Valium (diazepam) belongs to the class of medicines known as benzodiazepines. Other medications in this class include Librium (chlordiazepoxide), Halcion (triazolam), and Ativan (lorazepam). The benzodiazepines all have several features in common: They reduce anxiety, sedate the body, relax the muscles, and have anti-seizure activity.
What makes the compounds different from one another is how potent they are (how many milligrams in a typical dose), how rapid their absorption and onset of action is, what their half-life in the body is, and how they are metabolized. Valium, for example, is moderately potent (a typical oral dose is 2 to 5 milligrams), has a very rapid onset of action, has a long half-life of as much as two to four days, and is metabolized by the liver (with many active metabolites, which means it keeps on having an action for a long while).
Benzodiazepines like Valium are very useful medications under certain well-defined circumstances. They can help bring a seizure under control, play a role in the short-term treatment of anxiety and agitation, help people with serious psychiatric illnesses such as schizophrenia and bipolar disorder, and provide time-limited relief to the person who is undergoing alcohol withdrawal, acute stress or acute insomnia.
The problem with Valium and related medications is that, when they are used for more than the short haul, they change what experts call your sleep architecture — the patterns of brain waves during normal sleep. Because they are very sedating, they put a person at risk for accidents. These medications are also cross-tolerant with alcohol, which means they work on the same place in the brain that alcohol does, and the combination of the two can be lethal.
More importantly, these medications are “addictive”: your body develops tolerance to them, and may require higher and higher doses to get the same effect. At this point, your body can go into withdrawal when you stop taking the medication. Withdrawal from Valium and other benzodiazepines consists ofthe following symptoms: elevated blood pressure and heart rate, shakiness, sweating, confusion, and — in extreme cases — seizures.
For these reasons, well-trained physicians are very careful in how they prescribe medications like Valium, and patients should be thoroughly educated about how to take the medication and what side effects to expect. In clinical practice, there are some individuals who suffer from serious psychiatric symptoms who require ongoing treatment with these medications, despite the risks.
