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Librium (Chlordiazepoxide) Side Effects, Withdrawal and FAQs

Librium, developed at Hoffmann-La Roche Inc., became the prototype for the numerous benzodiazepine compounds that followed.
Still considered one of the safest in its class, it is prescribed for the relief of anxiety, and is used in withdrawal from alcohol and other sedatives.

Librium has been in use since its approval by the FDA in 1960. It heralded in a new age of tranquilizers, replacing earlier barbiturates. Initially, benzodiazepines were promoted as less addictive and causing less cognitive impairment than its predecessors. Soon after the release of Librium and the offshoots, however, it became increasingly clear that benzodiazepine drugs are also high risk for dependency and addiction, and because of this, the drug is not free of side effects as was originally hoped.

These and other topics, including withdrawal information and other frequently asked questions about Librium are further outlined below.

What is Librium (Chlordiazepoxide) Used For?

Librium is used in acute alcohol withdrawal and as a bridge medication for cessation from some other sedatives. It is also used as a pre-surgical sedative to reduce apprehension and fear.

The drug is also prescribed for the short term relief of anxiety and longer term management of anxiety disorders, because of its sedative and hypnotic effects.

The drug is not FDA recommended for children under the age of 6.

Librium (Chlordiazepoxide) Alternative Names and Slang

The generic drug name for Librium is chlordiazepoxide.

Librium and other benzodiazepines have developed a fairly common presence on the street, possibly due to their usefulness in easing withdrawals from other street drugs, producing a euphoric and relaxation effect. The drug has acquired nicknames such as benzos, heavenly blues, Z bars, goofballs, tranx, sleepers, valley girls, “blue bombs”, and others.

Librium (Chlordiazepoxide) Side Effects

Librium is a potent CNS depressant, producing a calming effect. In clinical trials using monkeys, hostile monkeys were made tame with low doses of Librium, without sedative effects. The drug reportedly reduced aggression and fear in these monkey trials. The same experiment yielded similar results when performed on mice.

If adverse effects do emerge your physician may suggest reducing the dosage. For life-threatening adverse effects, emergency treatment is required, including arranging immediate transport, by ambulance if needed, to the nearest hospital.

Some of the possible side effects include:

  • Dizziness
  • Fatigue
  • Nausea, vomiting
  • Slurred speech
  • Loss of balance, i.e., trouble walking
  • Headache
  • Rash
  • Constipation
  • Swelling
  • Depression
  • Loss of libido

Librium (Chlordiazepoxide) Withdrawal Symptoms

As with all benzodiazepines, there may be some extreme withdrawal adverse effects, especially if the drug is abruptly stopped. These are similar to coming off chronic alcohol use or barbiturates, and include:

  • Convulsions
  • Tremors
  • Stomach cramps
  • Sweating
  • Vomiting
  • Dysphoria
  • Insomnia
  • Excitability
  • Restlessness
  • Changes in appetite
  • Blurred vision

Discontinuing/Quitting Librium (Chlordiazepoxide)

The FDA recommends not to abruptly stop taking Librium, but to gradually reduce the dosage over a period of time to avoid these harsh adverse effects. (1)

The half life of the drug is anywhere from 24 to 48 hours, which is considered very long for a benzodiazepine.

Librium is a a benzodiazepine, and like all benzos, should not be stopped cold turkey, unless there is sound medical reasoning. An abrupt discontinuation could result in seizure. There may be the possibility that overestimation as a result of a fast or abrupt cessation could damage the n-MDA receptors, and result in a long term experience of protracted withdrawal.

The most reasonable approach to stopping Librium is to do a gentle taper with medical supervision. Sometimes a residential rehabilitation setting can be warranted as Librium tapering can be completed and often painful, especially when poorly handled. The importance of choosing a facility where staff are experienced with Librium withdrawal cannot be overstated.

Withdrawal symptoms can last week to significantly longer. Some patients report protracted withdrawal symptoms lasting even years, especially without proper treatment. Patients reporting protracted withdrawal express feelings of anxiety and other symptoms similar to those of early withdrawal. One predominant theory is that this might be due to damaged receptors. Another suspected etiology we have seen clinically is the ongoing effects of a body burden of neurotoxic poisoning. It is common for these individuals to be misunderstood, and subjected to doubt by family, friends and even medical providers. Unfortunately, they tend to be further pathologized and often disregarded. It is likely that mainstream viewpoints need to shift and take a deeper look at what these damaged people are truly experiencing and offer them hope and guidance, rather than abandonment.

Librium (Chlordiazepoxide) FAQs

Before starting or stopping any benzodiazepine drug, it is wise to thoroughly research the drug as much as possible so the decision is made based on adequate information.

Below, we have outlined some information for some of the most frequently asked questions about Librium including how it works, drug testing, overdose, side effects, withdrawal effects, and other important topics.

How Does Librium Work?

Librium is a benzodiazepine. All drugs in this class primarily influence the neurotransmitter called GABA, or gamma-aminobutyric acid. GABA is the most potent and prevalent of all human and vertebrate neurotransmitters. It is an inhibitory transmitter, which regulates or dampens excitatory neuron activity in the brain and elsewhere, acting somewhat as a natural tranquilizer.

Librium allows more GABA to bind to certain receptors, enhancing these calming effects.

Does Librium Show Up on Drug Tests?

Several different factors can determine how long Librium will show up on a drug test. Certain tests are not designed to detect Librium, and will not show any results even if Librium was taken a day before the test.

