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Valium vs Oxazepam
Introduction
For patients with anxiety disorders or symptoms of acute alcohol withdrawal, certain medications that alter the concentrations of compounds in the brain associated with calming effects can be helpful. Valium and Oxazepam are two such drugs frequently prescribed for these conditions. They both affect a neurotransmitter in the brain called gamma-aminobutyric acid (GABA), which inhibits activity in the nervous system and produces sedative effects to reduce tension and other related symptoms. Valium is known as a long-acting benzodiazepine, while Oxazepam is considered a short-to-intermediate acting benzodiazepine. This affects how quickly they work and how long their effects last: Valium acts more quickly but has lingering effects due to its longer half-life, whereas Oxazepam takes slightly longer to start working but its effects do not last as long.
Valium vs Oxazepam Side By Side
| Attribute | Valium | Oxazepam |
|---|---|---|
| Brand Name | Valium | Oxazepam |
| Contraindications | Should not be taken with opioid drugs due to risk of sedation, respiratory distress, coma, or death. May worsen symptoms of depression. | Should not be taken with opioid drugs due to risk of sedation, respiratory distress, coma, or death. May worsen symptoms of depression. |
| Cost | For brand name: approximately $400 for 60 tablets of 10 mg. For generic: ranges from as low as $0.25 up to about $1 per day depending on dosage. | For brand name: approximately $80 for 30 capsules of 15 mg. For generic: starts at doses of just over $0.50 per day. |
| Generic Name | Diazepam | Oxazepam |
| Most Serious Side Effect | Unusual changes in mood or behavior, including thoughts about suicide or self-harm; signs of an allergic reaction; visual disturbances; rapid heartbeats; lower than normal sodium levels; adverse nervous system reaction; symptoms indicative of serotonin syndrome. | Symptoms indicative of an allergic reaction; changes in mood or behavior towards depression or self-harm; signs suggestive of liver problems; unusual drowsiness/difficulty waking up; irregular heartbeats. |
| Severe Drug Interactions | Opioids, due to increased risk of sedation, respiratory distress, coma, or death. | Opioids, due to increased risk of sedation, respiratory distress, coma, or death. |
| Typical Dose | Oral dosages range from 2-10 mg/day, two to four times a day. Maximum dosage should not exceed 40mg per day. | Treatment typically initiated at a dosage of 10-15 mg per day, gradually increased to 60 mg/day, divided into three doses. Maximum daily dosage is usually around 120mg. |
What is Valium?
Diazepam (the generic name for Valium) was one of the early drugs in the benzodiazepine class, which marked a significant advancement from barbiturates. Diazepam was first approved by the FDA in 1963. Valium enhances GABA effects, an inhibitory neurotransmitter, effectively causing sedation and reducing anxiety. It is prescribed for treating different conditions such as anxiety disorders, muscle spasms and seizure disorders. On the other hand, Oxazepam (marketed under many brand names), another member of the benzodiazepine family introduced later on in 1965, works similarly but is primarily metabolized differently - it doesn't produce active metabolites like diazepam does. This can make its effects more predictable and fewer side effects are often seen with oxazepam than with other benzodiazepines that have these active metabolites.
What conditions is Valium approved to treat?
Valium is approved for the treatment of various conditions including:
- Anxiety disorders
- Alcohol withdrawal symptoms
- Muscle spasms
- Seizures (in combination with other medication)
Oxazepam, on the other hand, is primarily used to treat:
- Moderate to severe anxiety disorders and symptoms
- Acute alcohol withdrawal
How does Valium help with these illnesses?
Valium works to manage anxiety by increasing the amount of gamma-aminobutyric acid (GABA) available in the synapses of the brain. It does this by enhancing the effects of GABA, a neurotransmitter that inhibits activity in the brain and plays a central role in reducing neuronal excitability throughout the nervous system. Thus, it helps to calm hyperactive mental states and induce sleep.
Oxazepam also operates on GABA receptors but is metabolized more slowly than Valium. This slower metabolism can lead to fewer side effects and withdrawal symptoms, making it a potentially safer choice for patients who are elderly or have liver disease. Therefore, both Valium and Oxazepam can help patients manage their condition with differing benefits depending on individual patient characteristics such as age or liver function.
What is Oxazepam?
Oxazepam, which is a brand name for Serax among others, is a short-to-intermediate-acting benzodiazepine. Like Valium (diazepam), Oxazepam enhances the effect of the neurotransmitter gamma-aminobutyric acid (GABA) at the GABAA receptor resulting in sedative, sleep-inducing, anxiolytic, anti-convulsant and muscle relaxant properties. However unlike diazepam which has long acting metabolites that can accumulate with repeated use especially in elderly patients or those with liver disease; oxazepam doesn't have this problem because it's not metabolized into other active compounds making it safer to use in these patient groups.
FDA approved since 1965 as an anti-anxiety medication and used off-label for insomnia treatment. Notably different from diazepam and its longer action duration; oxazepam has shorter half-life meaning its effects are typically felt more quickly but also wear off faster compared to diazepams'. This makes oxazepam better suited for conditions where quick relief of symptoms is desired or when there's need to avoid over-sedation like treating acute alcohol withdrawal symptoms.
