The 5 differences between diazepam and trankimazin

Anxiety and depression are two global health problems that require, at the government level, an urgent approach. We are not speculating, since the figures speak for themselves: depression is a challenge for public health, since it affects more than 350 million inhabitants worldwide and its prevalence throughout the individual's life reaches up to 15%. This means that approximately 15 out of 100 people will experience a depressive episode at some point.

Anxiety is not short: more than 265 million people suffer from it, as indicated by the World Health Organization (WHO). This can be sporadic in nature or become chronic, but, in both cases, it can cause quantifiable physiological and psychological problems in the patient.

Based on these data, we are not surprised to learn that, in about 17 years, the use of benzodiazepines has increased by 67% in the United States. This translates to about 13.5 million Americans using these drugs or, failing that, 3.6 kilograms of lorazepam per 100,000 adult inhabitants. Due to the use (and abuse) of these drugs, we find it interesting to elucidate

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the differences between diazepam and trankimazin, two of the most used drugs for the problems mentioned above.

Related article: "Types of psychotropic drugs: uses and side effects"

What are the differences between diazepam and trankimazin?

First, we must equate both terms to start at an equidistance point. Both diazepam and trankimazin are benzodiazepines, that is to say, psychotropic drugs (which act on the central nervous system) with sedative, hypnotic, anxiolytic, anticonvulsant and muscle relaxant effects.

However, an initial distinction needs to be made: diazepam is the name of the drug, while trankimazin is the name by which another medicine is known commercially: alprazolam. Diazepam, for its part, is known commercially as valium.

Thus, we highlight that we are going to compare diazepam with alprazolam, although the second is known as trankimazin, xanax, tafil or niravam in pharmacies. As we have already said, diazepam is known in society as valium. Once these points are clarified, we turn to the drug leaflets and medical associations to show you the differences between them.

1. Differences in bioavailability

Bioavailability is defined as the rate at which the administered dose of a drug reaches its therapeutic target. Normally, intravenous drugs reach a bioavailability value of 100% (maximum efficacy), while the tablets oscillate a value of 70%, since the drug must first be absorbed at the level intestinal.

Alprazolam (trankimazin) has a bioavailability of 80-90%. On the other hand, diazepam (valium) ranges from 93-100% in its oral mode of administration. This means that, on a theoretical level, diazepam is a little more effective and faster in generating the desired effects. Of course, this does not mean that in all cases one should be chosen over the other: as we will see in later lines, each of these drugs has its reason for being.

2. Different uses

Both drugs belong to the group of benzodiazepines, so they work relatively similarly. The rationale for both compounds is to enhance or facilitate the inhibitory action of the neurotransmitter gamma aminobutyric acid (GABA), thus causing a depression of the hypothalamic-hyposphyseal-adrenal axis, roughly explained. Although the premise is very similar, its effects are not exactly the same.

Diazepam stands out above the rest for its effects as a muscle relaxant, so it is used in the treatment of reflex muscle spasms due to local trauma, such as wounds and inflammation. It can also be indicated in clinical conditions such as torticollis and even intravenously serves as a sedative prior to interventions (biopsies, fractures or endoscopies). Diazepam does the job of the other benzodiazepines well, but excels on these fronts.

On the other hand, alprazolam (trankimazin) has a slightly more “mainstream” use, effectively addressing simple anxiety disorders: tension, panic disorder, fears, apprehension, difficulty concentrating, insomnia, autonomic hyperactivity and irritability. Its use in other clinical conditions is also contemplated, such as the relief of symptoms in patients with Irritable Bowel Syndrome (IBS).

You may be interested in: "Diazepam: Uses, Precautions, and Side Effects of This Drug"

3. Diversity in dosage

Diazepam and alprazolam (trankimazin) differ markedly in the way they are consumed. You must bear in mind that alprazolam has a shorter bioavailability and half-life than other benzodiazepines, so it must be administered several times a day in many cases to ensure that the action lasts throughout the day. The prospectus supports this idea with the following data:

In generalized anxiety treatments, it is recommended to start with a dose of 0.25 mg to 0.5 mg, 3 times a day.
The usual range is 0.5 mg- 4 mg divided into 3-4 different doses per day.
For panic disorders, take 1 mg at bedtime every 3-4 days should not be exceeded.

