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Librium Withdrawal Symptoms, Signs & Detoxification

Librium is considered highly addictive and, like all benzodiazepines, can result in physical and psychological dependence. Even after only using Librium for a short amount of time, individuals can still experience undesirable withdrawal symptoms.

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Since Librium is no longer available in the U.S., withdrawal is generally related to its generic form, chlordiazepoxide.

What Is Librium?

Librium (chlordiazepoxide) is a benzodiazepine drug that is used to treat symptoms of alcohol withdrawal as well as anxiety disorder. Although Librium is a discontinued brand name, the generic form of chlordiazepoxide is still available on the market today.

What Is Librium Withdrawal?

The severity of chlordiazepoxide withdrawal symptoms is influenced by genetic factors, dosage and duration of use, and psychological factors. 

Both the body and the brain are affected by chlordiazepoxide. Discontinuing use or reducing the dosage suddenly after a period of sustained use can cause the body and the brain to react in severe ways.

Librium affects the neurotransmitter GABA (gamma-aminobutyric acid). This neurotransmitter produces feelings of relaxation and drowsiness. After prolonged use, an individual’s brain depends on Librium in order to produce this sensation.

As the body and brain go into withdrawal, symptoms of anxiety, increased blood pressure, and increased heart rate often occur.

Understanding Post-Acute Withdrawal Syndrome for Librium

Post-acute withdrawal syndrome can occur with Librium dependence, as it can with dependence on all benzodiazepines. This syndrome can last for weeks, months, or even years after quitting drug use. PAWS is sometimes referenced as post-withdrawal syndrome, protracted withdrawal syndrome, and prolonged withdrawal syndrome

Primary symptoms of post-acute withdrawal syndrome include the following:

  • Mood swings
  • Insomnia
  • Increased anxiety
  • Body aches
  • Headaches
  • Nausea

People who have been abusing benzodiazepines like Librium are most at risk for PAWS. Some people continue to experience PAWS symptoms for years after quitting benzodiazepine misuse.

What Causes Librium Withdrawal?

The severity of Librium withdrawal is dependent on a variety of factors, including frequency of use as well as average dose amounts, genetic factors, personal metabolism, and any health issues.

Librium withdrawal is caused by the body and brain’s dependency on the drug. The feel-good element becomes a sought-out source of comfort. Both the body and brain have been altered as a result of continued benzodiazepine use, which causes both physical and psychological dependence. 

Predominantly, Librium withdrawal is caused by central nervous system overactivity, which causes undesirable symptoms and complications. Anxiety, sleep disorders like insomnia, and seizures can all be traced to an under-regulated central nervous system. 

The body has become accustomed to the continual presence of chlordiazepoxide. When doses are lowered or it is no longer present at all, withdrawal sets in.

What Are the Common Symptoms of Librium Withdrawal?

Librium withdrawal symptoms can range from light to severe, depending on the circumstances and the individual. High-dose and long-term chlordiazepoxide misuse is likely to lead to more severe withdrawal symptoms.

Most common Librium withdrawal symptoms include the following:

You need medical supervision to detox from Librium safely.

  • Anxiety
  • Insomnia
  • Irregular heart rate
  • Elevated blood pressure
  • Nausea
  • Vomiting
  • Constipation
  • Hallucinations
  • Tremors or seizures
  • Memory loss
  • Psychosis

If you begin experiencing any sort of chlordiazepoxide withdrawal symptoms when you lower your dose or stop taking the medication, consult a medical professional. It’s a sign that you need a medical detox process to ensure you are safe throughout the withdrawal process. 

If you believe your withdrawal symptoms are severe or on the verge of being severe, it’s important to seek medical attention immediately.

Factors That Determine Intensity of Withdrawal Symptoms

Common factors that affect the intensity of Librium withdrawal symptoms include circumstantial biological, and psychological factors.

  • Dosage and duration of use: How long the drug has been used and dose amount are highly influential when it comes to withdrawal symptoms. The longer a person has used Librium and the higher the amount used, the more severe the withdrawal symptoms are generally going to be. 
  • Poly-substance abuse: Using other drugs and/or alcohol in conjunction with Librium can compound dependence and intensify withdrawal symptoms as well.
  • Drug’s half-life: As a long-acting benzodiazepine, Librium has a half-life of 24 to 48 hours. Withdrawal symptoms may not set in until one to three days after lowering or stopping use.
  • Personal differences: Individual differences in metabolism, physical health issues, age, and mental health conditions can all influence the intensity of withdrawal.

