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Valium for Anxiety: Benefits, Risks, and Important Considerations


Clinically Reviewed by: Charee Marquez, LMFT

Valium for Anxiety: Considerations and Risks

Valium, a commonly prescribed benzodiazepine medication, is often used to relieve symptoms of severe anxiety and various other mental health disorders. As a Schedule IV controlled substance, Valium (diazepam) provides significant therapeutic benefits but also carries substantial risks, particularly when misused. It is prescribed for a range of conditions, including muscle pain and upper motor neuron disorders like cerebral palsy, but its use requires careful consideration due to potential adverse reactions and physical dependence. Valium can be especially helpful for short-term treatment of acute anxiety episodes, panic disorders, and chronic pain management. However, it poses significant risks for elderly patients, those with decreased renal function, or individuals with severe respiratory insufficiency. Patients with mental health conditions like bipolar disorder or those suffering from substance use disorders must be closely monitored when prescribed Valium to avoid benzodiazepine misuse and dependence. Additionally, contraindications such as acute narrow-angle glaucoma, myasthenia gravis, severe hepatic insufficiency, and breastfeeding must be considered to prevent adverse effects and profound sedation.

What Is Valium?

Valium, also known by its generic name diazepam, is a prescription medication that belongs to a class of drugs called benzodiazepines. It is commonly used to treat anxiety disorders, muscle spasms, seizures, and alcohol withdrawal symptoms. Valium works by enhancing the effects of a neurotransmitter called gamma-aminobutyric acid (GABA) in the brain, which helps to produce a calming effect.

Valium is available in tablet, liquid, and injectable forms and is usually taken by mouth. The medication can be habit-forming, so it is typically prescribed for short-term use under the guidance of a healthcare provider. Common side effects of Valium include drowsiness, fatigue, and muscle weakness. It is important to use Valium exactly as prescribed to avoid potential dependence or withdrawal symptoms.


Valium Types and Dosages

Valium (diazepam) comes in various forms and dosages to accommodate different medical needs. Here are the common types and dosages:

Valium for Anxiety: Considerations and Risks of Different Forms

  1. Tablets: The most common form, taken orally.
  2. Oral Solution: A liquid form for those who have difficulty swallowing tablets.
  3. Injectable Solution: Used in a clinical setting for rapid effect.
  4. Rectal Gel: Typically used for treating seizures.


Valium tablets are available in the following strengths:

  • 2 mg
  • 5 mg
  • 10 mg

Typical Dosages for Different Conditions:

  1. Anxiety Disorders:
    • Adults: 2-10 mg taken 2-4 times daily.
  2. Alcohol Withdrawal:
    • Adults: 10 mg taken 3-4 times during the first 24 hours, then 5 mg taken 3-4 times daily as needed.
  3. Muscle Spasms:
    • Adults: 2-10 mg taken 3-4 times daily.
  4. Seizure Disorders:
    • Adults and children over 6 months: 1-2.5 mg taken 3-4 times daily.

Important Considerations:

  • Children and Elderly: Lower doses are usually prescribed, starting at 1-2.5 mg taken 1-2 times daily.
  • Adjustments: Dosages may be adjusted based on individual response and tolerability.
  • Short-Term Use: Due to the risk of dependence, Valium is generally prescribed for short-term use unless otherwise directed by a healthcare provider.
  • Acute Narrow-Angle Glaucoma: Valium is contraindicated in patients with acute narrow-angle glaucoma and should not be used in such cases.


Valium Dosage Guidelines

Anxiety Disorders:

  • Adults: 2-10 mg, 2-4 times daily.

Alcohol Withdrawal:

  • Adults: 10 mg, 3-4 times in the first 24 hours, then 5 mg, 3-4 times daily as needed.

Muscle Spasms:

Adults: 2-10 mg, 3-4 times daily.

Valium is also used for managing spasticity associated with cerebral palsy.


