Can You Take Paxil and Valium together? (Risks and Benefits)

This article will discuss the topic of taking Paxil (paroxetine) and Valium (diazepam) together for the management of certain conditions. It will explore the potential benefits and risks of combining these medications, as well as provide strategies for safely coadministering them.

Additionally, alternative medications with a lower risk of sedation or drowsiness will be discussed.

Can you take Paxil and Valium together?

Yes, Valium (diazepam) and Paxil (paroxetine) can be taken together under the supervision of a healthcare professional.

Valium is a benzodiazepine that can be used to treat anxiety and seizures, while Paxil is a selective serotonin reuptake inhibitor (SSRI) used to treat depression, anxiety disorders, and obsessive-compulsive disorder. When taken together, they can complement each other’s effects in managing certain conditions, such as severe anxiety or panic disorder [1,2]. 

However, combining these medications can increase the risk of side effects such as drowsiness, dizziness, and difficulty concentrating. It is important to follow the guidance of a healthcare provider when taking these medications together to minimize the risk of adverse effects and interactions.

What are the potential benefits of taking Paxil and Valium together?

Research suggests that combining benzodiazepines with SSRIs can result in faster improvement in depression and stabilization of panic or social phobia symptoms compared to using only an SSRI [3].

Moreover, the same study demonstrated that taking benzodiazepines with SSRIs could offer benefits such as more rapid anxiety control, lower occurrences of anxiety and agitation caused by SSRIs, improved adherence to SSRI therapy, and better control of episodic or situational anxiety [3].

Furthermore, in a study investigating panic disorder treatments, combining paroxetine with clonazepam, which is another benzodiazepine similar to Valium, led to a faster response compared to using paroxetine alone [4].

However, there were no significant differences in long-term benefits. The researchers suggested that starting with combination treatment and tapering off the benzodiazepine after a few weeks could provide early benefits while avoiding the potential adverse effects of long-term combination therapy [4].

Another study found that pre-treatment with diazepam reversed the anxiety-inducing effects of SSRIs. This suggests that Valium can reduce acute anxiety that may be caused by Paxil [5].

On a different note, a study compared using paroxetine alone versus combining it with clonazepam to treat generalized social anxiety disorder (GSAD). Although there was a slight preference for the combination in terms of overall improvement, there were no significant differences in GSAD symptoms between both groups [6]

Nevertheless, the paroxetine/clonazepam combination was well tolerated with few dropouts due to adverse events [6]

What are the potential risks of taking Paxil and Valium together?

One of the most common side effects of Paxil is drowsiness and tiredness. When combining paxil and valium, they can have an additive effect on the central nervous system, leading to increased sedation and drowsiness [1,2].

These symptoms can affect daily activities and general safety, as they increase the risk of accidents or falls, especially in elderly patients. In severe cases, the overlapping side effects of taking paroxetine and diazepam together may lead to confusion, difficulty concentrating, impaired coordination, and slowed or difficult breathing.

How can you safely take Paxil and Valium together?

Taking Paroxetine (Paxil) and Diazepam (Valium) together can be done safely if certain precautions are taken to avoid interactions and reduce the risk of additive side effects. Here are some strategies and recommendations to ensure the safe coadministration of these medications:

  • Before starting the combination of Paroxetine and Diazepam, it is crucial to consult with your doctor who can assess your specific medical condition, review your medication history, and consequently suggest the most suitable treatment plan for you.
  • Start with low doses, this helps minimize the risk of excessive sedation or other additive side effects. Your doctor will determine the appropriate starting doses based on your individual needs.
  • Pay close attention to your general health condition and monitor for any potential side effects that may arise from the combination of Paxil and Valium. Common side effects include sedation, drowsiness, difficulty concentrating, and fatigue. If you experience any concerning side effects, inform your doctor immediately.
  • Space out the doses of Paroxetine and Diazepam to reduce the likelihood of drug interactions. Generally, it is preferable to separate the intake of these medications by a few hours, as advised by your healthcare provider.
  • Don’t drive if you feel dizzy and avoid working on dangerous machinery. Doing such activities while taking Paxil with Valium can lead to accidents.
  • Avoid alcohol consumption, as it can intensify sedation and impair cognitive function.
  • Maintain a healthy sleep routine, exercise regularly, and reduce stress levels. This can help support the overall effectiveness of the medications.
  • Inform your doctor about any other medications, supplements, or herbal remedies you are taking to assess potential drug interactions.
  • Additionally, disclose any pre-existing medical conditions, such as liver or kidney problems, as they may affect the dosage adjustment and overall safety of the medications.
  • It is preferable to take them at night to avoid any negative impacts on your daily activities.