Other tests, such as a urine test, can detect Librium for up to six weeks after the drug was ingested. A blood test will show a result up to 48 hours after taking Librium. Saliva tests may test positive for up to 6 day, and a hair follicle test will show positive results for Librium for up to 90 days.

What’s the Difference between Librium and Xanax?

There are probably more similarities than differences between these two drugs. Both are benzodiazepines, producing similar side effects and withdrawals. Both are recommended only for short term use, due to the high risk for addiction and dependence.

However, Librium is different from Xanax and also other benzodiazepines due to its slower action. Librium will start to kick in from an hour to two hours, and reaches peak plasma levels at about 4 hours. Xanax goes into effect more quickly, peaking between one and two hours. Librium has a longer half-life of 24 to 48 hours, compared to Xanax which has a much shorter half-life, from 6 hours up to 20 hours.

Intramuscular use of Librium will start to take maximal effect in about 15 to 30 minutes, and will gradually wear off over the next 4 to 5 hours. For convenience, it is usually administered orally.

Dosage is different as well. Librium comes in 5 mg., 10 mg., and 25 mg. oral tablets or capsules. Xanax comes in tablets that range from .25 mg up to 2 mg.

Can You Overdose on Librium?

Yes. Like all sedatives Librium can cause the heart and breathing to slow to dangerous levels, or stop completely.  Over-sedation occurs more commonly when Librium is mixed with alcohol, opiates, or other sedative agents.

Can Librium Cause Heart Problems?

Librium is associated with a heart disorder called bradycardia, or sinus bradycardia. The sinus here refers to the pacemaker part of the heart (not the nasal cavity). In athletes and healthy young persons, 60 bpm is not necessarily an unhealthy heart rate. However, in some people it can be problematic, especially where it drops to 50 bpm or lower. (2)

Symptoms of bradycardia include:

  • Slowed heart beat of less than 60 bpm
  • Syncope (near-fainting, or fainting)
  • Shortness of breath
  • Chest pains
  • Dizziness
  • Fatigue
  • Memory problems
  • Confusion
  • Easily tired

What Medications can Librium Interact With?

There are about 900 known medications that can interact with Librium and may cause adverse effects as a result. Some of the common medications to avoid if you are taking Librium include:

  • Other benzodiazepines, such as Valium, Klonopin, Xanax, Ativan, etc.
  • Antidepressants including Prozac
  • Opiates including methadone, Norco, Oxycodone, etc.
  • Antipsychotics such as Abilify, Seroquel, etc.
  • Alcohol
  • Aspirin
  • Melatonin
  • Benadryl
  • Ibuprofen
  • Naltrexone
  • And hundreds of others.

Always seek medical guidance and advice before drinking alcohol, or combining any other drug while you are taking Librium.

If Librium is a Drug that is Addictive, How Is It Used to Treat Addiction?

Benzodiazepines are often used for alcohol withdrawal to prevent seizures. After several days, Librium is tapered gently to zero. If a person takes benzodiazepine drugs for more than a week or two, addiction or Librium abuse syndrome, will likely set in, requiring assistance safely come of the benzodiazepine drug. (5)

Treatment for Librium (Chlordiazepoxide) Abuse and Addiction?

One rather interesting correlation can be seen where certain genetic dispositions fail to be able to clear environmental toxins, particularly neurotoxins. Certain poisons, like various organophosphate pesticides and heavy metals like Mercury, have the ability to bottle up in those who are genetically susceptible and cause neuronal havoc. (6) (7)

Even popular food additives such as MSG and aspartame have been associated with neuronal excitotoxicity. (8)

There are many thousands of these toxic chemicals in our environment that create damage to our central nervous system, including the brain, hormones, organs, reproductive systems, and neurochemistry. Certain practices such as environmental medicine believe that lessening this toxic body burden can help the body and brain find balance. One key component of the Alternative to Meds Center program involves testing for and assisting in the removal of this toxic body burden.

The Alternative to Meds Center is an inpatient treatment center that specializes in withdrawal and recovery from prescription drugs, and to help patients who are seeking improvements to their natural mental health without focusing on labels or relying on prescription drugs.

Benzodiazepines can be particularly problematic for some due to their severe side effects, and the length of time these can persist. We have developed programs to address benzodiazepine dependence in ways which can significantly ease the process, without adding more addictive drugs into the process. Each client’s situation is unique and needs the guidance of an experienced, trusted team of medical staff to develop and implement the exact strategies for the individual.

Witnessing a loved one struggling through such challenges can impose significant and even emotionally painful challenges on to the family. Deciding on  inpatient care can ease the situation both for the family members, and for their loved one, allowing them to focus more fully on their recovery.

We have helped thousands of our clients to taper from medications in a safe and comfortable setting. Also, bridging across to the many alternative therapy choices in the center can also reduce discomfort and accelerate healing.  We help our clients focus on natural sustainable mental health.

Please contact us for more information on the programs we offer that could provide safe passage through the withdrawal from Librium, and improved health through the comprehensive recovery process.


This content has been reviewed, and approved by a licensed physician.

Dr. Michael Loes, M.D.

Dr. Michael Loes is board certified in Internal Medicine , Pain Management and Addiction Medicine. He holds a dual license in Homeopathic and Integrative Medicine. He obtained his medical doctorate at the University of Minnesota, Minneapolis, MN, 1978. Dr Loes performed an externship at the National Institute of Health for Psychopharmacology. Additionally he is a well published author including Arthritis: The Doctor’s Cure, The Aspirin Alternative, The Healing Response and Spirit Driven Health: The Psalmist’s Guide for Recovery. He has been awarded the Minnesota Medical Foundation’s “Excellence in Research” Award.

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