by Dr. Manura Nanayakkara

Created on: July 16, 2010   Last Updated: July 18, 2010

Chlordiazepoxide is a long acting drug in the benzodiazepine family. It is a prescription only medication used in anxiety disorders and alcohol withdrawal. Main side effects are lightheadedness and drowsiness.

How it acts

It increases the action of GABA type A receptors. This increases the inhibitory neurotransmission in the brain and it relieves anxiety and induces side effects such as drowsiness.

Uses

It’s mainly used as a detoxification agent in the acute alcohol withdrawal. Usually doctors start from very high doses in alcohol withdrawal and gradually tailing it off over period of time. Also it is prescribed in the management of anxiety disorders and for short term relief of anxiety.

What the doctor should know before prescribing?

If you have any medical problems such as kidney disease, liver disease, breathing disorders or myasthenia gravis, discuss with your doctor before taking Chlordiazepoxide. If you are pregnant, your doctor may not prescribe this medication, especially in last three months of the pregnancy.

General advice to avoid/minimize side effects

This medication is available as capsules. It should be taken as whole with a full glass of water. This medication must be taken according to the advice given by the doctor. You should avoid alcoholic beverages during the drug therapy. Operating machinery and driving is not recommended while on this medication. If the drowsiness is severely affecting patient’s day to day activities, it is recommended to discuss about the dosing schedule with the doctor.

Side effects

Most common side effects are light headedness and drowsiness which can continue to the next day. If the patient is taking Chlordiazepoxide for alcohol withdrawal, chances are high that he is taking high doses of the drug. This makes the side effects severe in patients who are taking the drug for alcohol withdrawal. Rarely excitation and aggression can occur (paradoxical excitation).

Confusion and ataxia (loss of full control of bodily movements) is also common. This usually manifest as a tremor when patient tries to move. Confusion and ataxia is common in elderly patients. It can also cause recent memory loss. Muscle weakness is also common.

If the patient continues to take the drug for a longer period, then patient can become dependant on the drug. That means having withdrawal symptoms after stopping the drug.

Occasionally patients complain of a headache. This can be controlled by taking over the counter pain killers such as paracetamol. Vertigo is another symptom that can occur occasionally.

Sometimes faintishness can occur due to low blood pressure (Hypotension) due to Chlordiazepoxide. Some patients will have gastro intestinal disturbances like nausea, vomiting and diarrhea.

Some patients will have visual hallucinations, illusions and various other visual disturbances but they are very uncommon. Rarely patients can develop urinary incontinence and urinary retention. Also there are harmful interactions with other central nervous system depressants like opiates.

Sources

BNF

Learn more about this author, Dr. Manura Nanayakkara.
Click here to send this author comments or questions.