Librium (Chlordiazepoxide)

Librium is the brand name for chlordiazepoxide, a form of benzodiazepine that is used to treat anxiety, insomnia, and muscle pain conditions. Due to its relaxing effect and interaction with the brain's neurotransmitters, Librium can be addiction-forming when abused.

What is Librium (Chlordiazepoxide)?

Chlordiazepoxide, better known by the brand name Librium, is a member of the benzodiazepine drug class. Librium is a central nervous system (CNS) depressant that interacts with neurotransmitters in the brain called gamma-aminobutyric acid (GABA). GABA neurotransmitters relax nerve impulses and suppress certain brain activity. It is commonly prescribed to treat anxiety conditions, insomnia, alcohol withdrawal, and muscle conditions.[1]

Librium dosage

Librium comes as a capsule or tablet that is intended to be taken orally between one and four times a day depending on the prescription. 

Librium comes in 5, 10, and 25mg tablets. The dosage depends on the condition being treated. Those being treated for acute or severe anxiety will likely have the full 25mg. 

When used in medically assisted treatment (MAT) for alcohol withdrawal, the dosage tends to be much higher. A standard dose used alcohol detox treatment will often range from 25-100mg administered every six hours.[1]

Is Librium a controlled substance?

Under the Controlled Substance Act (CSA) Librium is classified as a Schedule IV substance. This means that it is deemed to serve a medical purpose and has a low risk of abuse, dependence, and addiction.[3]

Librium and alcohol withdrawal treatment

Chlordiazepoxide is often used during alcohol detox to manage more severe alcohol withdrawal syndrome (AWS) symptoms. Some of the symptoms that are treated by Librium include seizures, tremors, and delirium tremens.

Chlordiazepoxide treatment for AWS needs to be carefully monitored by addiction treatment professionals and doctors as there is a high possibility of people becoming addicted to the substance. Additionally, as both are CNS depressants, there is a high risk of overdose if they are abused together which can lead to seizures, comas, and death.[5]

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Librium side effects

Benzodiazepines have been misused as recreational drugs since they were introduced in the 1960s. Benzodiazepines like chlordiazepoxide are abused in high doses as they can cause euphoric and relaxing effects similar to alcohol. They can also act as a sedative that relaxes the muscles. 

Librium has a range of side effects, most of which are heightened when abused in high doses or in conjunction with other substances, especially other CNS depressants like alcohol or opioid painkillers. Common side effects of Librium include:[1]

  • Drowsiness

  • Movement problems

  • Confusion

  • Passing out

  • Skin eruptions

  • Swelling

  • Irregular menstruation

  • Nausea

  • Constipation

  • Changes in libido

  • Liver problems including jaundice

  • Abnormal blood cells

If you have any of these symptoms it is important to notify your doctor and stop taking higher than the recommended dose if doing so.

Librium dependence and addiction

Like most CNS depressants, Librium is highly habit-forming as the brain becomes tolerant to its effects quickly. As the brain becomes more tolerant the individual taking it will require more and more of the drug to feel its effects. Over time, a physical dependence can form and the user may be unable to feel normal without taking Librium regularly. Physical dependence can form rapidly from benzodiazepines and can occur even if someone is not abusing the drug. 

Once dependence on Librium has formed it can quickly escalate to full addiction if left unchecked. Librium addiction is characterized by negative consequences arising from needing to use the substance. These can include abandoning responsibilities in order to use the drug, damaging personal relationships, cravings, and withdrawal symptoms presenting when use stops.

Librium withdrawal

Without Librium's interaction with the GABA neurotransmitter, the brain will become overactive. If use stops rapidly, withdrawal symptoms will present themselves which can be uncomfortable and will often lead people to relapse when attempting to stop. Librium withdrawal symptoms include:

  • Sweating

  • Rapid pulse

  • Hand tremor

  • Insomnia

  • Nausea or vomiting

  • Hallucinations

  • Agitation

  • Anxiety

  • Seizures

Librium taper

Most people do not experience all withdrawal symptoms but it is possible to have multiple symptoms at once. In order to safely manage withdrawal from chlordiazepoxide, most doctors will recommend a Librium taper whereby users slowly lower the dosage of the drug until they can safely stop altogether.[7]

Librium addiction treatment

Benzodiazepine addiction can be extremely difficult to get over and the same is true of Librium. Thankfully there are treatment options available throughout the country, either by attending an inpatient residential rehab or outpatient treatment center.  

These facilities offer a safe and comfortable place to detox and a course of treatments including therapy, counseling, support groups, and long-term recovery plans. Visit our rehab directory to find an addiction treatment center near you that can help with a benzodiazepine use disorder.