Librium Withdrawal Symptoms | Chlordiazepoxide Side Effects, Treatment Help

Last Updated on September 16, 2026 by Diane Ridaeus

Alternative to Meds Editorial Team
Medically Reviewed by Dr Michael Loes MD

Librium Withdrawal Symptoms

As with all benzodiazepines, there may be a range of Librium withdrawal symptoms ranging from mild to more extreme withdrawal adverse effects, especially if Librium is abruptly stopped.^1,16

Librium withdrawal symptoms can include:

• Convulsions, seizures, tremors
• Aggravation of psychosis
• Depression
• Stomach cramps
• Sweating
• Nausea, vomiting
• Dysphoria — a combination of symptoms such as discontent, resentment, irritability ²⁰
• Insomnia
• Excitability, agitation
• Restlessness
• Changes in appetite
• Blurred vision

Learn About Librium Being Discontinued in 2021

Librium was the first benzodiazepine marketed.  Librium was FDA-approved in 1960 and became the prototype for the numerous benzodiazepine compounds such as Valium that followed. In 2021 the brand name Librium was discontinued presumably after patent  expiration, though we are still looking for confirmation and any related details. The generic equivalent benzodiazepine is called chlordiazepoxide and is still prescribed in certain instances.¹

Librium heralded a new age of benzodiazepine tranquilizers, replacing earlier barbiturates that had gained great concern over safety issues. Initially, benzodiazepines were promoted as less addictive and causing less cognitive impairment than their predecessors. Soon after the release of Librium and the offshoots, however, it became increasingly clear that benzodiazepine drugs can also put a person at high risk for dependency and addiction. Because of this, we see that Librium is not free of side effects as was originally hoped.

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

What Is Librium (chlordiazepoxide) Used For?

Librium is approved for short-term anxiety relief. The drug label stipulates it should not be taken for more than 4 months.¹ However, other recommendations caution us that benzodiazepines be taken for several weeks at most. The guidelines proposed by Ashton recommend using benzodiazepines for a few days to a few weeks at maximum.¹⁴

Off-label uses for Librium include 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. These would be short-term uses and would be in accord with the recommendations noted above.

Over the past 50 years, Librium has been used off-label to treat various disorders such as chemotherapy-associated nausea and psychogenic catatonia. According to research by Benjelloun et al., catatonia and NMS are thought to be possibly related disorders, and the authors also suggest these conditions may be a result of a “dopamine deficiency.” Because GABAergic drugs such as benzodiazepines are thought to influence dopamine receptor sin various ways, this may explain at least in part, why some cases of NMS disorders are caused by neuroleptic (extremely sedating) drugs and why other cases may receive the same drugs therapeutically to alleviate these types of disorders. These cases tell us that there is much yet to be discovered about how to safely use benzodiazepines and other neuroleptic drugs as valid therapeutics.^11-13

The drug is not FDA recommended for children under the age of 6.¹

The use of Librium during pregnancy has not been studied.¹⁸

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 perceived usefulness in easing withdrawals from other street drugs, producing a euphoric and relaxation effect. Benzodiazepines have acquired many nicknames as street drugs, such as benzos, heavenly blues, bars, goofballs, nomies, tranx, sleepers, valley girls, “blue bombs,” for example.

Librium (chlordiazepoxide) Side Effects

Librium is a potent CNS depressant, producing a sedating, calming effect in human subjects. 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.^1,15

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

Librium side effects include:

• Sedation
• Mania, hyperexcitability, nervousness
• Hallucination
• Dizziness
• Fatigue, weakness
• Depression
• Confusion
• Memory impairment
• Nausea, vomiting
• Slurred speech
• Hyper-salivation
• Dry mouth
• Ataxia — loss of balance, trouble walking, speech difficulties
• Headache
• Rash, skin eruptions
• Constipation
• Swelling
• Depression
• Loss of libido
• Menstrual issues
• Hypotension
• Weight gain
• Blood disorders
• Slowed respiration
• Renal dysfunction

Coming Off Librium and Other Drugs Safely

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. These recommendations apply to virtually all drugs. Clinical trials published in the Journal of Psychopharmacologia show that abrupt Librium withdrawal is not advised because of patient safety issues.¹⁶

The half-life of the drug has been shown to vary anywhere from 7 to 52 hours, which is relatively long for a benzodiazepine.  Data cited from Heather Ashton’s work and others, notes the active metabolite in the drug has a half-life of up to 200 hours.²⁹  The dosage strength, how long it has been taken, and the presence of liver impairment are factors that influence the half-life elimination rates, as related to the accumulation and elimination rates of metabolites in the system.¹⁷

Librium should not be stopped cold turkey unless there is a sound medical reason for doing so. In the case of life-threatening adverse reactions, Librium cessation would best be done in a hospital setting. Abrupt discontinuation could result in seizures and other health issues, as noted above. In most other cases, protracted (harsh, long-lasting) withdrawals may result from abrupt cessation, possibly due to neuron damage.¹⁴

The most reasonable approach to stopping Librium is to do a gentle and gradual reduction with medical supervision. Sometimes a residential rehabilitation setting can be warranted as Librium withdrawal can often be painful, especially when adjunct therapies are not provided. The advantages of choosing a facility where the staff members and caregivers are experienced with Librium withdrawal, and where ample onboard therapies are available, cannot be overstated.

