Chlordiazepoxide, previously sold under the brand name Librium, is a benzodiazepine carrying a risk of dependence and addiction. Understanding the side effects is vital.

Librium was the brand name of a benzodiazepine, or benzo called chlordiazepoxide. The drug is still available as a generic, although the brand name Librium has been discontinued. It is FDA-approved for anxiety and symptoms of alcohol withdrawal. However, chlordiazepoxide is a Schedule IV controlled substance, meaning that it carries a risk of abuse, addiction and dependence. For this reason, it is important to be aware of the signs of abuse.

Article at a Glance:

  • Librium was the brand name of the benzodiazepine drug chlordiazepoxide. Although the brand name has been discontinued, the drug is still available as a generic.
  • Chlordiazepoxide is a Schedule IV controlled substance that is FDA-approved for anxiety and alcohol withdrawal symptoms.
  • Those who struggle with substances like alcohol are at a higher risk of becoming addicted to chlordiazepoxide.
  • Signs of chlordiazepoxide abuse can include having cravings and taking more of the drug than prescribed.
  • Because stopping cold-turkey can lead to withdrawal symptoms, it is important to come off the drug while under the care of a doctor.

Librium Side Effects

Like all drugs, chlordiazepoxide has potential side effects. Generally, these can be avoided by lowering the chlordiazepoxide dose. Side effects can include:

  • Drowsiness
  • Movement problems
  • Confusion
  • Passing out
  • Skin eruptions
  • Swelling
  • Irregular menstruation
  • Nausea
  • Constipation
  • Changes in libido
  • Liver problems including jaundice
  • Abnormal blood cells

Risks in Elderly People

Chlordiazepoxide is a long-acting benzo that experts think should generally be avoided in the elderly. Older adults taking chlordiazepoxide are more likely to experience side effects because they have increased sensitivity to benzos and their bodies cannot clear long-acting benzos as easily as younger adults. All benzos can increase risks in the elderly for issues including:

  • Cognitive impairment
  • Delirium
  • Falls
  • Fractures
  • Motor vehicle crashes

Risks in Pregnant or Nursing Women

Women who are pregnant or who may become pregnant are often strongly discouraged from taking chlordiazepoxide because studies show that chlordiazepoxide can cause birth defects. Risks are more pronounced during the first trimester of pregnancy and chlordiazepoxide should be avoided during that time. The choice of whether or not to take a benzo during pregnancy or while nursing involves weighing the risks of taking the medication against the risks of abstaining from it. Many anti-anxiety medications exist, and women should discuss these alternatives with their doctors.

It is also advised that women who are nursing should avoid using chlordiazepoxide because the drug can be passed to infants via breast milk.

Risks in Treating Alcohol Withdrawal

Chlordiazepoxide is often prescribed to treat alcohol withdrawal syndrome or AWS and can help people avoid AWS symptoms like tremors or seizures. However, as a controlled substance, chlordiazepoxide needs to be closely monitored in people suffering from AWS because they may be more likely to develop a dependence on the drug.

Because both chlordiazepoxide and alcohol are central nervous system depressants, they can have additive effects and may cause excessive drowsiness, dizziness, slowed breathing, coma and death.

Librium Abuse Potential

When you take chlordiazepoxide, it acts on the central nervous system and slows down brain activity. This can relieve anxiety and give you a sense of calm, relaxation and well-being. However, as a controlled substance, the drug can be misused, often in conjunction with other substances.

Risks of Dependence

Physical dependence can occur in anyone who takes chlordiazepoxide, even when the drug is taken as prescribed. Stopping the drug when you are physically dependent can cause withdrawal symptoms like:

  • Convulsions
  • Tremor
  • Abdominal pain
  • Muscle cramps
  • Vomiting
  • Sweating

To avoid withdrawal in instances where long-term treatment is needed, the FDA recommends that doctors taper down chlordiazepoxide doses toward the end of a person’s treatment in order to allow the body to adjust safely.

Signs of Misuse

Some of the signs of chlordiazepoxide addiction include taking it every day, focusing on acquiring it and continuing to take it even when negative consequences occur. It can also be a sign of addiction if you seem to have lost control over the drug, or you try to stop and can’t.

Other side effects of Librium addiction and warning signs include:

  • Combining it with alcohol or other drugs to maximize the effects
  • Experiencing cravings
  • Letting responsibilities suffer
  • Feeling like you can’t live your life normally without the drug
  • Doing risky things while taking chlordiazepoxide, like driving
  • Taking larger doses than you’re prescribed

Why Is Librium Abused?

Chlordiazepoxide is a long-acting drug that reaches its peak in the body within hours, unlike other anxiety drugs like antidepressants that can take weeks to have an effect. Generally, when drugs work quickly and create good feelings, they have a potential for abuse.

People may abuse chlordiazepoxide because they want a fast way to relieve stress, or because they need an outlet to escape their everyday life. In some cases, people consider its sedative effects as a high that they want to achieve.

Other reasons people may abuse chlordiazepoxide include the desire to self-medicate during substance withdrawal, to manage their feelings when they come down from cocaine, to increase the high from opioids or to amplify the effects of alcohol.

Librium Addiction

An addiction to chlordiazepoxide is different from physical dependence. Physical dependence happens when your brain and body become used to the drug’s presence, and if you stop taking it suddenly, you experience withdrawal symptoms. Dependence can occur with or without addiction. Addiction occurs when people take chlordiazepoxide despite negative consequences like the loss of friends or family or even legal troubles.

If you think you may have a chlordiazepoxide addiction or physical dependence, you should seek professional help. The sooner you can seek help for chlordiazepoxide addiction, the sooner you can begin a new life without the drug. Our team at The Recovery Village has expertise in helping people overcome chlordiazepoxide addiction and can help you take the first steps towards a better future. Contact us today.

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Editor – Rob Alston
Rob Alston has traveled around Australia, Japan, Europe, and America as a writer and editor for industries including personal wellness and recovery. Read more
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Medically Reviewed By – Dr. Jessica Pyhtila, PharmD
Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more

U.S. National Library of Medicine. “Chlordiazepoxide.” March 31, 2019. Accessed September 13, 2020.

American Geriatrics Society Beers Criteria® Update Expert Panel. “American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults.” 2019. Accessed September 13, 2020.

Kang, Michael; Galuska, Michael A.; Ghassemzadeh, Sassan. “Benzodiazepine Toxicity.” StatPearls, July 1, 2020. Accessed September 13, 2020.

National Library of Medicine. “Commonly Prescribed Antidepressants and How They Work.” NIH MedlinePlus Magazine, March 31, 2020. Accessed September 13, 2020.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.