From the Guidelines
Chlordiazepoxide (Librium) is primarily used for the management of alcohol withdrawal syndrome (AWS).
Key Uses
- Treatment of AWS: Chlordiazepoxide is a long-acting benzodiazepine that provides protection against seizures and delirium in patients with AWS 1.
- Symptom relief: It is used to alleviate withdrawal discomfort, prevent and treat seizures and delirium, and provide anxiety relief, sedation, and somnolence via activation of gamma-aminobutyric acid (GABA) 1.
Dosage and Administration
- The recommended dosage of chlordiazepoxide for AWS is 25-100 mg every 4-6 hours, administered orally (PO) 1.
Important Considerations
- Risk of abuse: Benzodiazepines, including chlordiazepoxide, carry a potential risk of abuse, and their use should be limited to the initial 10-14 days of treatment 1.
- Patient selection: Chlordiazepoxide is suitable for patients with AWS, but other benzodiazepines, such as lorazepam, may be preferred in patients with severe AWS, advanced age, or hepatic dysfunction 1.
From the FDA Drug Label
INDICATIONS AND USAGE: Chlordiazepoxide HCI Capsules are indicated for the management of anxiety disorders or for the short-term relief of symptoms of anxiety, withdrawal symptoms of acute alcoholism, and preoperative apprehension and anxiety. Chlordiazepoxide (Librium) is used for:
- Management of anxiety disorders
- Short-term relief of symptoms of anxiety
- Withdrawal symptoms of acute alcoholism
- Preoperative apprehension and anxiety 2
From the Research
Uses of Chlordiazepoxide (Librium)
- Chlordiazepoxide, also known as Librium, is a benzodiazepine used to treat anxiety disorders 3, 4
- It is used to treat "minor forms" (neuroses) of mental disorders, providing effective treatment for anxiety disorders 3
- Chlordiazepoxide is also used to treat alcohol withdrawal syndrome (AWS) 5
- However, its use in the elderly and in patients with liver disease is limited due to its decreased oxidation and potential for accumulation, resulting in excessive sedation and respiratory depression 5, 6
Clinical Indications
- Chlordiazepoxide is not the drug of choice for all clinical indications recommended for the benzodiazepines as a class, particularly for use as an antianxiety agent 6
- Diazepam and lorazepam are preferred choices in acute anxiety because they are themselves active anxiolytics 6
- Oxazepam is recommended in alcoholic cirrhotics because its plasma clearance does not seem to be significantly affected by liver disease 6