Librium (Chlordiazepoxide) Withdrawal, Detox, And Treatment
Withdrawal from Librium can be very intense, producing symptoms like anxiety, depression, and psychosis. Librium withdrawal is best managed in a medical detox program.
Author Kristen Fuller, MD
Withdrawal From Librium (Chlordiazepoxide)
Librium (chlordiazepoxide) withdrawal occurs when a person who is dependent on chlordiazepoxide stops taking this prescription medication or abruptly reduces their dosage. Chlordiazepoxide is a benzodiazepine, and withdrawal from this class of drugs can cause dangerous withdrawal symptoms, including seizures. While the brand name Librium is no longer available, the drug is still available under its generic name, chlordiazepoxide.
When a person becomes dependent on chlordiazepoxide, the brain becomes rewired, hijacking the brain’s natural reward (dopamine) system and changing how GABA neurotransmitters respond.
Chlordiazepoxide acts on the GABA neurotransmitter system in the brain. This inhibitory system slows or reduces nervous system activity, which is why people feel relaxed and happy after taking chlordiazepoxide. Over time, the body and brain become reliant on chlordiazepoxide to feel this way.
When chlordiazepoxide is abruptly stopped or reduced, the sudden discontinuation of GABA inhibitory effects results in an overall excitatory state, resulting in withdrawal symptoms, including agitation and increased heart rate. The person will continue to experience these excitatory withdrawal symptoms until their brain readjusts to a pre-chlordiazepoxide level of functioning.
Fortunately, a medical detox program can assist with the withdrawal process, making it safer and more comfortable.
Symptoms Of Withdrawal
Chlordiazepoxide withdrawal can be extremely uncomfortable. Symptoms can range from moderate to severe depending on various factors, such as the length of time chlordiazepoxide has been used, the amount used, other substances used, and the method of administration.
Generally, the longer and more severe the chlordiazepoxide dependency, the longer and more severe the withdrawal process.
Chlordiazepoxide withdrawal symptoms include:
- Anxiety
- Increased heart rate
- Elevated blood pressure
- Sensory hypersensitivity (hypersensitive to lights, sounds, touch, smell)
- Nausea
- Vomiting
- Loss of appetite
- Sweating
- Hallucinations
- Irritability
- Depression
- Drug cravings
- Seizures
- Psychosis
- Tremors
- Insomnia
Left unmanaged, seizures caused by chlordiazepoxide withdrawal may get progressively worse, difficult to control, and potentially lethal. For this reason, it is critical to attend a medically supervised detox program.
Post-Acute Withdrawal Syndrome
Post-acute withdrawal syndrome (PAWS) consists of longer-term psychological withdrawal symptoms that last for months or even years after the last dose of chlordiazepoxide or other benzos. It is also known as post-withdrawal syndrome, prolonged withdrawal syndrome, or protracted withdrawal syndrome.
PAWS symptoms usually begin at least 3-4 weeks after the initial withdrawal period and consist of the following:
- Persistent anxiety
- Chronic insomnia
- Difficulty performing complex tasks
- Poor concentration
- Distractibility
- Loss of sex drive
- Depression
Rebound Symptoms
Withdrawal from chlordiazepoxide is often accompanied by an intense “rebound effect” or rebound symptoms. This is the re-emergence of symptoms, such as anxiety, that were the reason for being initially treated with chlordiazepoxide.
When chlordiazepoxide is stopped, not only is the person at risk for withdrawal symptoms, but also rebound anxiety symptoms as well, because their initial anxiety symptoms are no longer being treated with medication. In the case of rebound anxiety, symptoms may be more severe than they were before initiating treatment with chlordiazepoxide. The difference between rebound symptoms and withdrawal symptoms is that rebound symptoms are the return of previous symptoms that were in existence before chlordiazepoxide use began. In contrast, withdrawal symptoms are caused by the body struggling to adapt to the cessation of chlordiazepoxide.
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Librium Withdrawal Timeline
| Week 1 | For some people, withdrawal can begin within 24 hours of the last dose. It can take over a week for others to start feeling the effects of withdrawal. The first signs may be the user beginning to feel anxious, start sweating, and noticing an increase in their heart rate. They may also feel agitated and lose their appetite. |
|---|---|
| Weeks 2-3 | Withdrawal symptoms usually peak during this time. Depression and insomnia typically set in, and some users report psychosis and seizures. |
| Weeks 4-6 | Symptoms will fade over the next several weeks, becoming increasingly manageable as time goes on. |
| Weeks 7+ | Some users may continue to feel psychological symptoms, like depression, anxiety, or cravings, for months after quitting Librium. Users may also experience protracted withdrawal, with symptoms such as anxiety suddenly appearing after a period of time without any symptoms. With prolonged abstinence, protracted withdrawal symptoms will eventually subside. |
Which Factors Affect The Duration Of Withdrawal?
Several factors will impact the user’s withdrawal process, including how long they used Librium (chlordiazepoxide), how often, and how high their dosage was.
Because chlordiazepoxide is metabolized in the liver, people with poor liver function or liver disease may have a longer withdrawal period because it will take longer to metabolize chlordiazepoxide and eliminate it from the body.
Chlordiazepoxide is primarily used to treat alcohol withdrawal, so many people taking this medication may have an increased risk of liver damage due to extensive alcohol abuse.
Other factors affecting the duration of withdrawal include age and whether any other medications or drugs are also being used, as these can interfere with the metabolism of chlordiazepoxide. Elimination of the drug from the body also takes longer in elderly users, extending the withdrawal timeline.
How To Detox From Chlordiazepoxide
People who are interested in stopping chlordiazepoxide are advised to complete withdrawal under a doctor’s supervision.
A taper method is the preferred course of treatment for chlordiazepoxide and other benzodiazepines. A tapering program slowly reduces the dosage of chlordiazepoxide over time, allowing the body to gradually adjust to the new dosage and hence minimizing dangerous withdrawal side effects, like seizures.
The tapering process can take several days to several weeks, and some withdrawal symptoms may still occur, but they’ll be much milder.
During the tapering process, a user’s doctor may substitute another long-acting benzodiazepine, such as diazepam (Valium), for chlordiazepoxide to assist with rebound anxiety symptoms and withdrawal symptoms. Other non-benzodiazepine medications may also be used to help manage withdrawal and rebound symptoms. These medications may include:
How Is Librium (Chlordiazepoxide) Addiction Treated?
Chlordiazepoxide addiction is a chronic and progressive disease characterized by prioritizing compulsive drug use over important areas of everyday life, such as work, family, and social obligations. The individual will continue to use drugs despite harmful personal consequences.
Therefore, treatment for a chlordiazepoxide addiction focuses on identifying the underlying triggers that drove the person to begin compulsively using. Once the person has undergone detoxification, they can receive professional psychological therapy to identify their triggers and adopt healthy coping skills to overcome future cravings and urges.
Addiction treatment often includes group therapy and individual therapy with different types of psychotherapy approaches, such as cognitive behavioral therapy, motivational interviewing, and contingency management.
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Find A Treatment Center Today
Receiving professional treatment for chlordiazepoxide addiction at an inpatient treatment center or an outpatient program can offer chlordiazepoxide users a safe and supportive environment for their recovery. Treatment programs that offer medically assisted detox will make withdrawal from chlordiazepoxide more comfortable, increasing the user’s chance of achieving sobriety.
For help finding a Librium treatment program, visit our rehab directory or contact a treatment provider today.