  • Adults: 2-10 mg, 2-4 times daily.
  • Children (6+ months): 1-2.5 mg, 3-4 times daily.

Elderly/Debilitated Patients:

  • Start with 2-2.5 mg, 1-2 times daily; adjust as needed.

Valium Side Effects

Short-Term Side Effects:

  • Drowsiness
  • Dizziness
  • Fatigue
  • Muscle weakness
  • Confusion
  • Headache
  • Nausea
  • Dry mouth
  • Blurred vision

Long-Term Side Effects:

  • Dependence and withdrawal symptoms
  • Memory impairment
  • Cognitive decline
  • Depression
  • Tolerance (requiring higher doses for the same effect)
  • Coordination problems
  • Increased risk of falls and fractures (especially in elderly)


How Long Does Valium Stay in Your System?

Valium (diazepam) has a long half-life, typically ranging from 20 to 50 hours, and its active metabolite, desmethyldiazepam, can have a half-life of 36 to 200 hours. This means that Valium can remain in your system for an extended period. On average, it can be detected in blood for up to 48 hours, in urine for 1 to 6 weeks, in saliva for up to 10 days, and in hair for up to 90 days. The exact duration Valium stays in your system depends on various factors, including age, liver function, dosage, frequency of use, and overall health.


Valium Onset and Duration

Onset of Action:

  • Oral Tablets: Effects typically begin within 15 to 60 minutes.
  • Intramuscular Injection: Effects begin within 15 to 30 minutes.
  • Intravenous Injection: Effects are almost immediate, within 1 to 5 minutes.

Duration of Action:

  • Oral Tablets: The effects last for 4 to 6 hours, though the sedative effects can persist longer.
  • Intramuscular and Intravenous Injections: The effects last for about 1 to 4 hours.


Valium Efficacy

Valium (diazepam) is widely recognized for its efficacy in various medical conditions due to its ability to enhance the effects of the neurotransmitter gamma-aminobutyric acid (GABA), producing a calming effect on the brain and nerves. Here are some key points regarding its efficacy:

Anxiety Disorders:

  • Efficacy: Highly effective in reducing anxiety symptoms.
  • Onset: Rapid onset of action, typically within 15 to 60 minutes when taken orally.
  • Duration: Provides relief for 4 to 6 hours per dose, though long-term efficacy can be limited by tolerance development.

Muscle Spasms:

  • Efficacy: Effective in relieving muscle spasms and associated pain.
  • Onset: Noticeable relief usually within 15 to 60 minutes.
  • Duration: Effects last for several hours, aiding in the relaxation of muscles.

Seizure Disorders:

  • Efficacy: Effective as an adjunctive therapy for controlling seizures.
  • Onset: Rapid onset, making it useful for acute seizure management.
  • Duration: Provides short-term control of seizure activity.

Alcohol Withdrawal:

  • Efficacy: Effective in managing symptoms of acute alcohol withdrawal.
  • Onset: Quick relief of withdrawal symptoms, including anxiety and tremors.
  • Duration: Helps manage withdrawal over the initial critical period.

Sedation for Medical Procedures:

  • Efficacy: Provides reliable sedation and anxiolysis for minor procedures.
  • Onset: Intravenous administration acts almost immediately, while oral forms take effect within an hour.
  • Duration: Adequate sedation for the duration of most minor procedures.


How Does Valium Work in the Brain and Body?

Valium (diazepam) works by enhancing the effects of a neurotransmitter called gamma-aminobutyric acid (GABA) in the brain and body. Here’s a detailed explanation of how it functions:

Mechanism of Action:

  1. GABA Enhancement:
    • GABA is the primary inhibitory neurotransmitter in the central nervous system (CNS). It reduces neuronal excitability throughout the nervous system.
    • Valium binds to GABA-A receptors in the brain, which are ion channels that, when activated by GABA, open to allow chloride ions to enter the neuron.
    • By binding to these receptors, Valium enhances the affinity of GABA for the GABA-A receptor, increasing the frequency of chloride channel opening and thus increasing chloride ion influx.
  2. Neuronal Inhibition:
    • The influx of chloride ions into neurons hyperpolarizes the cell membrane, making the neuron less likely to fire an action potential (i.e., it becomes more resistant to excitation).
    • This results in an overall calming effect on the brain and body, reducing symptoms of anxiety, inducing muscle relaxation, and exerting anticonvulsant properties.


