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Chlordiazepoxide

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Chlordiazepoxide

Chlordiazepoxide hydrochloride, sold under the brand name Librium, is a sedative and hypnotic medication of the benzodiazepine class. It is used to treat anxiety, insomnia, and symptoms of withdrawal from alcohol, benzodiazepines, and other drugs. It is also used to discontinue long-term use of other, shorter-acting benzodiazepines due to its long half-life.

Chlordiazepoxide has a medium to long half-life, while its active metabolite has a very long half-life. The drug has amnesic, anticonvulsant, anxiolytic, hypnotic, sedative, and skeletal muscle relaxant properties.

Chlordiazepoxide was patented in 1958 and approved for medical use in 1960. It was the first benzodiazepine to be synthesized, and the discovery of chlordiazepoxide was by pure chance. Chlordiazepoxide and other benzodiazepines were initially accepted with widespread public approval, but were followed with widespread public disapproval and recommendations for more restrictive medical guidelines for its use.

Chlordiazepoxide hydrochloride is indicated for the short-term (2–4 weeks) treatment of anxiety that is severe and disabling or subjecting the person to uncomfortable distress. It is also indicated as a treatment for the management of acute alcohol withdrawal syndrome.

Chlordiazepoxide hydrochloride may be used in chronic benzodiazepine users to discontinue benzodiazepine use. The long half-life means that the patient’s final dose will last several days, making the likelihood of withdrawal symptoms low. Tapering can last months to years.

It can sometimes be prescribed to ease symptoms of irritable bowel syndrome (IBS) combined with clidinium bromide as a fixed dose medication, Librax.

Use of chlordiazepoxide should be avoided in individuals with the following conditions:

Chlordiazepoxide is generally considered an inappropriate benzodiazepine for the elderly due to its long elimination half-life and the risks of accumulation. Benzodiazepines require special precaution if used in the elderly, pregnancy, children, alcohol- or drug-dependent individuals and individuals with comorbid psychiatric disorders.

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