Valium: indications, usage, and hidden dangersValium is one of the trade names for diazepam—a benzodiazepine anxiolytic drug. It has a range of effects on the body, from reducing anxiety to making muscles relax and inducing amnesia.

Valium and what you need to know about it

Valium is an original branded anxiolytic produced by a Swiss pharmaceutical company Roche. Its main constituent is diazepam. While Valium was first introduced to patients in the USA in 1963, its FDA approval has been changed over the years and was last revised in 2016. Diazepam belongs to the group of drugs called benzodiazepines. They possess a whole range of effects, including:

• anxiolytic (reducing anxiety);
• sedative (suppresses CNS activity, inducing calmness and/or sleepiness);
• muscle relaxation;
• anticonvulsive (alleviates convulsive, or generalized tonic-clonic, seizures);
• amnesia-inducing (affects memory and can cause memory loss).

A doctor may prescribe Valium to:

• treat anxiety disorder;
• provide temporary relief from the symptoms of anxiety;
• manage acute alcohol withdrawal syndrome and reduce tremor, hallucinosis, delirium tremens, and acute agitation;
• alleviate skeletal muscle spasms;
• treat convulsive disorders (in combination with other treatment methods).

Mechanism of action

Benzodiazepine drugs bind to GABA receptors, change ion transportation in the neurons, and reduce their excitability. Depending on the affected receptor’s location, the drug’s effect will vary. Thus, binding to GABA receptors in the limbic system helps decrease anxiety. Myorelaxation occurs when Valium and its analogs act within the spinal cord and motor neurons. Interactions with the cortex, thalamus, and cerebellum receptors cause anticonvulsant, sedative, and amnestic effects.

Doses and availability

Valium is manufactured in 2, 5, or 10 mg tablets. Because diazepam has high abuse potential, it was classified as a Schedule IV substance. This means that all drugs that contain diazepam, including Valium, are available only to those who have a doctor’s prescription. It can be refilled only up to 5 times in 6 months.

How to take Valium

If you were prescribed Valium, your healthcare provider will adjust the dose individually. Common starting doses depend on many factors, including the patient’s age and condition. Here are examples:

• When treating anxiety disorders and alleviating anxiety symptoms: 2 to 10 mg, 2 to 4 times per day.
• When managing acute alcohol withdrawal syndrome: 10 mg, 3 or 4 times during the first 24 hours, reducing to 5 mg, 3 or 4 times per day as necessary.
• When reducing skeletal muscle spasms in comprehensive therapy: 2 to 10 mg, 3 to 4 times per day.
• In comprehensive therapy of convulsive disorders: 2 to 10 mg, 2 to 4 times per day.
• Geriatric (older) patients or those who have debilitating conditions start from the lower doses and frequency of administration. They take 2–2.5 mg of Valium one or two times per day. If the medication is well-tolerated but the effect is insufficient, the dose may be increased gradually.
• Children older than six months should begin with the lowest dose feasible and increase it progressively if necessary and well-received.

The drug can be taken with or without a meal.

Adverse reactions

Common

• Depression
• Anterograde amnesia
• Confusion
• Tremor
• Irritability
• Sedation
• Fatigue
• Headache
• Nausea
• Urinary retention
• Constipation
• Incontinence
• Menstrual irregularities
• Libido changes
• Rash

Even if you experience a side effect that may seem to be “bearable”, do not hesitate to tell your doctor about it. Do not discontinue treatment unless it is specifically recommended (the doctor will tell you how to do it safely).

Severe

Serious side effects require immediate medical attention.

• Dependency and abuse
• Withdrawal symptoms
• Suicidality
• Paradoxical CNS stimulation
• Bradycardia (slow heart rate)
• Cardiovascular collapse
• Hypotension
• Respiratory depression
• Syncope

There is a reported case of severe delirium caused by an abrupt withdrawal of diazepam and olanzapine.

Warnings and precautions

Who cannot take Valium:

• patients intolerant to diazepam;
• babies less than 6 months of age;
• patients with myasthenia gravis (an autoimmune condition characterized by abnormally weak skeletal muscle);
• patients with severe hepatic or respiratory insufficiency;
• patients with sleep apnea;
• patients with acute narrow-angle glaucoma;
• expecting and nursing mothers.

Valium interacts with certain drugs and alcohol. Inform your doctor about every other medicine you take and do not drink while on therapy. When taking Valium, you should avoid driving and operating other machines.