Psychiatry & Medication

Chlordiazepoxide for Anxiety

 April 27, 2022

By  Natalie Kirilova

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The Bottom Line:

  • Chlordiazepoxide is a benzodiazepine (benzo) medication.

  • Available under the brand name Librium.

  • Prescribed for anxiety, insomnia, alcohol withdrawal treatment.

  • FDA-approved for anxiety.

What is Chlordiazepoxide?

Chlordiazepoxide is a medication from the benzodiazepine (benzo) class. In the U.S., it is available under the brand name Librium. Doctors usually prescribe it for short-term treatment of anxiety, insomnia and alcohol withdrawal. In some cases, a doctor may choose it for irritable bowel syndrome treatment, the symptoms of which are abdominal pain, muscle cramps, and diarrhea. 

The long-term application has not been linked to efficacy or safety but it has shown abuse and dependence in adults. It is a habit-forming medication that should be prescribed with caution.

Chlordiazepoxide similarly to other benzo medications works by affecting neurotransmitters which then lower the brain’s activity. The antianxiety effect is sometimes felt in a few hours.

It is available in capsules of 5,10,25mg strengths.

Can Chlordiazepoxide be taken for Anxiety?

It is usually prescribed to treat anxiety disorder and its symptoms. It provides anxiety relief and starts working in 1 to 2 hours. Before taking Chlordiazepoxide, speak to your doctor. It only fits certain types of patients. 

Chlordiazepoxide is not prescribed for anxiety states which are caused by the stress of everyday life. A doctor may need to examine your health condition to determine the right direction in the treatment.

Is Chlordiazepoxide  FDA approved for anxiety?

Chlordiazepoxide was approved to treat anxiety disorder by the Food and Drug Administration (FDA) in 1960. The FDA also issued a black box warning to the Chlordiazepoxide application. Its long use may lead to abuse and dependence in adults. And, it is contraindicated for interactions with opioids. The interactions may lead to coma and death. 

What research supports Chlordiazepoxide for anxiety?

There is limited research documented on Chlordiazepoxide efficacy for anxiety treatment.

  • Chlordiazepoxide was given to rats on the plus-maze testing. The results were studied in three clinical trials. Rats were administered 7.5mg/kg dosage daily. During the trials, Chlordiazepoxide has shown efficacy in providing the anxiolytic effects. 

  • Chlordiazepoxide, Diazepam, and Oxazepam were studied on hostility relief in volunteers. Those with high levels of anxiety have been found less anxious while taking one of the medications. Reversely, volunteers with low anxiety levels reported higher levels at the end. All medications have shown efficacy in hostility relief.

  • Chlordiazepoxide was studied on efficacy in the long-term treatment of anxiety in rats. During 5, 15, and 25 days, rats were administered with 5mg/kg dosages. The higher efficacy of Chlordiazepoxide was observed in the first and second weeks of the application while the assessment of rats’ condition after 25 days showed no significant changes.

What are the possible side effects?

Chlordiazepoxide should be prescribed with caution. If the right dosage is adjusted and taken as directed, there are rare side effects in patients. Still, elderly people and medically fragile patients with anxiety disorders are most likely to experience side effects.

Chlordiazepoxide side effects:

  • drowsiness;

  • dizziness;

  • diarrhea;

  • ataxia;

  • confusion;

  • nausea;

  • low libido;

  • fainting;

  • mood changes;

Withdrawal symptoms after discontinuing the treatment with Chlordiazepoxide:

  • muscle cramps;

  • tremor;

  • vomiting;

  • anxiety.

Overdose incidents have been reported when taking Chlordiazepoxide. If you believe you have overdosed, please seek emergency assistance immediately (call 911).

Overdose symptoms:

  • excessive sleepiness;

  • somnolence;

  • confusion.

Do not abruptly stop taking Chlordiazepoxide. A doctor should gradually decrease the dosage. 

