DESCRIPTION / DEFINITIONS: Librium is the brand name for Chlordiazepoxide, a benzodiazepine prescribed primarily for severe anxiety and acute alcohol withdrawal.
ABUSE: Librium is a Schedule IV drug – meaning it has a legitimate medical use and is prone to abuse, although less so than drugs in Schedules I through III. However, even though it is not as abused as opioids – including fentanyl, hydrocodone, hydromorphone, and morphine, which are schedule III – it is still commonly abused.
ADDICTION / DEPENDENCE: Abusing Librium, meaning taking too much of it or for too long, can easily lead to dependence and/or addiction. Three to four weeks is the maximum time period recommended for using Librium.
SIDE EFFECTS: Side effects include: blunting of emotions, blurred vision, confusion, constipation, coordination problems, decreased libido, depression, facial twitching and more. See more complete list below.
WITHDRAWAL SYMPTOMS: Withdrawal symptoms can include abdominal cramps, convulsions, exhaustion, insomnia, paranoia, and tremors. See more complete list below.
TREATMENT: Treatment should be done under the care of a medical professional. A medical detox facility can get you through withdrawal safely and comfortably. Call us to talk to a Novus Detox Advisor.
Librium is the brand name for Chlordiazepoxide, a benzodiazepene prescribed primarily for severe and disabling anxiety, acute alcohol withdrawal and tremors.
Librium is actually the benzodiazepine prototype – the first benzodiazepine developed and the basis for all others. Librium was discovered accidentally in 1957 when scientists trying to create an artificial dye became aware of their creation’s medicinal properties.
Librium is supposed to be prescribed for severe and disabling anxiety, but only for a period of two to four weeks, although it is sometimes prescribed for longer term management of anxiety ‘disorders’. It is also prescribed for acute alcohol withdrawal syndrome.
Librium acts on the nervous system more slowly than some of the more modern benzos – Xanax, for example. Librium stays in the body a lot longer, and is effective for a lot longer than Xanax. Although Librium kicks in within about an hour, it doesn’t reach its peak level of effectiveness for several hours. The effect of Xanax, by comparison, is basically over in about four hours.
Librium is not intended for long-term use, partially because of its high potential for abuse. Abuse generally consists of taking more Librium than prescribed, for a longer period of time, or taking it in a way that it should not be taken – crushing it and snorting it (quickly inhaling it through the nose), for example.
When you consider the effect Librium can have – taking someone from feeling really anxious, fearful, and physically and mentally tense to feeling calm, enthusiastic, confident, and motivated, there’s no question why someone would want to continue taking it when the initial prescription is expired.
But along with those good feelings comes a long list of side effects that could make your problems worse and bring on many new problems. See more in the ‘side effects’ section below.
Abuse sometimes takes the form of combining Librium with barbiturates (sedatives), opioids (painkillers), or alcohol. These combinations are sometimes even prescribed by doctors. And they can lead to overdose, and death.
Long-term use of benzodiazepines like Librium can lead to dependence as well as addiction. One can build up a physical tolerance for the drug – meaning they will gradually need more and more of the drug to get the same effect. This can lead to further dependence. Plus, when you stop using them suddenly after having used them for a few weeks at the prescribed dose, you can experience withdrawal symptoms – some of which can be severe, and even medically dangerous.
When one decides to stop taking Librium, the withdrawal symptoms can lead a person to change their mind so they don’t have to suffer. Withdrawal symptoms can be scary and create anxiety and fear, the very problems the person was trying to address with the drug. See more about the withdrawal symptoms below.
These problems – along with feeling so much better on the drug than off – can lead to addiction.
But, as with abuse, the chances of experiencing negative and potential dangerous side effects increase when one becomes dependent or addicted.
HALF LIFE AND METABOLISM
The biological half-life of a substance is the time it takes for a drug to lose half of its pharmacologic activity. This is significant because it affects how soon withdrawal symptoms may appear.
The half life of Librium is 24 to 48 hours, much longer than most other benzodiazepines. The Xanax half-life, for example, is 6 to 20 hours.
Libirum is metabolized by a group of enzymes in the liver known as the cytochrome (CYPs) P450 3A4 enzymes.
The CYP enzymes are the major enzymes involved in drug metabolism, and since many drugs may increase or decrease the activity of various CYP isozymes, this is a major source of adverse drug interactions, since changes in CYP enzyme activity may affect the metabolism and clearance of various drugs. For example, if one drug inhibits the CYP-mediated metabolism of another drug, the second drug may accumulate within the body to toxic levels, possibly causing an overdose.
The side effects of Librium can be mild or severe depending on how much of the drug a person is taking, for what period of time, and their individual metabolism and sensitivity to the drug. The side effects include:
- blunting of emotions
- blurred vision
- changes in sex drive
- coordination problems
- decreased libido
- difficulty concentrating
- extrapyramidal symptoms – these include dyskinesia (abnormal, uncontrollable, involuntary movements that usually start out as minor shakes, tics, or tremors, usually in someone’s dominant hand or foot.), dystonic reactions (intermittent spasmodic or sustained involuntary contractions of muscles in the face, neck, trunk, pelvis, extremities, and even the larynx.), Tardive dyskinesia (symptoms include stiff, jerky movements of your face and body that you can’t control), Parkinson Disease, akinesia (loss or impairment of the power of voluntary movement), akathisia (a state of agitation, distress, restlessness and the feeling of an urgent need to move), and Neuroleptic malignant syndrome (NMS), a life-threatening idiosyncratic reaction to antipsychotic drugs characterized by fever, altered mental status, muscle rigidity, and autonomic dysfunction.
- facial twitching
- gastrointestinal problems
- impaired mental alertness in children
- impaired mental and/or physical abilities to perform hazardous tasks such as driving a vehicle or operating heavy equipment or machinery
- increased libido
- irregular menstrual periods
- jaundice (yellowing of the skin or eyes) and liver dysfunction
- low blood pressure
- memory loss
- minor menstrual irregularities
- muscle twitching
- paradoxical disinhibition – an unexpected increase in aggressiveness, hostility, impulsivity, or talkativeness in a patient after treatment with a tranquilizing drug, especially a sedative/hypnotic
- shortness of breath
- skin eruptions
- skin rash
- sleep disturbances
- slowed breathing
- slurred speech
- suicidal thoughts
- syncope – loss of consciousness due to a drop in blood pressure
- trouble urinating
- trouble walking
- uncontrolled movements of the eyes
- vision problems
- vomiting weakness
Quitting Librium suddenly can be very uncomfortable, sometimes painful, and medically dangerous, even if you haven’t been taking it for a very long time. It’s recommended to be taken for only two to four weeks. But some experts say you can become dependent or addicted in as little as three weeks.
Here are some of the symptoms you may experience during withdrawal:
- abdominal cramps
- dysphoria – a state of unease or general dissatisfaction with life
- mood swings
- unpleasant dreams
- worsening of the symptoms the drug was used to treat
Quitting Librium should always be done with medical supervision. At times it is best to go to a medical detox facility that can help make withdrawal safe and more comfortable. Call us to talk to a Novus Detox Advisor.