Chlordiazepoxide is a psychoactive benzodiazepine, commonly known by the brand name Librium. It was the first benzodiazepine ever discovered and affects the GABA neurotransmitters in the body, which result in sedative, relaxing, sleep-inducing effects. Chlordiazepoxide is commonly misused and abused because of its hypnotic drug effects and is often used as a secondary drug in combination with other illegal and illicit drugs. In a medical setting, Chlordiazepoxide is generally prescribed for treating anxiety, insomnia, tremors, seizures, muscle spasms, and for reducing side effects of alcohol withdrawal. Benzodiazepines are a class of drugs that work well in those with anxiety and seizure disorders, as the medication suppresses the rapid, excessive firing of brain neurons that occur during a panic attack or seizure. In addition to reducing anxiety and inducing sleep, Chlordiazepoxide also works as a muscle relaxer and has amnestic properties, which are some of the reasons this drug is commonly abused and misused.
Short and Long-term Use of Chlordiazepoxide
Short-term usage of Chlordiazepoxide is generally safe, with the most common psychological effects being aggression or behavioral changes. Physical side effects seen in some patients taking Chlordiazepoxide for a short period of time include:
- Blurred vision
- Diarrhea or constipation
- Drowsiness, dizziness or clumsiness
- Upset stomach
- Dry mouth
- Feeling drowsy or hungover the next day after bedtime usage
- Difficulty concentrating
Long-term effects of Chlordiazepoxide can have more intense adverse physical and psychological effects. In addition to the effectiveness of the medicine decreasing, physical dependence can take place and benzodiazepine withdrawal syndrome can occur when the medication is stopped. Long-term effects can also include a deterioration in physical and mental health, in addition to:
- Increasing anxiety
- Loss of sex-drive
- Social phobia
- Loss of interest in pursuits and interests
- Increased inability to express feelings and emotions
Chlordiazepoxide Withdrawal Syndrome and Detoxification
Chlordiazepoxide is considered a Schedule IV controlled substance by the U.S. Drug Enforcement Administration. Mild withdrawal symptoms of insomnia and dysphoria can occur after stopping the drug if it has been taken for several months at prescribed therapeutic levels. Sudden withdrawal of abusive and non-therapeutic levels of Chlordiazepoxide can cause more severe symptoms in certain individuals this is classified as Chlordiazepoxide Withdrawal Syndrome. These symptoms can include:
- Suicidal behavior
- Hypersensitive to stimuli
- Delirium Tremens
Because abrupt withdrawal can produce these symptoms, a supervised detoxification process is recommended in addicted individuals. Research shows that up to ten percent of addicts will experience a prolonged withdrawal syndrome period, where side effects can last up to several months. These symptoms do eventually disappear with time.
Chlordiazepoxide for Alcohol Withdrawal Treatment
For individuals who abuse and are addicted to alcohol, medically assisted withdrawal or detoxification using Chlordiazepoxide is often prescribed and completed in a treatment or medical facility. Receiving medically assisted withdrawal helps to prevents complications including seizures and delirium tremens. It can also make the patient more comfortable knowing they are in a safe environment that has medical interventions available should withdrawal symptoms become severe.
Benzodiazepines such as Chlordiazepoxide are one of the most commonly used drugs for treatment of alcohol withdrawal. In most cases, Chlordiazepoxide will be used for five to seven days, with the dosage reduced each day. Chlordiazepoxide dosing is dependent upon alcohol dependence, weight, sex and the liver function of the patient. People at increased risk for seizures or delirium tremens may have to take a tapering dose of Chlordiazepoxide for up to two weeks.
The greatest risk in taking Chlordiazepoxide over a long period of time is addiction. If the drug is abused, the individual will develop drug cravings, may exhibit drug-seeking behaviors, withdrawal symptoms and also a tolerance to its euphoric effects. Though the drug has not been studied long term in humans, animal studies show that over time the medication makes them lose interest in caring for their dependents, experience loss of sex drive as well as increased anxiety, anorexia, weakness and insomnia. An interesting study by the University of California showed women over the age of 65 had a 60 percent increase of hip fractures when taking Chlordiazepoxide, which was attributed to side effects such as drowsiness and unsteadiness and increased chances of falling.
Chlordiazepoxide overdoses have occurred in individuals who have taken a large quantity of the drug at one time or have combined the drug with other central nervous system depressants, such as narcotics and/or alcohol. Overdoses have most often been seen in individuals who have become addicted to Chlordiazepoxide and are also addicted to cocaine or heroin. Chlordiazepoxide is most often used by this group of individuals to modulate the effects of the stimulants they are taking, and to help them relax and fall asleep.
Symptoms of overdose can include:
- Low blood pressure
- Slow rate of breathing
- Cessation of breathing
In cases of Chlordiazepoxide overdose, emergency medical assistance should be sought immediately, as there is one antidote physicians can use called flumazenil.