Effects on the Brain and Body:

  1. Anxiolytic (Anti-Anxiety) Effect:
    • By enhancing GABAergic inhibition, Valium reduces the excessive neuronal activity associated with anxiety.
  2. Sedative and Hypnotic Effects:
    • The increase in GABA activity produces sedation and can help with sleep disorders by promoting drowsiness and sleep onset.
  3. Muscle Relaxant:
    • Valium’s action on spinal cord neurons that regulate muscle tone results in muscle relaxation, making it effective for treating muscle spasms.
  4. Anticonvulsant:
    • The enhanced inhibitory effects in the CNS help control seizure activity, making Valium useful in the management of certain types of seizures.
  5. Alcohol Withdrawal:
    • Valium can help mitigate the hyperexcitability of the nervous system that occurs during alcohol withdrawal, reducing symptoms such as tremors, anxiety, and seizures.


  • Absorption: Valium is well-absorbed from the gastrointestinal tract, with peak plasma concentrations occurring within 1-2 hours after oral administration.
  • Distribution: It is widely distributed throughout the body and highly lipid-soluble, allowing it to cross the blood-brain barrier effectively.
  • Metabolism: Valium is metabolized in the liver to active metabolites, including desmethyldiazepam, which contribute to its prolonged effects.
  • Elimination: It is eliminated primarily through the urine, with a half-life ranging from 20 to 50 hours, and its active metabolites can extend its duration of action.

By enhancing GABAergic transmission, Valium exerts a wide range of therapeutic effects, making it useful for treating anxiety, muscle spasms, seizures, and other conditions that benefit from CNS depression.


Effects of Valium on the Body

Anxiety Relief:

  • Reduces symptoms of anxiety and nervousness.


  • Induces drowsiness and helps with sleep disorders.

Muscle Relaxation:

  • Relieves muscle spasms and tension.

Seizure Control:

  • Helps prevent and manage seizures.

Alcohol Withdrawal Management:

  • Mitigates withdrawal symptoms like tremors and agitation.

Central Nervous System Depression:

  • Slows down brain activity, leading to calmness and reduced stress.

Cognitive and Motor Impairment:

  • Can cause drowsiness, dizziness, and impaired coordination.


How does Valium work for anxiety?

Valium enhances the effects of GABA, a neurotransmitter that inhibits brain activity, leading to a calming effect and reducing anxiety symptoms.


How quickly does Valium work for anxiety?

Valium typically begins to work within 15 to 60 minutes after oral administration.


What is the typical dosage of Valium for anxiety?

The usual dosage for anxiety ranges from 2 to 10 mg, taken 2 to 4 times daily as prescribed by a healthcare provider.


How long can I take Valium for anxiety?

Valium is generally prescribed for short-term use due to the risk of dependence, typically not exceeding 4 to 6 weeks.


Can I stop taking Valium abruptly?

No, stopping Valium suddenly can cause withdrawal symptoms. It should be tapered off gradually under the supervision of a healthcare provider.


Alcohol Use and Valium

Combining alcohol with Valium (diazepam) can be dangerous. Both substances are central nervous system depressants, which can enhance each other’s effects, leading to increased drowsiness, dizziness, and impaired coordination. This combination also raises the risk of severe side effects, such as respiratory depression, coma, and potentially fatal overdose. It’s crucial to avoid alcohol while taking Valium and to follow medical advice closely.


