Chlordiazepoxide 83withdrawal. An experiment found chlordiazepoxide to be as effective asmeth-
adonein easing opiate withdrawal symptoms experienced byheroinaddicts.
Drawbacks.Chlordiazepoxide is one of the longer-lasting benzodiazepines,
which can have advantages—but it can also have disadvantages; for example,
the drug is associated with higher chance of hip fractures in older persons,
perhaps because it makes them unsteady longer and more likely to fall.
Blood disorders can be an unusual unwanted effect, and a case is reported
in which long-term use produced purpura, tiny purple spots in the skin
caused by bleeding under the skin surface. Although the drug is used to re-
lieve anxiety, studies conflict on whether it increases users’ hostility. The drug
reduces aggression in animal experiments, and human aggression is certainly
not a typical result of a dose; perhaps lowered anxiety among resentful per-
sons also lowers inhibitions, allowing those angry individuals to engage in
aggression they had been afraid to attempt. That outcome is more likely when
a person using chlordiazepoxide has also been drinking alcohol, and alcohol
definitely can lower inhibitions. Chlordiazepoxide can make people weary,
degrade verbal communication ability, and raise or lower interest in sex.
Among alcoholics, measurements find that chlordiazepoxide reduces rapid
eye movement (REM) sleep and delta (deep) sleep; those types are considered
important for maintaining normal mental functioning. A case report indicates
that the substance may worsen symptoms of Parkinson’s disease, possibly due
to untoward reaction with the Parkinson’s drug levodopa. Another case report
notes a diabetic whose blood sugar levels rose substantially while taking chlor-
diazepoxide. An instance is known of continual hiccups starting soon after a
person started taking the drug and stopping soon after the drug dosage
stopped. Still another case report associated the drug with gout.
Persons who receive chlordiazepoxide by injection should avoid hazardous
activity (such as driving a car) for several hours; a test of the oral format
showed that it lowered driving ability as well. Drivers can be unaware that
chlordiazepoxide is affecting them. A study of bronchitis patients found that
the drug worsened their breathing, and in general the compound impairs
respiration. Chlordiazepoxide is also suspected of worsening porphyria, a dis-
ease involving body chemistry and that makes a person extremely sensitive
to light. Porphyria caused the madness of George III, king of Great Britain
during the American Revolution.
Abuse factors.Sudden stoppage of chlordiazepoxide dosage can produce
symptoms similar to those of alcohol or barbiturate withdrawal: tremors and
cramps, vomiting, perspiring, and even convulsions.
Drug interactions.When delta-9-tetrahydrocannabinol (also called THC, the
main psychoactive chemical inmarijuana) was given to pregnant mice in an
experiment, administering chlordiazepoxide along with THC raised the blood
level of THC. Another mice experiment showed an increase in THC’s catalep-
tic effect when chlordiazepoxide was administered. In mice chlordiazepoxide
can increase potency of the anticancer drug ifosfamide, and in both mice and
humans alcohol can boost chlordiazepoxide’s potency (though a rat experi-
ment did not find that effect). In humans monoamine oxidase inhibitors
(MAOIs) boost chlordiazepoxide actions, and the antacid-heartburn medicine
cimetidine lengthens the effect of a chlordiazepoxide dose. Cigarette smoking