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What Is the Difference between Diazepam and Alprazolam?

By B. Chisholm
Updated May 17, 2024
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The major difference between diazepam and alprazolam is their half-lives. This is a measure of how long their action lasts in the body. Diazepam has a longer half-life than alprazolam, meaning that it affects the body for a longer time, while alprazolam exerts its effect for a shorter interval. Diazepam is referred to as long-acting and alprazolam as intermediate-acting.

Belonging to the same class, diazepam and alprazolam are both benzodiazepine drugs. They are sedative hypnotics used mainly to treat anxiety in the short term. Benzodiazepines may also be used for pre-operative sedation, management of alcohol withdrawal, treatment of some seizure disorders and as a muscle relaxant. Long term use of either drug is discouraged due to their addictive potential, both psychologically and physically.

Diazepam and alprazolam share a common mechanism of action on the central nervous system (CNS). They affect the GABA receptors in the brain, causing an anxiolytic, or calming effect. The therapeutic doses of these medications differ, however, to get the same effect. For alprazolam, 0.5 mg is approximately equivalent to 5 mg of diazepam.

Both diazepam and alprazolam are metabolized, or broken down in the body, by the hepatic microsomal enzyme system in the liver. This may make them more susceptible to drug interactions with other medications, especially those also metabolized by the liver. Any concomitant medications should be discussed with the prescribing medical practitioner. Some of the other drugs in the benzodiazepine class, like lorazepam and oxazepam, are not metabolized in the liver.

Benzodiazepines are available in most countries by prescription only, due to their highly addictive nature. Diazepam is available as an oral or injectable product. Alprazolam is available only as an oral product, in both normal release and sustained release forms. The dose and duration of both diazepam and alprazolam will be determined by the prescribing doctor, according to the condition being treated. The lowest effective dose for the shortest duration will be given.

Due to the fact that diazepam is available as an injectable and alprazolam is not, diazepam may be used in acute situations. These include treatment of status epilepticus, where a rapid onset of action is required. Absorption via the injectable route tends to be quicker than oral administration and may be preferred in life-threatening situations.

Patients addicted to benzodiazepines who try to stop using them may experience withdrawal symptoms. The withdrawal symptoms will appear more quickly with the intermediate-acting alprazolam than the longer-acting diazepam. Diazepam is sometimes used during the withdrawal period, allowing a lessening of withdrawal symptoms. Diazepam is then withdrawn slowly. Withdrawal from benzodiazepines should be done only under close medical supervision.

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Discussion Comments
By anon989706 — On Mar 18, 2015

A longer half-life is useful for medicating a person during an episode of alcohol addiction withdrawal which typically occurs over three days. Diazepam can be given to the person and it occupies similar brain receptors which alcohol stimulates and it will continue this action for many hours without the need for highly repetitive dosing.

Diazepam will accumulate in the bloodstream and hold a blood level for a number of hours, thus providing stability to the person who might experience severe discomfort and risk of seizure/s when their body isn't receiving alcohol regularly, which may be that person's usual situation.

By burcidi — On Feb 01, 2014

I've taken both of these medications before. If we look at diazepam vs alprazolam dose wise, about 20mg of diazepam equals 2mg of alprazolam. So alprazolam is way stronger. But they're both benzodiazepine group of drugs. So they both make me feel like a zombie and they're both addictive. People need to be very careful when taking either. Doctors are careful and will not prescribe these unless necessary. But I think they're best avoided if an alternative medication/treatment can be used.

By donasmrs — On Jan 31, 2014

@turquoise-- Great question.

What this means is that the medication with the shorter half-life, that is alprazolam, has to be taken more frequently to experience the same effect. Also, when withdrawing from the medication, it will be more difficult to withdraw from alprazolam because the withdrawal symptoms will be greater.

The half-life of diazepam is extremely long, it ranges from 20-100 hours. So what this means is that after you take the medication, it takes 20-100 hours for half of the medication to leave your system. If you were to quit the medication cold-turkey (which is never recommended), you wouldn't start experiencing withdrawal symptoms for 2-8 days. The half-life of alprazolam is about 11 hours on average. So if you quit it cold-turkey, you might start experiencing withdrawal symptoms the next day.

By turquoise — On Jan 31, 2014

Diazepam has a longer half-life than alprazolam, but what does this mean? Is a longer half-life a good thing or not?

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