Can You Take Valium While Pregnant?

Taking Valium (diazepam) while pregnant is generally not recommended. It can pose risks to the developing fetus, including congenital malformations, especially if used during the first trimester. Additionally, use during the later stages of pregnancy can lead to withdrawal symptoms and respiratory problems in the newborn. Always consult a healthcare provider before taking any medication during pregnancy.


Can You Overdose on Valium?

 Yes, you can overdose on Valium (diazepam). Symptoms of a Valium overdose can include extreme drowsiness, confusion, diminished reflexes, respiratory depression, and loss of consciousness. In severe cases, an overdose can lead to coma or death, especially if combined with other central nervous system depressants like alcohol or opioids. If an overdose is suspected, seek emergency medical attention immediately.


Is Valium Addictive?

Yes, Valium (diazepam) is addictive. It can lead to physical and psychological dependence, especially with prolonged use or misuse. Symptoms of addiction may include cravings, increased tolerance (needing higher doses for the same effect), and withdrawal symptoms when not taking the drug. It is important to use Valium only as prescribed and under the supervision of a healthcare provider to minimize the risk of addiction.


Valium and Drug Interactions

Valium (diazepam) can interact with several other medications and substances, potentially leading to increased side effects or reduced efficacy. Key interactions include:

Central Nervous System Depressants:

  • Alcohol, opioids, and other benzodiazepines: Increased risk of sedation, respiratory depression, coma, and death.
  • Antidepressants, antipsychotics, and antihistamines: Enhanced sedative effects.

Medications Affecting Liver Enzymes:

  • CYP3A4 and CYP2C19 inhibitors (e.g., ketoconazole, fluvoxamine): Increased Valium levels, leading to enhanced effects and risk of toxicity.
  • CYP3A4 inducers (e.g., rifampin, phenytoin): Decreased Valium levels, reducing its effectiveness.

Other Medications:

  • Antacids: May slow the absorption of Valium, delaying its onset of action.
  • Muscle relaxants: Increased muscle-relaxing effects, leading to enhanced sedation and muscle weakness.


Valium Storage and Disposal


  • Temperature: Store at room temperature, between 20-25°C (68-77°F).
  • Conditions: Keep in a dry place, away from moisture and heat.
  • Accessibility: Store out of reach of children and pets.


  • Unused Medication: Take to a drug take-back program if available.
  • If No Take-Back Program: Mix with an undesirable substance (e.g., coffee grounds or cat litter) and place in a sealed bag before disposing of in the trash.
  • Do Not: Flush down the toilet unless instructed by a healthcare provider.


How Is Valium Used for Anxiety and Sleep?

For Anxiety:

  • Dosage: Typically 2-10 mg taken 2-4 times daily.
  • Effectiveness: Provides rapid relief of anxiety symptoms by enhancing the calming effects of GABA in the brain.
  • Duration: Effects last for 4-6 hours per dose, but it can remain in the system longer due to its long half-life.

For Sleep:

  • Dosage: Often prescribed at lower doses, such as 2-5 mg, taken before bedtime.
  • Effectiveness: Induces sedation and helps with sleep onset by promoting relaxation and reducing nervousness.
  • Duration: Helps maintain sleep through its sedative effects, but its long half-life can cause drowsiness the next day.


What are the Benefits of Valium for Generalized Anxiety Disorder?

Benefits of Valium for Generalized Anxiety Disorder (GAD)

  1. Rapid Onset of Action:
    • Valium begins to work within 15 to 60 minutes when taken orally, providing quick relief from anxiety symptoms.
  2. Effective Symptom Relief:
    • Reduces excessive nervousness, restlessness, and tension associated with GAD.
    • Helps alleviate physical symptoms of anxiety, such as muscle tension, trembling, and palpitations.
  3. Promotes Relaxation:
    • Enhances the calming effects of GABA, leading to a sense of calm and well-being.
    • Helps improve sleep quality by reducing anxiety that can interfere with sleep.
  4. Muscle Relaxation:
    • Provides relief from muscle spasms and tension, which are common in anxiety disorders.
  5. Adjunct to Other Therapies:
    • Can be used in combination with other medications or therapies (e.g., SSRIs, cognitive-behavioral therapy) to enhance overall treatment effectiveness.
  6. Short-Term Management:
    • Useful for managing acute anxiety episodes or for short-term use while waiting for longer-acting medications to take effect.


