Doval contains diazepam 5 mg, a benzodiazepine. It is prescribed for short-term severe anxiety, muscle spasm, some seizures and alcohol withdrawal, and sometimes as sedation before a procedure. It is a Schedule 5 medicine intended for short courses, because dependence develops with regular use.
What is Doval?
Doval contains diazepam 5 mg in tablet form and is Schedule 5 in South Africa — prescription-only, with additional controls on how it is supplied and recorded.
Diazepam is a benzodiazepine. It enhances the effect of GABA, the brain’s main calming neurotransmitter. GABA quietens nerve activity; diazepam makes each unit of GABA more effective, so the overall result is reduced excitability across the nervous system.
That produces four effects at once, and every use of diazepam draws on one or more of them:
- Anxiolytic — reduces anxiety.
- Sedative and hypnotic — causes drowsiness.
- Muscle relaxant — acts centrally to reduce muscle spasm.
- Anticonvulsant — raises the threshold for seizures.
Diazepam is long-acting compared with most benzodiazepines. It is broken down into active substances that themselves persist, so effects can last well beyond the point at which the tablet seems to have worn off — and it accumulates with repeated doses, particularly in older people and those with liver problems.
Related medicines in South Africa include lorazepam, clonazepam, and alprazolam (Xanax). They share the same mechanism and the same cautions, differing mainly in how quickly and how long they act.
What is Doval commonly used for?
- Severe anxiety, for short periods — typically no more than two to four weeks, including the taper.
- Muscle spasm, from injury, back problems, or neurological conditions such as spasticity.
- Seizures and status epilepticus, usually with other formulations in an emergency setting.
- Alcohol withdrawal, where diazepam prevents seizures and manages agitation under supervision.
- Sedation before procedures, including some dental and endoscopic work.
- Short-term severe insomnia, occasionally, where anxiety is the driver.
The short-term framing is not a formality. Diazepam works well for acute distress, but tolerance to its calming effect develops within weeks, and physical dependence follows regular use. Long-term use tends to stop delivering benefit while still producing withdrawal on stopping — the worst of both.
For ongoing anxiety, the treatments that work over the long run are different: antidepressants such as SSRIs, and psychological therapy. Diazepam is best thought of as a bridge, not a destination.
How Doval fits into this medicine category
| Group | Examples | Typical role |
|---|---|---|
| Benzodiazepines | Diazepam (Doval), lorazepam, alprazolam | Short-term anxiety, spasm, seizures, withdrawal |
| SSRIs / SNRIs | Fluoxetine, escitalopram, venlafaxine | First-line for ongoing anxiety and depression |
| Tricyclics | Amitriptyline | Nerve pain, mood, sleep |
| Anti-epileptics | Carbamazepine, valproate | Seizure control; some nerve pain |
| Gabapentinoids | Pregabalin | Nerve pain, add-on epilepsy, anxiety |
| Beta-blockers | Propranolol | Physical symptoms of anxiety — tremor, palpitations |
Benzodiazepines act fastest of these, which is exactly why they are useful in a crisis and problematic as a routine. See the mental health, nerve and neurological medicines hub.
What to check before using Doval
Do not combine it with opioids unless a doctor has specifically planned it. Diazepam with codeine, tramadol, morphine or similar substantially raises the risk of severe sedation, suppressed breathing, coma and death. This combination is among the most common contributors to medication-related deaths worldwide.
Do not drink alcohol with it. The same risk applies, and alcohol also worsens the memory effects.
Tell your doctor or pharmacist if you:
- Have breathing problems — sleep apnoea, COPD, or severe asthma.
- Have liver or kidney disease. Diazepam accumulates when the liver is impaired.
- Are elderly. Older people are markedly more sensitive: confusion, unsteadiness and falls with fractures are real risks, and lower doses are used.
- Have myasthenia gravis.
- Have a history of substance or alcohol misuse, or of dependence on these medicines.
- Have depression, which benzodiazepines can deepen.
- Have a personality disorder or a history of disinhibited behaviour on sedatives.
- Are pregnant, planning pregnancy or breastfeeding.
- Take any other sedating medicine, including sedating antihistamines such as promethazine, sleeping tablets, or antipsychotics.
- Take medicines that inhibit liver enzymes, such as some antifungals, HIV medicines, or certain antibiotics.
Do not drive or operate machinery. Diazepam impairs reaction time, coordination and judgement, often for longer than it feels — including the morning after a night-time dose. Driving while impaired by a prescribed sedative is still an offence.
Possible cautions and when to ask a pharmacist or doctor
Common effects are drowsiness, unsteadiness, poor coordination, muddled thinking, memory gaps, dry mouth and reduced alertness the following day.
Seek medical attention urgently if you notice:
- Slow, shallow or difficult breathing, or unusual difficulty rousing someone. Treat this as an emergency, especially where an opioid or alcohol is involved.
- Marked confusion or hallucinations, particularly in an older person.
- Paradoxical reactions — agitation, restlessness, irritability, aggression or disinhibition instead of calm. This is uncommon but recognised, and more likely in children and older people.
- A fall, or repeated unsteadiness.
- Yellowing of the eyes or skin.
- Swelling of the face, lips or tongue, or difficulty breathing.
Never stop diazepam abruptly after regular use. Withdrawal can cause rebound anxiety and insomnia, tremor, sweating, nausea, muscle pain, perceptual disturbance and — importantly — seizures, which can be life-threatening. Stopping is done by tapering slowly, sometimes over months, guided by a doctor. The length of the taper is not a measure of how badly things have gone; it is simply how these medicines are stopped safely.
If you find you need it more often, need more for the same effect, or feel unable to cope without it, tell your doctor. Dependence on a prescribed medicine taken as directed is a common and treatable situation, and raising it early makes it considerably easier to resolve.
Contact your doctor if anxiety persists beyond the short course intended, so that longer-term treatment can be arranged.
Related medicine guides
- Browse Mental Health, Nerve & Neurological Medicines guides
- Read: Trepiline used for
- Read: Nurika used for
Frequently asked questions
What are Doval 5 mg tablets used for? Short-term severe anxiety, muscle spasm, some seizure situations, alcohol withdrawal, and sedation before procedures. Each tablet contains diazepam 5 mg.
Is Doval a sleeping tablet? Not primarily, though it causes drowsiness and is sometimes used briefly where anxiety disturbs sleep. It is not intended for ongoing insomnia.
Is Doval addictive? Physical dependence develops with regular use, which is why courses are kept short. That is a property of the medicine, not a failing of the person taking it.
How long can I take it for? Usually no more than two to four weeks including the taper. Longer use should be a deliberate medical decision.
Can I stop taking it suddenly? No. Abrupt withdrawal after regular use can cause severe symptoms including seizures. Stopping must be tapered under medical guidance.
Can I drink alcohol with it? No. The combination can dangerously suppress breathing.
Can I drive on it? No, not while it affects you — and effects can persist into the next day. Driving while impaired remains an offence.
Can I take it with painkillers? Paracetamol and anti-inflammatories are generally fine. Opioid painkillers such as codeine and tramadol are the serious concern — ask a pharmacist before combining.