Chlordiazepoxide Withdrawal Help and Medications
Symptoms of chlordiazepoxide withdrawal can include anxiety, insomnia, restlessness, and seizures.
Chlordiazepoxide is the generic name for a benzodiazepine medication known by the brand name Librium. It is prescribed to treat anxiety symptoms and alcohol withdrawal, but like other benzodiazepines (benzos), chlordiazepoxide use can lead to abuse, addiction, and dependence.1,2
In people dependent on chlordiazepoxide, ending or reducing use can trigger withdrawal symptoms. People should not attempt to stop taking chlordiazepoxide on their own. The withdrawal symptoms can be severe and even fatal.8
Professional detox can help manage withdrawal symptoms and increase safety. But it is only the first step in recovery.3 Ongoing treatment can improve the chances of sustained sobriety. Medications used in withdrawal treatment may include antidepressants, anticonvulsants, and long-acting benzodiazepines such as Valium.
Treatment Options for Chlordiazepoxide
Chlordiazepoxide withdrawal treatment is available in several different settings, each with a different intensity and duration. Factors that can determine which type of setting is best for the person include:
- Adequate transportation.
- History of seizures.
- Previous episodes of complicated withdrawal.
- Mental health or medical conditions.
- Support system.4
Potential help for chlordiazepoxide withdrawal includes:3,4,5
- Detox centers. These are treatment facilities that help people get through the withdrawal phase. They do not usually provide treatment beyond detox. Many people begin some form of addiction treatment after they detox.
- Inpatient/residential centers. Generally, inpatient/residential refers to any location that provides housing as well as treatment. These programs offer 24-hour care and medical attention as needed. They are usually intensive and very structured, and they can last anywhere from a few days to a year. Luxury and executive inpatient options are tailored to people who desire certain features in treatment, such as massage, horseback riding, and Internet-connected workspaces.
- Outpatient. Outpatient treatment options allow the person to live at home, work, and care for their other responsibilities during treatment. Depending on the level of care needed, the person in recovery can attend treatment for an hour weekly or more if in a higher level of care such as:
- Partial hospitalization programs (PHP) – the highest level of outpatient that offers treatment for roughly 4-6 hours per day, 5 days per week.
- Intensive outpatient programs (IOP) – a lower level of care that consists of roughly 3-hour sessions twice or more weekly.
Whether the treatment occurs in an inpatient/residential setting or an outpatient setting, it will begin with detoxification from chlordiazepoxide and managing withdrawal symptoms and cravings. Once the person has detoxed, they can start addiction treatment, which usually consists of individual and group therapy, addiction education, and relapse prevention training.
Withdrawal Medications for Chlordiazepoxide
According to the National Institute on Drug Abuse, medications are used during 80% of all detoxifications to limit withdrawal symptoms.3 When withdrawal symptoms are mild or not severe, the person will have less desire to use drugs.
With chlordiazepoxide and other benzodiazepines, several medications might be used during withdrawal treatment, including:4
- Anticonvulsants, like carbamazepine, to help reduce the risk of seizures and other dangerous withdrawal symptoms.
- Clonidine and sedating antidepressants, like trazodone, to improve comfort and limit other withdrawals.
- Phenobarbital or diazepam (Valium) – phenobarbital, a long-acting barbiturate, or diazepam, a long-acting benzodiazepine, can replace chlordiazepoxide prior to carrying out a tapering protocol (see next section).
Tapering Off Chlordiazepoxide
Tapering can include gradually smaller doses of chlordiazepoxide or another medication. Though chlordiazepoxide withdrawal medications can be helpful in some situations, the safest way to treat chlordiazepoxide withdrawal is for a healthcare professional to give the medication in smaller doses over time.6 This taper allows the person to wean off chlordiazepoxide slowly, which reduces the discomfort of withdrawal.
A taper is usually performed in one of two ways:
- Chlordiazepoxide taper – The healthcare professional gives gradually decreasing doses of chlordiazepoxide over a period of time.
- Replacement medication taper – A healthcare provider first replaces chlordiazepoxide with a long-acting medication such as phenobarbital or diazepam (or, potentially, some other long-acting benzodiazepine) and then gradually decreases the dose of the replacement medication over time.
The timeline for this process is based on the person’s withdrawal symptoms. Acute benzodiazepine withdrawal syndrome is potentially severe, so it is recommended to only taper off chlordiazepoxide under the supervision of a medical provider experienced in addiction.4,6
Detoxing Cold Turkey at Home
Some people may consider detoxing “cold turkey” at home by abruptly ending all chlordiazepoxide use. This process is not recommended.4,8 Without medical treatment and professional supervision, there is a greater risk of intense and lasting withdrawal symptoms. Some symptoms can be life-threatening.8 Symptoms of chlordiazepoxide withdrawal may include:1,4,6
- Inability to sleep.
- Low/ depressed mood.
- Poor attention and memory.
- Muscle tension.
For people using chlordiazepoxide at recommended doses, the process will likely still be uncomfortable.
Issues that make detoxing from chlordiazepoxide at home problematic include:6,7
- The inconsistency of symptoms. Rather than steadily worsening and then gradually improving, benzo withdrawal symptoms can fluctuate wildly, leading to more dangerous and unpredictable situations.
- The reemergence of mental health symptoms. If the person used chlordiazepoxide to treat anxiety, it is likely that anxiety will return with increased severity during and following withdrawal.
- The use of self-medication. People in withdrawal may self-medicate to relieve symptoms. By consuming alcohol or other drugs, they may begin another addiction.
- The risk of relapse. When someone has strong withdrawal symptoms, they may be tempted to start using chlordiazepoxide again. A relapse will only treat symptoms temporarily, though.
Detoxing and withdrawing from chlordiazepoxide can help ensure a safe and successful recovery.8 Call 1-888-935-1318 to speak to a representative about treatment options for benzodiazepine abuse, addiction, and dependence.
. Drug Enforcement Administration. (2013). Benzodiazepines.
. Center for Substance Abuse Research. (2013). Benzodiazepines.
. National Institute on Drug Abuse (NIDA). (2016). Drug Facts: Treatment Approaches for Drug Addiction.
. Substance Abuse and Mental Health Services Administration. (2015). Detoxification and Substance Abuse Treatment.
. World Health Organization. (2009). Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Setting.
. Substance Abuse and Mental Health Services Administration. (2010). Protracted Withdrawal.
. NIDA. (2014). Research Report Series: Misuse of Prescription Drugs.