Withdrawal symptoms can last a few weeks to significantly longer. Some patients report protracted withdrawal symptoms lasting even years, especially without proper treatment.

Patients reporting protracted withdrawal may express feelings of anxiety and other symptoms similar to those of early withdrawal.

The literature of Dr. Heather Ashton theorizes that this might be due to damaged receptors.¹⁴

Alternative to Meds Center designs holistic withdrawal programs based on therapies that will promote neurotransmitter rehabilitation as a fundamental for authentic recovery.

Removal of Neurotoxins

Another suspected etiology (cause of illness or symptoms of mental illness) that 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 from family members, 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. Holistic, non-invasive neurotoxin removal is a fundamental pillar of Librium withdrawal at Alternative to Meds Center. Please take a moment to review the protocols used at Alternative to Meds Center. Neurotoxins come in many forms, from pesticides to cosmetics and foods, and we have all been subjected to these exposures, and potentially suffer from symptoms of toxic exposures, that are sometimes misdiagnosed as puzzling mental disorders.²¹

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 based on adequate information.

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

How Does Chlordiazepoxide Work?

Librium is a benzodiazepine. All drugs in this class are thought to primarily influence the neurotransmitter called GABA, or gamma-aminobutyric acid. GABA is the most potent and most prevalent of all human and vertebrate neurotransmitters.¹⁹

It is an inhibitory transmitter, which regulates or dampens excitatory neuron activity in the brain and elsewhere, acting somewhat as a natural tranquilizer and a calming, sleep inducer.

It is thought that benzodiazepines such as Librium allow more GABA to bind to certain receptors, enhancing these calming effects.²²

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 positive result up to 48 hours after taking Librium.¹ A saliva test may register positive for up to 6 days, and a hair follicle test may show positive results for much longer periods post-ingestion. Urine testing is the most common medium used in drug testing, although other tests may use saliva, blood, perspiration, nails, and breath for samples.^23,24

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.^1,14,25

However, Librium is different from Xanax and some other benzodiazepines due to its slower onset of effects. 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.

According to the FDA drug label, 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 5mg, 10mg, and 25mg oral tablets or capsules. Xanax comes in tablets that range from .25mg up to 2mg.

Can You Overdose on Librium?

Yes. Like all sedatives, Librium can cause the heart and breathing to slow to dangerous levels, or stop completely. The FDA put a black box warning concerning taking benzodiazepines concurrently with opiates.¹ Over-sedation can occur when Librium is mixed with alcohol, opiates, or other sedative agents.

Can Chlordiazepoxide 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 when it drops to 50 bpm or lower.²

Symptoms of bradycardia include:

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

What About Drug Interactions?

There are hundreds of known medications that can interact with Librium and may cause adverse effects as a result.^1,26 Some of the medications to avoid if you are taking Librium include:

• Other benzodiazepines, such as Valium, Klonopin, Xanax, Ativan, etc.
• Antidepressants including Prozac
• Opioids 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, and also during Librium withdrawal.

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

Benzodiazepines are often used for a short time in alcohol withdrawal to prevent seizures. After several days, Librium should be 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 more careful assistance to safely come off the benzodiazepine drug.⁵

Librium Withdrawal Protocol

Testing is of prime importance when we are designing an individual’s treatment program. Testing can open the door to treatment opportunities that were perhaps overlooked in the past.

For example, a 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

Extensively used food additives such as MSG and aspartame have been associated with neuronal excitotoxicity, and testing can reveal whether these have significantly accumulated in the body. While there has been controversy and reluctance to publicly conclude whether some food additives are safe or unsafe, research has shown there are valid concerns regarding cancers, CNS disorders, obesity, and other adverse effects that have been linked to food additives such as Aspartame and chronic or extensive use of MSG.^7,8,27

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.

Alternative to Meds Center is an inpatient treatment center that specializes in healthy Librium alternatives and holistic, medically supervised withdrawal protocols to help patients who are seeking improvements to their natural mental health without focusing on labels or relying on prescription drugs. Using holistic methods including orthomolecular diet, supplementation, counseling, equine therapy, cleansing neurotoxin accumulations, IV and NAD therapies, colon hydrotherapy, acupuncture, and many others, individual programs are designed for the best health outcomes possible.

Benzodiazepines can be particularly problematic for some due to their severe side effects, and the length of time these can persist without adequate treatment. We have developed programs to address benzodiazepine dependence using benzodiazepine alternatives that 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.

Individualized Withdrawal Programs at Alternative to Meds Center

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

We have helped thousands of our clients to taper from medications in a safe and comfortable setting. Also, bridging across the many alternative therapy choices, including educational components delivered during the program can also empower one’s confidence, reduce discomfort and accelerate healing. We help our clients focus on natural mental health.