What are the Benefits of Valium for Sleep?

Rapid Onset:

  • Helps individuals fall asleep quickly due to its fast-acting nature.

Sedative Effect:

  • Promotes relaxation and reduces anxiety, making it easier to drift into sleep.

Muscle Relaxation:

  • Alleviates muscle tension, contributing to a more restful sleep.

Improved Sleep Quality:

  • Enhances overall sleep quality by reducing nighttime awakenings.


More on Anxiety and Sleep Disorders

Anxiety and sleep disorders often coexist, significantly impacting an individual’s quality of life. Anxiety can manifest as excessive worry, restlessness, and physical symptoms such as muscle tension and rapid heartbeat, making it difficult to fall asleep or stay asleep. Conversely, lack of sleep can exacerbate anxiety symptoms, creating a vicious cycle. Generalized anxiety disorder (GAD), panic disorder, social anxiety disorder, and post-traumatic stress disorder (PTSD) are common anxiety disorders that can disrupt sleep. Similarly, sleep disorders such as insomnia, sleep apnea, and restless legs syndrome (RLS) can be exacerbated by anxiety. Treatment approaches include medications like benzodiazepines (e.g., Valium) for short-term relief, SSRIs for long-term management, and non-benzodiazepine hypnotics for sleep disorders. Cognitive-behavioral therapy (CBT), particularly CBT for insomnia (CBT-I), mindfulness, and relaxation techniques are effective non-pharmacological treatments. Additionally, lifestyle changes such as maintaining good sleep hygiene, establishing a regular sleep schedule, creating a comfortable sleep environment, and avoiding stimulants before bedtime are crucial in managing both anxiety and sleep disorders.


Is Valium for Anxiety and Sleep Right for You?

Deciding if Valium (diazepam) is right for treating your anxiety and sleep issues depends on several factors. Valium can provide rapid relief from anxiety and improve sleep quality due to its calming and sedative effects. However, it is generally recommended for short-term use due to the risk of dependence and potential side effects. It’s crucial to consult with a healthcare provider to evaluate your specific condition, medical history, and potential risks. They can determine the most appropriate treatment plan for your needs, which may include alternative medications or therapies.


Alternative Anxiety Treatment Options

Alternative treatment options for anxiety include:

  1. Medications:
    • Selective Serotonin Reuptake Inhibitors (SSRIs): Such as sertraline and fluoxetine.
    • Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): Such as venlafaxine and duloxetine.
    • Beta-Blockers: Such as propranolol for physical symptoms.
  2. Therapies:
    • Cognitive-Behavioral Therapy (CBT): Effective for changing negative thought patterns.
    • Mindfulness-Based Stress Reduction (MBSR): Helps reduce anxiety through mindfulness practices.
  3. Lifestyle Changes:
    • Regular Exercise: Reduces stress and improves mood.
    • Healthy Diet: Supports overall mental health.
    • Adequate Sleep: Essential for managing anxiety.
  4. Alternative Therapies:
    • Yoga and Meditation: Promote relaxation.
    • Acupuncture: Can help reduce anxiety symptoms.


Anxiety Disorder Treatment Options


  • SSRIs: (e.g., sertraline, fluoxetine)
  • SNRIs: (e.g., venlafaxine, duloxetine)
  • Benzodiazepines: (e.g., Valium, for short-term use)
  • Beta-Blockers: (e.g., propranolol)


  • Cognitive-Behavioral Therapy (CBT): Focuses on changing negative thought patterns.
  • Mindfulness-Based Stress Reduction (MBSR): Uses mindfulness practices to reduce anxiety.