What conditions is Oxazepam approved to treat?
Oxazepam is a medication green-lighted by the FDA for managing certain conditions including:
- Anxiety disorders or short-term relief of symptoms of anxiety
- Alcohol withdrawal, including acute alcohol withdrawal syndrome which can manifest as delirium tremens.
Just like Valium, Oxazepam falls under the class of drugs known as benzodiazepines and acts on the brain to produce a calming effect.
How does Oxazepam help with these illnesses?
Oxazepam, like Valium, is a benzodiazepine medication that works by enhancing the effects of a neurotransmitter called gamma-aminobutyric acid (GABA) in the brain. GABA inhibits activity in the brain to induce sleepiness and reduce anxiety and muscle tension. Oxazepam's action on this system makes it effective for treating symptoms associated with alcohol withdrawal, as well as anxiety and insomnia disorders. It has a slower onset of effect compared to other drugs in its class like Valium which may be beneficial for patients who have experienced side effects such as excessive sedation or loss of motor control with other faster-acting benzodiazepines. Due to these qualities, Oxazepam might be prescribed when patients do not respond well to "typical" benzodiazepines or experience troublesome side effects.
How effective are both Valium and Oxazepam?
Both diazepam (Valium) and oxazepam have long histories of use in managing symptoms of anxiety and acute alcohol withdrawal, with Valium having been first approved by the FDA in 1963 and oxazepam following shortly after in 1965. Both belong to the class of benzodiazepines which work on GABA receptors, although they are metabolized differently and thus may be prescribed under different circumstances. A direct comparison study showed that both drugs were equally effective at alleviating symptoms of generalized anxiety disorder.
A meta-analysis from 2004 indicated that diazepam is highly effective for short term relief from acute symptoms of anxiety starting from the first dose, has a favorable side effect profile compared to many other anxiolytics, especially older ones like barbiturates, and appears to be well-tolerated even in elderly populations who often metabolize drugs more slowly. This same study also mentioned that diazepam has become one of the most widely prescribed benzodiazepine drugs globally due to its quick onset action and significant body evidence supporting its effectiveness.
In contrast, a review conducted in 2016 suggested oxazepam seems beneficial as an initial treatment option when slower onset but longer duration is favored or when there's concern over potential misuse due to less severe withdrawal effects than some other benzodiazepines like diazepam. However, it’s typically considered as second-line treatment if rapid symptom control isn't vital or where patients may benefit more specifically from this drug's unique pharmacokinetic properties such as shorter half-life avoiding excessive sedation seen with others like diazepam.
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At what dose is Valium typically prescribed?
Oral dosages of Valium range from 2-10 mg/day, two to four times a day depending on the severity of symptoms. However, for Oxazepam, oral dosage ranges between 10–30 mg/day taken two to three times daily. It's important to note that elderly or debilitated patients may be started on lower doses due to potential sensitivity. The dosage can be increased after a few weeks if there is no response in both cases. Nevertheless, the maximum dosage for Valium should not exceed 40mg per day and for Oxazepam it should not go beyond 120mg per day under any circumstance.
At what dose is Oxazepam typically prescribed?
Oxazepam treatment is typically initiated at a dosage of 10-15 mg per day. The dose can then be gradually increased to 60 mg/day, divided into three doses, spaced approximately 8 hours apart. Maximum daily dosage is usually around 120mg, which should be divided into several smaller doses throughout the day. If there's no response to treatment at this level after a reasonable period of time or if symptoms worsen, it may warrant further evaluation and possible medication adjustment by your healthcare provider.
What are the most common side effects for Valium?
Common side effects of Valium and Oxazepam, which are both benzodiazepines used to treat anxiety, include:
- Drowsiness or sleepiness
- Fatigue and generalized weakness
- Dizziness
- Dry mouth
- Shakiness or tremor
- Changes in sexual desire or ability
- Upset stomach or nausea
- Constipation or diarrhea
- Changes in appetite
- Skin rash
- Memory problems
These medications may also cause more serious side effects such as severe drowsiness, trouble breathing, mood changes (including thoughts of suicide), confusion, hallucinations. If you experience any of these symptoms while taking either medication, seek medical attention immediately.
Are there any potential serious side effects for Valium?
When comparing Valium and Oxazepam, it's important to be aware of the potential serious side effects associated with each medication.
- Unusual changes in mood or behavior, including thoughts about suicide or self-harm
- Signs of an allergic reaction such as hives, difficulty breathing, swelling in your face or throat
- Visual disturbances like blurred vision or seeing halos around lights
- Rapid heartbeats, fluttering sensation in your chest area, unexpected shortness of breath and sudden dizziness; these could indicate a cardiac event
- Lower than normal sodium levels may produce symptoms like headache, confusion, slurred speech severe weakness and/or vomiting; loss of coordination is also possible
- An adverse nervous system reaction can cause rigid muscles accompanied by high fever sweating confusion uneven heartbeats tremors and even fainting
- If you experience any symptoms indicative of serotonin syndrome: restlessness hallucinations fever excessive sweating rapid heartbeat muscle stiffness twitching lack of coordination nausea vomiting diarrhea seek medical attention immediately.