The case of diazepam is a little different, since its consumption is considered more in intensity disorders and other disabling and prolonged pathologies. With severe symptoms of anxiety, withdrawal syndrome, as a muscle relaxant and in therapy anticonvulsant can be prescribed up to 10 mg per day (with a minimum of 2 mg), divided into 3 or 4 take a day. As you can observe, the dose of drug that is contemplated is much higher than in the case of alprazolam (trankimazin).

In any case, you must take into account the following information: 1 mg of alprazolam is equivalent to 5-10 mg of diazepam.

4. Differences in sensations by the patient

Psychiatric sources argue that for anxiety disorders that are not disabling, it is better to turn to alprazolam (trankimazin). As we have seen so far, it has a shorter half-life, its effect is less, and it produces less fatigue and atypical sensations in patients.

On the other hand, diazepam has a half-life of 20-30 hours and some of its active compounds show activity for up to 100 hours. For this reason, many patients experience tiredness, slight confusion and fatigue for up to 2 full days after consumption. It is a drug that is considered in situations that require a more “aggressive” approach and, therefore, its side effects are more intense.

5. Rebound effect and other side effects

By lasting less time in the body, alprazolam (trankimazin) can have a more pronounced rebound effect or insomnia. Hours after administration, the patient can perceive anxiety pictures that should not be there theoretically. In these cases, it is necessary to contact the psychiatrist urgently, as it is a clear sign that the patient is generating some kind of dependence on the drug earlier than expected.

To avoid this undesirable effect, one can resort to the delayed-release variant of trankimazin (Alprazolam retard) or switch to a benzodiazepine with a longer half-life. As you can see, one of the biggest problems with trankimazin is that its half-life can be too short for the patient's needs, so sometimes it is necessary to change it for another.

Resume

We cannot end this space without making a series of final considerations. As the National Institute on Drug Abuse (NIH) indicates, approximately more than 136 Americans die every day after intoxication due to the consumption of opioids, an event that is greatly favored by the simultaneous use of benzodiazepines. According to medical studies, the chance of death after an overdose is 10 times higher in those who use benzos and opioids at the same time, compared to those who only use the second drug in isolation.

Benzodiazepines are causing significant addiction problems in both youth and adults on a social and medical level. it is easy to develop emotional dependence on them and they can be achieved without much difficulty (even if a prescription is needed medical). The rebound effect and dependence on these drugs are more than known in the medical field.

For this reason, the prospectuses of the aforementioned drugs are clear: continuous administration is not recommended. of them for more than 12 weeks in almost no case, unless the medical professional considers it essential. If treatment must be prolonged for longer than stipulated, this will be done in a limited way and with frequent monitoring of the general health of the patient.

Bibliographic references:

Ait-Daoud, N., Hamby, A. S., Sharma, S., & Blevins, D. (2018). A review of alprazolam use, misuse, and withdrawal. Journal of addiction medicine, 12 (1), 4.
Ashton, H. (2005). The diagnosis and management of benzodiazepine dependence. Current opinion in Psychiatry, 18 (3), 249-255.
Benzodiazepines and opioids, NIH. Picked up on March 3 in https://www.drugabuse.gov/drug-topics/opioids/benzodiazepines-opioids
Olfson, M., King, M., & Schoenbaum, M. (2015). Benzodiazepine use in the United States. JAMA psychiatry, 72 (2), 136-142.
Alprazolam cinfa leaflet, collected on March 3 in https://cima.aemps.es/cima/dochtml/p/62791/Prospecto_62791.html
Diazepam normon leaflet, collected on March 3 in https://cima.aemps.es/cima/dochtml/p/51208/P_51208.html