Do not operate heavy machinery or drive a car before knowing how Chlordiazepoxide works for your health condition. It may cause drowsiness and blurred vision which may affect your alertness.

Inform your doctor if you have liver or kidney problems, previous or current depression symptoms or suicidal thoughts, history of drug addiction.

Does Chlordiazepoxide have interactions with other medications? 

Chlordiazepoxide may interact with other medications, herbs, health supplements. Any combination may cause side effects or lead to negative outcomes. Speak to your doctor about possible interactions, and inform him if you already take any medications.

This medication has a black box warning from the Food and Drug Administration (FDA). It is strictly prohibited to interact with Chlordiazepoxide opioids. Benzo drugs interacted with opioids may lead to coma and death.

There are potential interactions of Chlordiazepoxide with the following medications:

  • antihistamines;

  • Fluoxetine;

  • depression medications;

  • oral contraceptives;

  • sedatives;

  • sleeping aids;

  • hypnotics;

  • Methadone;

  • Ethyl;

  • Zydelig.

Do not take with alcohol. You may experience trouble breathing and drowsiness.

Cigarettes may reduce the efficacy of Chlordiazepoxide. Inform your doctor if you smoke.

Can you take Chlordiazepoxide while pregnant or breastfeeding? 

It is not recommended for use in pregnant women. Chlordiazepoxide used during the first trimester of pregnancy may lead to malformations and abnormalities in the fetus. Speak to your doctor if you are pregnant or plan to become pregnant.

There is no known information on whether Chlordiazepoxide may excrete into breast milk. However, this medication stays long in the body and accumulates its metabolites. It is not recommended for use when breastfeeding. 

Can children take Chlordiazepoxide for anxiety? 

The Food and Drug Administration (FDA) does not recommend prescribing Chlordiazepoxide to children under 6. And, it is not the medication occasionally prescribed for pediatrics use.

How to take Chlordiazepoxide? 

Chlordiazepoxide should be prescribed individually based on the health condition. 

Take tablets by mouth with or without food as prescribed. Make a habit of taking tablets at the same time every day.

The dosage may vary in adults with mild and severe anxiety symptoms.

  • Adults with mild anxiety symptoms. 5-10mg 3-4 times daily.

  • Adults with severe anxiety symptoms. 20-25mg 2-4 times daily.

  • Elderly. 5mg 2 to 4 times daily.

Chlordiazepoxide for alcohol withdrawal treatment:

  • Adults. 50-100mg one time per day.

Do not exceed the prescribed dosage. It may lead to abuse, dependence, and severe side effects. If you skip a dose, take it as soon as possible, and address this concern with a doctor.

Are there alternatives to Chlordiazepoxide?

Prescription medications as Alternatives to Chlordiazepoxide for Anxiety

Chlordiazepoxide is a medication used to treat anxiety disorder, insomnia, alcohol withdrawal. Its potential to lead to abuse and dependence may not fit previous or current drug-addicts or your particular case. There are many other medications you can speak about with your doctor. Some of them are:

  • Klonopin

  • Valium

  • Lexapro

  • Prozac

  • Buspirone

  • Xanax

  • Inderal

  • Cymbalta

  • Tofranil

  • Hydroxyzine

  • Zoloft

There are various alternatives. If you’d like to learn more about whether Chlordiazepoxide, another medication or treatment modality is right for you, we recommend that you speak with a licensed psychiatrist. Here are the best online psychiatry platforms so you can speak with someone right away!

Therapy as an Alternative to Chlordiazepoxide

Learn more about different therapy options for anxiety here

Energy & Holistic Modalities as an Alternative to Chlordiazepoxide

Learn more about different energy & holistics modalities for anxiety here

Tech & Devices as Alternative Treatments to Chlordiazepoxide

Learn more about tech & devices for anxiety here

Disclaimer: This website does not provide medical advice. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on our Site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

Natalie is a writer with a focus in medical research with over 10 years of experience

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