn’t mean that it will be more effective across the board. Plus, one drug may not be as effective for you like another one, even if it’s stronger. 

A standard dose of Xanax is between 0.25 mg and 0.5 mg, which is taken three times per day. A standard dose of Valium is 2 mg to 10 mg, which is taken four times per day. Because it takes a much higher dose of Valium taken more often throughout the day, Xanax is much stronger. Valium is also available in an extended-release form, which means that a single tablet can be taken that delivers a larger dose throughout the day. 

It’s important to note that the relative strengths of both of these drugs don’t mean you will have a smoother experience taking the weaker drug. Valium is still a serious prescription drug. If it’s taken in high doses, it can cause significant side effects. 

This also doesn’t mean that Xanax will be more effective in treating your anxiety or other issues. The right drug for your needs may not be based on its strength. You may find that Xanax produces more side effects with fewer benefits than Valium. It’s important to work with your doctor to find the right medication and dosage for your needs. 

How are Xanax and Valium Different?

Xanax and Valium are similar drugs, and they can be used to treat some of the same problems. However, they do have some differences that can be significant. Valium is an older medication, and it’s approved for more uses in the United States. It may be a better choice for people that are struggling with multiple issues that Valium may be able to address. Valium is also administered in intravenous solutions and a rectal gel, which can be helpful in clinical settings. On the other hand, the therapeutic use of Xanax takes fewer doses throughout the day (three rather than Valium’s four). Xanax is also sold as an extended-release tablet that only has to be taken once per day. 

When it comes to their effectiveness in treating anxiety, they are both relatively similar. However, one study that was published in the Journal of Clinical Psychopharmacology in 1984 found that Valium was slightly more effective. However, the study also noted that both drugs were effective. They also said, “…the statistically significant differences between the two drugs were not clinically striking.” Valium may be more effective in treating seizures, and the rectal gel is the only FDA-approved pre-hospital treatment for seizures. 

Valium has a longer half-life than Xanax. It takes up to 48 hours for your body to reduce Valium to half of its original concentration in your bloodstream. Xanax’s half-life is around 11.2 hours. A long half-life can be significant in choosing the right medication for your needs. You may not be able to take certain medications that may be dangerous when mixed with Valium.

How Often is Anxiety Treated with Benzodiazepines? 

Anxiety is a common problem, and there are several treatment options available. There are no treatment options that are guaranteed to work for everyone, and effective treatment is largely based on your needs. Anxiety can be treated with self-care options and psychotherapies. For many people, these options are enough to address their addiction problems without the use of prescription medication. General talk therapy can help you work through some of the problems you experience with an anxiety disorder. 

Behavioral therapies are commonly used to treat anxiety and other mental health problems. Cognitive-behavioral therapy (CBT) is a very common treatment option that helps identify thinking patterns that may lead to ineffective coping and unhelpful behaviors. CBT also allows you to identify common triggers and learn more effective coping mechanisms. Dialectical behavior therapy (DBT) is a type of CBT that emphasizes accepting your current situation. It’s based on the concept of mindfulness, which is a practice of making notes of yourself and your surroundings to help keep your mind at the moment. 

If you do need a prescription medication to help manage your anxiety symptoms, your doctor will likely start by prescribing an antidepressant. Antidepressants are commonly used to treat depression, but they are also useful in treating anxiety. A particular kind of antidepressant called selective serotonin reuptake inhibitors (SSRI) is the first-line treatment for depression. Serotonin-norepinephrine reuptake inhibitors (SNRI) are also used to treat depression and anxiety.

Benzodiazepines may not be a first-line medication for treating generalized anxiety disorder, but they are sometimes helpful, especially when other medications aren’t effective. However, benzodiazepines may be more effective in treating panic disorders. Panic attacks come on suddenly, and they can be intense. Antidepressants often need to be taken for several days before they become effective. If you have a panic disorder that requires mediation, your doctor may prescribe Xanax or Valium.

Is Xanax Addictive?

Xanax, like other benzodiazepines, can be misused and abused, which can lead to chemical dependence and addiction. Benzodiazepines can lead to chemical dependence when they are used for too long. Xanax is recommended for use up to six weeks, and Valium isn’t recommended to be taken for longer than four months. Taking a benzo for too long could cause dependence and tolerance. Both tolerance and dependence occur when your body gets used to the drug after a period of consistent use. Tolerance can make the drug less effective over time, and you may start to struggle with symptoms again. Chemical dependence on Xanax can cause you to feel uncomfortable symptoms when you try to quit, which can worsen the drug’s addiction potential.

Xanax is often considered highly addictive, especially when it’s misused as a recreational drug. As a central nervous system depressant, Xanax may cause some intoxicating symptoms that are similar to alcohol. Benzodiazepines may also be mixed with other substances like alcohol or opioids to increase their potency. They may be combined with stimulants like cocaine to counteract some of the drug’s negative effects. However, mixing Xanax with other substances can increase your risk of a deadly overdose. 

Alprazolam is one of the most commonly abused benzodiazepines, and it’s sold on the street illegally. Drug dealers may also sell counterfeit versions of Xanax pills that are indistinguishable from the real thing. These counterfeit pills can contain Xanax or any other substance, including fentanyl, an extremely potent opioid that can cause an overdose, even in relatively small doses. 

Is Valium Addictive?

Valium, like other central nervous system depressants, can cause substance use disorders, tolerance, and chemical dependence. According to the FDA, abuse and dependence have been reported, and people that are prone to addiction may need to seek other treatment options. Drugs that can cause pleasant psychoactive effects quickly are generally preferred as recreational drugs over substances that take a long time to take effect. 

Valium can begin working in 15 minutes, which may increase the drugs abuse liability. However, drugs with a long duration of action may not be as attractive for recreational drug users. Recreational highs that have longer effects may not be as pleasant. Valium lasts for five hours, but it has a very long half-life. Taking the drug in high doses may mean experiencing side effects for long periods of time. 

Still, Valium may be abused as a recreational drug. Valium abuse increases your risk of chemical dependence and addiction. It also increases your risk of a dangerous overdose. Like Xanax, it’s unlikely for Valium to cause a life-threatening accidental overdose on its own, but it can cause a deadly overdose when mixed with opioids or other central nervous system depressants. 

How is Benzodiazepine Addiction Treated?

A substance use disorder involving a benzodiazepine may require addiction treatment. Because Valium and Xanax are depressants, quitting can be potentially dangerous, especially if you stop using them cold turkey. You may go through a tapering schedule with your doctor that helps you avoid serious withdrawal symptoms. However, if you’ve become addicted to a benzodiazepine, you may need to start with medical detox, a high level of care that’s designed to help you get through severe withdrawal symptoms safely and as comfortably as possible.

Once you reach sobriety safely, you may move onto the next level of treatment that’s appropriate for your needs. If you have high-level medical or psychological needs, you may continue in inpatient treatment. But if you’re able to live on your own, you may go through outpatient treatment. Treatment will involve individual and group therapy sessions. You may go through dual diagnosis treatment that can help you deal with substance use problems and anxiety at the same time.

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