Librium and the Effects of Benzos

Chlordiazepoxide (Librium) is a sedative-hypnotic medication that belongs to a class of drugs called benzodiazepines. The benzodiazepine class includes a number of popular and well-known medications, such as Xanax, Valium, Klonopin, and Ativan, and remains one of the most prescribed classes of drugs.

Sedative-hypnotic medications slow down the functioning of the body’s central nervous system and are useful to treat anxiety, panic, acute stress and sleeping disorders.1

What is Librium?

Chlordiazepoxide was the first-ever benzodiazepine developed when it was synthesized in 1957.2 It was approved by the U.S. Food and Drug Administration as a medication to reduce anxiety and marketed as Librium in 1960.3 Within only a few years, additional benzodiazepines were developed. Benzodiazepines quickly became popular medication for those suffering from anxiety due to an improved safety profile when compared with barbiturates, an older class of sedative-hypnotic medications with similar properties and indications for use.3

Although undoubtedly safer than barbiturates, misuse and abuse of benzodiazepines is commonly seen in individuals with substance use disorders. In 2018, according to the 2018 National Survey on Drug Use and Health, 2.0% of people aged 18 or older reported that they misused benzodiazepines in 2018.4

Misuse of benzodiazepines such as Librium—either alone or combined with other CNS depressants such as alcohol, barbiturates, prescription sleep medications or opioids—can lead to overdose that includes respiratory depression and even coma or death.5

Effects of Librium

The desired therapeutic effect of Librium is a short-term reduction of symptoms of anxiety. Individuals in recovery for alcohol use disorder may also take Librium as it has proven effective in reducing withdrawal symptoms following cessation of alcohol.2,6

Side Effects of Librium

Those who take benzodiazepines, whether as prescribed or for non-medical reasons, can experience various side effects. However, people who struggle with benzodiazepine abuse or addiction are more likely to experience side effects, especially at higher doses.

Common side effects of Librium mirror those of other benzodiazepines:1,5,7

  • Fatigue and sleepiness.
  • Depression.
  • Slurred speech.
  • Uncoordinated movement.
  • Stumbling and falling.
  • Memory problems.
  • Confusion.
  • Nausea.

Individuals are advised not to drive a motor vehicle or operate heavy machinery when taking Librium or other benzodiazepines.6 Drivers who use benzodiazepines are twice as likely to be involved in a motor vehicle crash vs. an unimpaired driver.7

Librium Dependence and Addiction

Prolonged use of benzodiazepines can lead to both tolerance and physical dependence, both of which increase the risk of addiction.2 Tolerance occurs when an individual requires increased doses of a drug to achieve the effects produced at lower doses. Physical dependence occurs when the body adapts to a drug in a way that produces withdrawal effects after cessation or dose reduction.

Addiction is a treatable, chronic medical disease resulting in compulsive behaviors that continue despite harmful consequences.2 There are many options available to treat a Librium or benzodiazepine substance use disorder.


  1. National Institute on Drug Abuse. (2018). DrugFacts: Prescription CNS Depressants.
  2. Miller, S. C., Fiellin, D. A., Rosenthal, R. N., & Saitz, R. (2019). The ASAM Principles of Addiction Medicine, Sixth Edition. Philadelphia: Wolters Kluwer.
  3. Schmitz A. (2016). Benzodiazepine use, misuse, and abuse: A reviewThe Mental Health Clinician, 6(3), 120–126.
  4. Center for Behavioral Health Statistics and Quality. (2019). Results from the 2018 National Survey on Drug Use and Health: Detailed Tables.Substance Abuse and Mental Health Services Administration, Rockville, MD.
  5. Hamilton, R. (2017). Tarascon Pharmacopoeia, 18th Edition. Burlington, Mass: Jones & Bartlett Learning.
  6. Food and Drug Administration. (2016). Librium.
  7. Ahwazi, H. H., & Abdijadid, S. (2019). StatPearls: Chlordiazepoxide.
  8. Hetland, A., & Carr, D. B. (2014). Medications and Impaired DrivingAnnals of Pharmacotherapy, 48(4), 494–506.

About The Contributor

Ryan Kelley, NREMT
Ryan Kelley, NREMT

Medical Editor, American Addiction Centers

Ryan Kelley is a nationally registered Emergency Medical Technician and the former managing editor of the Journal of Emergency Medical Services (JEMS). During his time at JEMS, Ryan developed Mobile Integrated Healthcare in Action, a series... Read More

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