Chlordiazepoxide
Pronunciation:klor-dye-az-uh-POX-ide
Chemical Abstracts Service Registry Number:58-25-3. (Hydrochloride form 438-
41-5)
Formal Names:Libritabs, Librium, Limbitrol
Informal Names:Libs
Type:Depressant (benzodiazepine class).Seepage 21
Federal Schedule Listing:Schedule IV (DEA no. 2744)
USA Availability:Prescription
Pregnancy Category:D
Uses.Chlordiazepoxide was the first benzodiazepine tranquilizer and has
been commonly used since 1960. It is considered one of the safer psychiatric
drugs and has actions comparable to those of barbiturates andalcohol.
This classic benzodiazepine is used mainly for calming anxiety and for treat-
ing symptoms of alcohol withdrawal, including delirium tremens. Studies
have found, however, that alcoholics receiving this drug to help them through
withdrawal are about three times more likely to resume drinking than alco-
holics who receive a placebo. The substance is also used to overcome convul-
sions and to treat insomnia, migraine headache, gastric ulcers, and irritable
bowel syndrome (persistent cramps and diarrhea). Actions from a dose of this
drug take longer to appear than actions from a dose oflorazepamordiaze-
pam, so those latter substances are sometimes preferred when faster results
are needed.
Researchers have used rats and mice to demonstrate partial cross-tolerance
betweenpentobarbital, alcohol, and chlordiazepoxide, and that relationship
may contribute to the latter’s therapeutic role in treating alcohol withdrawal.
An argument has been made that when clinical signs of alcohol withdrawal
can be treated as well with chlordiazepoxide as with lorazepam, the former
is preferable because of cheaper cost. Chlordiazepoxide can be substituted for
alprazolamto wean someone from that drug, although one study found chlor-
diazepoxide to be about 86 times weaker than alprazolam (consistent with
animal experiments, where large doses of chlordiazepoxide are needed to pro-
duce dependence). Chlordiazepoxide can be used in place of most benzodi-
azepines if someone who stops taking one of those drugs is troubled by