Diazepam (Valium) and alprazolam (Xanax) both treat anxiety disorders, but they differ in the other conditions they treat. In choosing which is best for you, a doctor will consider your age, symptoms, and medical history.

Many of us feel symptoms of anxiety from time to time. For some people, though, anxiety and its symptoms, which can be challenging, are a daily occurrence. Ongoing anxiety can affect your ability to function at home, school, and work.

Treating anxiety often involves talk therapy and antidepressant medications. Benzodiazepines are another class of medications used to help curb anxiety. Two commonly prescribed benzodiazepines are Valium and Xanax. These drugs are similar, but not exactly alike.

Both drugs are used to treat anxiety disorders. Xanax also treats panic disorder.

In addition, Valium treats several other conditions, including:

Valium and Xanax are both brand-name versions of different generic drugs. Valium is a brand name for the drug diazepam, and Xanax is a brand name for the drug alprazolam. Both of these drugs are minor tranquilizers.

They work by helping to boost the activity of gamma-aminobutyric acid (GABA). GABA is a neurotransmitter, a chemical messenger that transmits signals throughout your body. If your body doesn’t have enough GABA, you may feel anxiety.

Dietary interaction

If you take Valium or Xanax, you should avoid large amounts of grapefruit or grapefruit juice. Grapefruit blocks the enzyme CYP3A4, which helps break down certain drugs. So having large amounts of grapefruit can increase the levels of Valium and Xanax in your body. This can increase your risk of side effects.

Drug interactions

Xanax and Valium are in the same drug class, so they have many of the same interactions with other drugs and substances. Medications that affect your central nervous system can be dangerous when combined with benzodiazepines. That’s because they can affect your respiratory system.

Several groups that interact include:

These are not all of the possible drug interactions. For a more complete list, see the interactions for diazepam and interactions for alprazolam.

Always tell your doctor and pharmacist about all drugs and supplements you currently take before you start taking any new drug.

Certain people should not take one or either of these drugs. You should not take Xanax or Valium if you have acute angle-closure glaucoma (also known as narrow-angle glaucoma) or a history of allergic reaction to either drug.

You also should not take Valium if you have:

  • a history of drug dependence
  • myasthenia gravis, a neuromuscular disease
  • severe respiratory insufficiency
  • sleep apnea
  • severe liver insufficiency or liver failure

Common side effects of each drug include:

The effects may last for a day after you stop taking the drug. If you feel lightheaded or sleepy, do not drive or operate dangerous equipment.

The most serious concerns about using Valium or Xanax are dependence and withdrawal.

You can become dependent on these drugs after a few days or weeks. People who take these drugs may build a tolerance over time, and the risk of dependence increases the longer you take the drugs.

The risk of dependence and withdrawal also increases as you age. The drugs may have longer effects in older adults and take longer to leave their bodies.

These effects can happen with both drugs, so if they’re a serious concern for you, talk with your doctor about the right treatment for your anxiety.

You should also never stop taking these drugs abruptly. Stopping these drugs too quickly can lead to withdrawal. Seek your doctor’s advice on the best way to stop taking these drugs slowly.

Differences at a glance

slower to take effecttakes effect quickly
stays active for a shorter periodstays active for a longer period
approved for panic disordernot approved for panic disorder
safety not established for childrenmay be used to treat children

Diazepam and alprazolam are effective in treating several conditions, including acute anxiety. However, each drug also treats different conditions.

One drug may be more appropriate for you based on the condition you’re treating and your medical history.

Talk with your doctor about your symptoms and medical history to help them determine what medication may be best for you.