What are the alternatives to taking Paxil and Valium together?

Here are some potential alternative medications for treating anxiety and depression with a lower risk of sedation or drowsiness [7,8]:

Selective Serotonin Reuptake Inhibitors (SSRIs)

SSRIs such as Prozac (fluoxetine), Zoloft (sertraline), and escitalopram are frequently prescribed for anxiety and depression.

Serotonin-norepinephrine reuptake Inhibitors (SNRIs)

SNRIs like Cymbalta (duloxetine) and Effexor (venlafaxine), are commonly prescribed for anxiety and depression, offering a dual mechanism of action by increasing levels of both serotonin and norepinephrine in the brain.

Buspirone

Buspirone is often used for generalized anxiety disorder. It works differently from SSRIs and benzodiazepines. It has a lower risk of sedation and dependence and is generally well-tolerated.

Atypical antidepressants

Atypical antidepressants like Wellbutrin (bupropion) and Remeron (mirtazapine) work differently from SSRIs and may have a lower likelihood of sedation.

However, as each patient may respond differently to medications, it is important to consult with a doctor. They will be able to select an alternative treatment plan based on your condition, medical history, and medication interactions.

Final words

In conclusion, I believe that Paxil (paroxetine) and Valium (diazepam) can be taken together under the supervision of a healthcare professional. Based on my research, I found that combining them can result in faster improvement in depression, anxiety, and panic disorder, and possibly prevent SSRI-induced anxiety.

However, there are potential risks, including increased sedation and drowsiness. To safely take Paxil and Valium together, I recommend consulting with a doctor, starting with low doses, monitoring for side effects, avoiding alcohol, and being mindful of drug interactions. 

Based on my knowledge, there are alternative medications with a lower risk of sedation or drowsiness, such as SSRIs, SNRIs, buspirone, and atypical antidepressants. However, it is important to consult a doctor to determine the most appropriate treatment plan for individual needs.

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References

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Shrestha P, Fariba KA, Abdijadid S. Paroxetine. [Updated 2023 Jul 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from:https://www.ncbi.nlm.nih.gov/books/NBK526022/#:~:text=Paroxetine%20is%20a%20selective%20serotonin%20reuptake%20inhibitor%20(SSRI)%20and%2C,is%20identified%20as%20an%20antidepressant.

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Dhaliwal JS, Rosani A, Saadabadi A. Diazepam. [Updated 2022 Sep 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537022/#:~:text=Diazepam%20is%20a%20benzodiazepine%20medication,certain%20refractory%20epilepsy%20patients%2C%20and

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Pollack MH, Simon NM, Worthington JJ, Doyle AL, Peters P, Toshkov F, Otto MW. Combined paroxetine and clonazepam treatment strategies compared to paroxetine monotherapy for panic disorder. J Psychopharmacol. 2003 Sep;17(3):276-82. doi: 10.1177/02698811030173009. PMID: 14513919. https://pubmed.ncbi.nlm.nih.gov/14513919/

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Birkett MA, Shinday NM, Kessler EJ, Meyer JS, Ritchie S, Rowlett JK. Acute anxiogenic-like effects of selective serotonin reuptake inhibitors are attenuated by the benzodiazepine diazepam in BALB/c mice. Pharmacol Biochem Behav. 2011 Jun;98(4):544-51. doi: 10.1016/j.pbb.2011.03.006. Epub 2011 Mar 21. PMID: 21397628; PMCID: PMC3085089. https://pubmed.ncbi.nlm.nih.gov/21397628/

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Seedat S, Stein MB. Double-blind, placebo-controlled assessment of combined clonazepam with paroxetine compared with paroxetine monotherapy for generalized social anxiety disorder. J Clin Psychiatry. 2004 Feb;65(2):244-8. PMID: 15003080. https://pubmed.ncbi.nlm.nih.gov/15003080/

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Bandelow B, Michaelis S, Wedekind D. Treatment of anxiety disorders. Dialogues Clin Neurosci. 2017 Jun;19(2):93-107. doi: 10.31887/DCNS.2017.19.2/bbandelow. PMID: 28867934; PMCID: PMC5573566. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5573566/

8.-

Drugs for Depression. Med Lett Drugs Ther. 2020 Feb 24;62(1592):25-32. PMID: 32320387. https://pubmed.ncbi.nlm.nih.gov/32320387/#:~:text=Keywords%3A%20Abilify%3B%20Aplenzin%3B%20Aventyl,%3B%20Seroquel%3B%20Spravato%3B%20St.

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