How Long Does Librium Withdrawal Last? 

Withdrawal duration depends on the individual in question and the factors described above. Generally, early symptoms will start to set in within one to three days of last use. Symptoms most often peak around the seven-day mark. 

With many individuals, symptoms will begin to fade and subside around two weeks after discontinuing use. Certain symptoms, such as cravings for chlordiazepoxide, can last a month or longer. In cases of PAWS, some symptoms can even last years.

Librium withdrawal can be largely avoided with a tapered approach to withdrawal. This will help to reduce undesirable effects. It generally entails switching to another long-acting benzodiazepine and tapering off that medication. 

Librium Withdrawal Timeline

Again, there isn’t an exact timeline for chlordiazepoxide withdrawal since individual factors come into play. Those who use Librium for an extended period of time and in high amounts usually experience withdrawal symptoms that come on quicker and last longer.

Here is a general withdrawal timeline for Librium:

  • 1–3 days: Symptoms begin to set in, especially symptoms like anxiety, mood swings, insomnia, and drug cravings. 
  • 7 days: Symptoms begin to peak within the first week of Librium withdrawal. Seizures, delirium, and hallucinations may happen during this time.
  • 14 days: At around the two-week mark, undesirable withdrawal symptoms usually begin to subside. While physical symptoms are the first to dissipate, psychological symptoms like insomnia, anxiety, and cravings may still remain. 
  • 30 days: In most cases, withdrawal symptoms are largely gone around the one-month mark. Cravings for Librium and sleep issues may continue indefinitely. 

Medical Detox 

Medical detox is recommended for chlordiazepoxide withdrawal. It is never recommended to stop taking benzodiazepines suddenly, as this can trigger dangerous withdrawal symptoms. You need medical supervision to detox from Librium safely.

Doctors recommend tapering off benzodiazepines to ensure a safe withdrawal process. The taper method entails slowly reducing dose amounts until the individual is completely off the drug. This is the preferable method for those who are physically and mentally dependent on Librium. 

As dose amounts are lowered, the body gradually readjusts to the lower dose. Tapering generally takes around eight weeks to complete. While withdrawal symptoms may still occur, they will be far milder than they would be if quitting cold turkey.

While tapering, a doctor might replace Librium with a different benzodiazepine with a longer half-life. Valium is often the chosen replacement for Librium for tapering. Valium is also often used during the acute and more severe stages of withdrawal to treat seizures and hallucinations.

While the goal of withdrawal is to ultimately stop taking Librium, this isn’t addiction treatment in and of itself. Medical detox must be combined with therapy to effectively treat chlordiazepoxide abuse.

Updated June 9, 2023
Resources
  1. Chlordiazepoxide. (November 2022). StatPearls.
  2. Librium Prescribing Information. (October 2022). Drugs.com.
  3. Outcomes After Implementation of a Benzodiazepine-Sparing Alcohol Withdrawal Order Set in an Integrated Health Care System. (February 2022). Original Investigation Psychiatry.
  4. Withdrawal Syndromes. (October 2022). StatPearls.
  5. Post-Acute Withdrawal Syndrome (PAWS). Semel Institute for Neuroscience and Human Behavior.
  6. Alcohol Withdrawal Syndrome: Benzodiazepines and Beyond. (September 2015). Journal of Clinical & Diagnostic Research.
  7. Chlordiazepoxide-Induced Delirium in a Patient Undergoing Alcohol Withdrawal: A Case Report. (July 2022). Journal of Medical Case Reports.
  8. Challenges of the Pharmacological Management of Benzodiazepine Withdrawal, Dependence, and Discontinuation. (May 2018). Therapeutics Advances in Psychopharmacology.
  9. Does Type and Number of Used Substances Affect the Severity of Illness in Patients With Substance Use Disorders? (August 2021). The Egyptian Journal of Neurology, Psychiatry and Neurosurgery.
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