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

1. FDA label LIBRIUM (chlordiazepoxide hydrochloride) Ref ID 4029707 [Internet] N.D. [cited 2022 May 26]

2. eHealth Information Portal, “Will you have Sinus bradycardia with Librium?” compilation of 600+ articles [cited 2022 May 26]

3. Gillis R, Thibodeaus T, Barr L, “Antiarrythmic Properties of Chlordiazepoxide.” AHA Journals Vol. XLIX [Internet] 1974 Feb [cited 2022 May 26]

4. Eldridge P R, Punt J A, “Risks associated with giving benzodiazepines to patients with acute neurological injuries.” British Medical Journal/ PubMed [Internet] 1990 May 5; [cited 2022 May 26]

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9. Ghiasi N, Bhansali RK, Marwaha R. Lorazepam. [Updated 2021 Feb 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532890/ [cited 2022 May 26]

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11. Benjelloun G, Jehel L, Abgrall G, Pelissolo A, Allilaire J. Syndrome catatonique et syndrome malin des neuroleptiques (à propos d’un cas) [Acute catatonic syndrome after neuroleptic malignant syndrome]. Encephale. 2005 Nov-Dec;31(6 Pt 1):705-9. French. doi: 10.1016/s0013-7006(05)82429-7. PMID: 16462690. [cited 2022 May 26]

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15. Ahwazi HH, Abdijadid S. Chlordiazepoxide. [Updated 2020 Nov 22]. In: StatPearls [cited page published online]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547659/ [cited 2022 May 26]

16. Hollister, L.E., Motzenbecker, F.P. & Degan, R.O. Withdrawal reactions from chlordiazepoxide (“Librium”). Psychopharmacologia 2, 63–68 (1961). https://doi.org/10.1007/BF00429621 [cited 2022 May 26]

17. Greenblatt DJ, Shader RI, Franke K, Harmatz JS. Pharmacokinetics of chlordiazepoxide and metabolites following single and multiple oral doses. Int J Clin Pharmacol Biopharm. 1978 Oct;16(10):486-93. PMID: 700911. [cited 2022 May 26]

18. Armstrong C, “ACOG Guidelines on Psychiatric Medication Use During Pregnancy.” American Family Physician Sept 15 2008 [cited 2022 May 26]

19. Hepsomali P, Groeger JA, Nishihira J, Scholey A. Effects of Oral Gamma-Aminobutyric Acid (GABA) Administration on Stress and Sleep in Humans: A Systematic Review. Front Neurosci. 2020;14:923. Published 2020 Sep 17. doi:10.3389/fnins.2020.00923 [cited 2022 May 26]

20. Moretti P, Bachetti MC, Sciarma T, Tortorella A. Dysphoria as a psychiatric syndrome: a preliminary study for a new transnosographic dimensional approach. Psychiatr Danub. 2018 Nov;30(Suppl 7):582-587. PMID: 30439852. [cited 2022 May 26]

21. Mason LH, Mathews MJ, Han DY. Neuropsychiatric symptom assessments in toxic exposure. Psychiatr Clin North Am. 2013 Jun;36(2):201-8. doi: 10.1016/j.psc.2013.02.001. Epub 2013 Apr 15. PMID: 23688687. [cited 2022 May 26]

22. Haefely W. Benzodiazepine interactions with GABA receptors. Neurosci Lett. 1984 Jun 29;47(3):201-6. doi: 10.1016/0304-3940(84)90514-7. PMID: 6147796. [cited 2022 May 26]

23. Taylor M, Sullivan J, Ring SM, Macleod J, Hickman M. Assessment of rates of recanting and hair testing as a biological measure of drug use in a general population sample of young people. Addiction. 2017;112(3):477-485. doi:10.1111/add.13645 [cited 2022 May 26]

24. McNeil SE, Cogburn M. Drug Testing. [Updated 2021 Mar 16]. In: StatPearls [cited page published online]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459334/ [cited 2022 May 26]

25. FDA Drug label XANAX [cited 2022 May 26]

26. “Librium Interactions” [online] Drugs. com [cited 2022 May 26]

27. Niaz K, Zaplatic E, Spoor J. Extensive use of monosodium glutamate: A threat to public health?. EXCLI J. 2018;17:273-278. Published 2018 Mar 19. doi:10.17179/excli2018-1092 [cited 2022 May 26]

28.  Ahwazi HH, Patel P, Abdijadid S. Chlordiazepoxide. [Updated 2024 Jan 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547659/  [cited 2024 July 1]

29.  Ashton H et al, Benzodiazepine Equivalence Table published online by bcnc.org  April 2007 [cited 2024 July 1]

Originally Published Sep 13, 2018 by Diane Ridaeus

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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Diane Ridaeus

Diane is an avid supporter and researcher of natural mental health strategies. Diane received her medical writing and science communication certification through Stanford University and has published over 3 million words on the topics of holistic health, addiction, recovery, and alternative medicine. She has proudly worked with the Alternative to Meds Center since its inception and is grateful for the opportunity to help the founding members develop this world-class center that has helped so many thousands regain natural mental health.