Alprazolam vs Diazepam: Uses, Differences, Side Effects & Addiction

In this article, we’ll compare alprazolam and diazepam. We’ll cover what these medications are, how they work and the types of symptoms they are designed to treat. You’ll also find detailed information on the typical dosages for each medication, potential side effects and any risks associated with their use, particularly for people who are pregnant or breastfeeding. We’ll also discuss whether these medications can potentially be addictive and how they may interact with other drugs. If you are considering using alprazolam or diazepam it is important to consult with a healthcare provider before you do so.

Key Takeaways

Here are the 5 biggest takeaways from this article about alprazolam and diazepam:

• Both alprazolam and diazepam are benzodiazepines that work by enhancing the calming effects of the neurotransmitter GABA in the brain. Alprazolam is primarily used for short-term relief of anxiety and panic disorders, while diazepam is prescribed for anxiety, muscle spasms and alcohol withdrawal.

• The typical dosage for alprazolam is 0.25 mg to 0.5 mg taken three times a day, whereas diazepam is generally prescribed at 2 mg three times a day for anxiety, which may be increased to 5 mg or 10 mg as needed. For sleep-related issues, diazepam dosages range from 5 mg to 15 mg taken at bedtime.

• Both medications can cause side effects, with common issues for alprazolam including low blood pressure, sleepiness, and coordination problems, while diazepam may cause drowsiness, confusion, and issues with coordination and movement.

• Neither alprazolam nor diazepam is recommended during pregnancy or breastfeeding due to the risks they pose to infants.

• Both medications carry a risk of addiction, particularly with long-term use or at high doses. Alprazolam, having a shorter half-life, can lead to more severe withdrawal symptoms compared to diazepam.

What are Alprazolam and Diazepam and what are they used for?

Alprazolam and diazepam are both medications that belong to a group known as benzodiazepines. This group of medications are commonly used for a number of different conditions. 

Benzodiazepines, including alprazolam and diazepam, work by enhancing the effects of a neurotransmitter in the brain called gamma-aminobutyric acid (GABA). This neurotransmitter has a calming effect on the nervous system (Carter & Nordqvist, 2024).

Alprazolam (Xanax) Uses

Alprazolam is typically used for the short-term treatment of anxiety and panic disorders (Entrigner, 2023). Also known by the brand name Xanax (which is not available in the UK), alprazolam provides quick relief for people using it, making it useful for sudden episodes of anxiety and panic.

Diazepam (Valium) Uses

Diazepam, which is also known by the brand name Valium, can sometimes be prescribed to help with short-term sleep issues, especially when linked with anxiety (NHS, 2022). The calming effects of diazepam can help you to fall asleep and stay asleep. Some prescribers will also provide diazepam to help with anxiety, muscle spasms and alcohol withdrawal symptoms.

What are the typical dosages for Alprazolam and Diazepam?

Alprazolam Dosage

For the treatment of anxiety disorders, the typical adult dosage of alprazolam is 0.25 mg to 0.5 mg taken three times a day. The dosage you need may be adjusted by a healthcare provider depending on how you respond to the medication and your specific needs. It’s essential that alprazolam is taken exactly as prescribed as higher doses or long-term use can increase the risk of dependence and side effects (George & Tripp, 2023).

Diazepam Dosage

The usual dosage for an adult on Diazepam will vary depending on what it is being used to treat. For anxiety, adults will usually take 2mg, three times a day. This may be increased to 5 or 10mg three times a day depending on needs and response. For sleep problems, adults will use 5 to 15mg once a day, just before bed (NHS, 2022). It is important to use Diazepam as outlined by your prescriber to ensure that you remain safe and avoid potential addiction.  

What are the side effects of Alprazolam and Diazepam?

Alprazolam (Xanax) Side Effects

Like all medications, alprazolam can cause some users to experience side effects when they are using it. These side effects vary in frequency and severity. The most common side effects of alprazolam include (Johnston & Marshall, 2024):

• Low blood pressure

• Issues with coordination and balance

• Issues with sexual activity including temporary erectile dysfunction and reduced libido

• Problems with speech

• Sleepiness

Diazepam (Valium) Side Effects

Diazepam users can also experience some side effects when they are using the medication. Again, these will vary in frequency and severity. The most common side effects of Diazepam include (NHS, 2022):

• Sleepiness

• Drowsiness

• Confusion

• Issues with coordination and movement

• Shaky hands

Are Alprazolam and Diazepam safe to take during pregnancy or breastfeeding?

Alprazolam and diazepam are generally not recommended for use during pregnancy or breastfeeding due to potential risks to the baby. Alprazolam has been shown to cause symptoms in babies when the mother uses the medication whilst pregnant, including withdrawal symptoms (George & Tripp, 2023).

Diazepam is also not recommended for use during pregnancy or breastfeeding as there is also evidence to suggest that it can affect the baby. As well as withdrawal symptoms, diazepam can also pass into breast milk in small amounts, potentially leading to a build-up of the medication in the baby's system. This can cause issues with sleepiness and weight gain (Mother To Baby Fact Sheets, 2022).

Are Alprazolam and Diazepam addictive?

Yes, both alprazolam and diazepam have the potential to be addictive. Both medications are benzodiazepines which can lead to dependence, particularly when they are used for prolonged periods and at high doses (Juergens, 1991). This is why both alprazolam and diazepam are typically diagnosed for the short-term treatment of conditions.

Alprazolam has a shorter half-life than diazepam, meaning it will leave the body quicker. This can cause more intense withdrawal symptoms if you suddenly stop taking it. Whilst diazepam has a longer half-life it can still cause addiction and withdrawal symptoms if you do not stop using it properly.

For advice on how to stop using a benzodiazepine medication like alprazolam and diazepam, it is important to consult with your doctor. 

Do Alprazolam and Diazepam interact with other drugs?

As with all medications, certain interactions may occur when you use alprazolam or diazepam alongside other treatments. It is important to let your doctor know about all of the medications and supplements you may be using before you start using alprazolam and diazepam. They will be able to make sure you avoid any potential interactions. 

Alprazolam Drug Interactions

Known interactions that affect how alprazolam works include (George & Tripp, 2023):

• Azole antifungal medications

• Certain antidepressants

• Macrolide antibiotics

• St. John’s Wort

• Medications for seizures

• Antihistamines

• Muscle relaxants

Diazepam Drug Interactions

Known interactions for diazepam that affect the medication and how it works include, according to the NHS:

• Antipsychotics

• Antidepressants

• Anticonvulsants

• Hypnotics

• Drowsy or sedating antihistamines

• Strong painkillers

• HIV medicines

• Antifungal medicines

• Proton pump inhibitors (PPIs)

• Muscle relaxants

Alprazolam vs Diazepam: Key Facts

EU Meds have summarised the key information for alprazolam and diazepam below:

Sources

Valium vs Xanax: Which is better? - Drugs.com

Alprazolam vs Diazepam Comparison - Drugs.com

Comparing benzodiazepines - Mind

Alprazolam and diazepam: Addiction potential - ScienceDirect