Lifestyle Changes:

  • Regular Exercise: Helps reduce stress.
  • Healthy Diet: Supports overall mental health.
  • Adequate Sleep: Crucial for managing anxiety.

Alternative Therapies:

  • Yoga and Meditation: Promote relaxation.
  • Acupuncture: May help reduce anxiety symptoms.


Does Insurance Cover Anxiety Disorder Treatment?

Insurance coverage for anxiety disorder treatment varies depending on the insurance plan and provider. Generally, most health insurance plans, including those offered through employers and government programs like Medicare and Medicaid, do provide coverage for mental health services, including treatment for anxiety disorders. This typically includes:

  1. Medications: Coverage for prescription medications like SSRIs, SNRIs, and other anxiety-related medications.
  2. Therapy: Coverage for sessions with licensed mental health professionals, such as psychologists or therapists, including Cognitive-Behavioral Therapy (CBT) and other evidence-based therapies.
  3. Hospitalization: Coverage for inpatient and outpatient mental health services if necessary.

To confirm specific coverage details, it’s important to check with your insurance provider or review your insurance policy. Additionally, many plans require prior authorization for certain treatments and may have copayments, deductibles, or limits on the number of covered therapy sessions.


Common Insurance Plans Used for Addiction and Mental Health Treatment

Employer-Sponsored Plans:

  • Blue Cross Blue Shield
  • Aetna
  • Cigna
  • UnitedHealthcare
  • Humana

Government Programs:

  • Medicare
  • Medicaid (varies by state)

Marketplace Plans (ACA):

  • Bronze, Silver, Gold, and Platinum Plans

Specialized Behavioral Health Plans:

  • Magellan Health
  • Beacon Health Options

Employer Assistance Programs (EAPs):

  • Offer limited, confidential counseling and referrals



Valium remains a valuable anti-anxiety medication for managing severe anxiety and other mental health conditions, but it must be used with caution due to its potential for physical dependence and withdrawal syndrome. As a Schedule IV controlled substance, it is crucial to balance its benefits with the risks of benzodiazepine misuse, particularly in patients with a history of substance abuse or those on concomitant prescribing regimens involving other drugs. Special considerations are needed for patients with chronic active hepatitis, mild and moderate cirrhosis, and other hepatic issues, as well as those with chronic pain or undergoing benzodiazepine discontinuation. Valium should be prescribed as part of an appropriate therapy plan, closely monitoring for paradoxical reactions and ensuring it does not exacerbate conditions like sleep apnea syndrome or acute delirium tremens. Proper education on the potential adverse reactions and safe use of Valium can help patients achieve peak plasma concentrations effectively, maintaining their everyday life without falling into the pitfalls of benzodiazepine use disorder.


Seeking Treatment? We Can Help!

At California Prime Recovery, as an in-network provider we work with most insurance plans, such as:

If you or a loved one are struggling with mental health challenges or substance abuse, reach out to California Prime Recovery today. Our team of compassionate professionals is here to support your journey towards lasting well-being. We offer individualized programs to aid those struggling with mental health disorders. For more information and support, give us a call at 866-208-2390.

Also, check out our blogs posted weekly on Medium.


Valium (diazepam) is used to treat anxiety disorders, muscle spasms, seizures, and alcohol withdrawal symptoms.
Common side effects include drowsiness, dizziness, fatigue, muscle weakness, and confusion.
Yes, Valium can be habit-forming, leading to physical and psychological dependence, especially with long-term use.
No, combining alcohol with Valium can increase the risk of severe side effects, including respiratory depression, sedation, and overdose.
If you miss a dose, take it as soon as you remember unless it is almost time for your next dose. Do not double up on doses.

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