It should be noted that while both medications have similar side effects due to their classification as benzodiazepines. However individual reactions will vary based on factors relating to personal health history dosage prescribed among others. Always consult with your healthcare provider for personalized advice before starting stopping or altering a prescribed course treatment.
What are the most common side effects for Oxazepam?
Common side effects of Oxazepam might include:
- Drowsiness, dizziness or lightheadedness
- Dry mouth
- Nausea or upset stomach
- Changes in appetite
- Sleep disturbances such as insomnia
- Mild skin rash or itching
- Memory problems or forgetfulness
These symptoms are generally mild and transient. However, if they persist or become bothersome, medical attention should be sought promptly. Please remember that every individual reacts differently to medications, and what works best will depend on your specific health situation. Always consult with a healthcare provider before starting any new medication.
Are there any potential serious side effects for Oxazepam?
While Oxazepam is frequently used to manage anxiety and alcohol withdrawal symptoms, it does bear a risk of certain side effects. Be sure to consult your doctor immediately if you experience:
- Symptoms indicative of an allergic reaction such as hives, itching, swollen glands, trouble breathing or swelling in your face or throat
- Changes in mood or behavior that may lean towards depression or thoughts about self-harm
- Signs suggestive of liver problems like persistent nausea/vomiting, severe stomach/abdominal pain, yellowing eyes/skin (jaundice)
- Unusual drowsiness/difficulty waking up
- Irregular heartbeats; Remember: the goal with any medication is to balance its benefits against potential risks. Always talk with your healthcare provider regarding any concerns.
Contraindications for Valium and Oxazepam?
Both Valium and Oxazepam, like all benzodiazepines, can potentially worsen symptoms of depression in some individuals. If you observe a worsening depressive state or an increase in suicidal thoughts or behaviors while taking these medications, please seek immediate medical attention.
Neither Valium nor Oxazepam should be taken if you are using, or have recently used opioid drugs. The combination of opioids and benzodiazepines may result in sedation, respiratory distress (trouble breathing), coma, or even death. Therefore it's crucial to always inform your physician about the medicines that you're currently on; any residual opioids will need a period of time to clear from the system to avoid dangerous interactions with Valium and Oxazepam.
How much do Valium and Oxazepam cost?
For the brand name versions of these drugs:
- The average price for 60 tablets of Valium (10 mg) is approximately $400, which works out to about $13-$26 a day depending on your dose.
- The cost for 30 capsules of Oxazepam (15 mg) averages around $80, working out to roughly $2.66 per day.
Thus, if you are in the higher dosage range for Valium (i.e., 20mg/day or more), then brand-name Oxazepam would be less expensive on a per-day treatment basis. It's important to remember that cost should not be the primary deciding factor when determining which drug is best suited for you.
For generic versions - Diazepam and Oxazepam respectively, costs are significantly lower:
- Diazepam comes in packs starting from 30 tablets with an approximate cost ranging from as low as $0.25 up to about $1 per day depending on dosages varying between 5mg/day and up to even 40mg/day.
- Generic oxazepam starts at doses of just over $0.50 per day making it relatively affordable compared with many other anxiety medications available on prescription.
Popularity of Valium and Oxazepam
Diazepam, in generic form as well as brand names such as Valium, was estimated to have been prescribed about 14 million times in the US in 2020. Diazepam accounted for a significant portion of benzodiazepine prescriptions in the US. It's commonly used for treating anxiety disorders, alcohol withdrawal syndrome, and muscle spasms among other conditions. The use of diazepam has remained steady over the last decade.
Oxazepam is another medication from the benzodiazepine class that is typically prescribed less frequently than diazepam. In 2020, oxazepam prescriptions were estimated around 1 million within the USA. Oxazepam accounts for a smaller fraction of overall benzodiazepine prescriptions compared to diazepam due mainly to its more specific indications which include moderate to severe anxiety and symptoms related to alcohol withdrawal.
Conclusion
Both Valium (diazepam) and Oxazepam have a long-standing history of use in patients with anxiety disorders, insomnia, or dealing with alcohol withdrawal. They are backed by numerous clinical studies indicating that they are more effective than placebo treatments. These medications might be combined in some instances, but this needs careful consideration by a physician due to potential drug interactions. Both drugs work on the GABA receptors in the brain, which helps reduce excitement and induce calming effects.
In terms of usage circumstances, Valium is often considered first-line treatment for its rapid onset action and longer half-life compared to Oxazepam. The latter is usually preferred for elderly individuals or those with liver disease as it does not require hepatic metabolism prior to renal elimination like Valium does.
Both drugs are available in generic form providing significant financial savings especially important for self-paying patients. An adjustment period may also be required where full effects aren't noticeable immediately after starting either medication.
The side effect profile between the two is similar; both being generally well-tolerated but can cause drowsiness, confusion and balance issues among others at higher doses or prolonged use. It's crucial for patients using these medications to monitor their mental state closely particularly when commencing treatment since sedative-hypnotics such as these can sometimes paradoxically worsen mood disturbances or suicidal thoughts.
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Refrences
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