Chlordiazepoxide: characteristics and side effects of this drug

Benzodiazepines are, together with barbiturates, antidepressants and antipsychotics, one of the best-known groups of psychoactive drugs.

The first benzodiazepine that was synthesized in the middle of the last century, is Chlordiazepoxide, a drug discovered by chance by Leo Sternbach and used in anxiety problems.

Thanks to the synthesis of this drug, benzodiazepines were gaining greater popularity during the over the next two decades, expediting the treatment of anxiety disorders and other medical conditions. Let's see the exciting history and uses of this medicine.

Related article: "Benzodiazepines (psychopharmaceuticals): uses, effects and risks"

What is chlordiazepoxide?

Chlordiazepoxide, originally called metaminodiazepoxide, is a drug that belongs to the group of benzodiazepines, being the first substance of this type to be synthesized. It is marketed under multiple names: Klopoxid, Libritabs, Librium, Mesural, Multum, Novapam, Risolid, Silibrin, Sonimen, Tropium, and Zetran. It was patented in 1958 and approved for use in the United States from the year 1960, having been discovered by pure serendipity.

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Its discoverer was Leo Sternbach in the mid-50s, seeing that had a great relaxing capacity on laboratory animals. Subsequently, new benzodiazepines were synthesized, whose popularity was on the rise until the decade of the 70's and, at the same time, laying the foundations of the problem of drug addiction in laboratory.

Like other benzodiazepines, chlordiazepoxide is mainly used to treat problems associated with anxiety, thanks to the fact that the drug has amnesic, anticonvulsant, anxiolytic, sedative and relaxing.

Mechanism of action

Chlordiazepoxide is thought to act on GABA type A receptors., producing a prolonged inhibitory effect. Thus, it blocks the increase in abnormal electrical activity in the brain from the brain stem.

It has been seen that it intervenes on the limbic system, which could explain the emotional effects that this drug has, mainly a decrease in fear and aggression.

Administration

The presentation of this drug comes in the form of pills or tablets that are consumed orally. The presentations of this benzodiazepine are 5 mg, 10 mg and 25 mg. It is normally taken between one and four times a day and can be taken with or without food. Because chlordiazepoxide can be addictive, you should not consume more doses than what has been prescribed by the professional.

Indications: what is it used for?

The use of chlordiazepoxide is indicated for short periods of time, between 2 and 4 weeks. As we have already indicated, it has anxiolytic and sedative properties. It is because of that its use is fundamentally aimed at the treatment of anxiety, especially if this is so serious that it makes it difficult to lead a normal life, with high levels of distress.

Fundamentally, this drug is used for anxiety, insomnia and panic disorder, although it is also used in the addiction to substances, being especially useful in alcohol withdrawal syndrome and also in drug withdrawal. opiates. Also It has been shown to be useful in certain medical conditions, especially related to gastrointestinal problems.such as Crohn's disease and ulcerative colitis.

You may be interested in: "Types of anxiolytics: drugs that fight anxiety"

Side effects

As in all drugs, chlordiazepoxide can involve the appearance of a whole list of effects secondary, some of them due to an overdose of the drug and others due to allergies. Chlordiazepoxide overdose is a medical emergency and requires immediate assistance. of health personnel. The antidote used to treat this overdose is flumazenil, which is a benzodiazepine antagonist.

Among the most common adverse effects and those with the least degree of clinical concern are:

Drowsiness.
Fatigue.
Dizziness.
Muscular weakness.
Dry mouth.
stomach upset.
Diarrhea.
Changes in appetite.

If you are under treatment with this drug, the prescribing doctor or psychiatrist should be called in case of suffering any of the following symptoms:

Agitation or motor excitement.
Nervousness.
Headache.
Ataxia.
Diplopia.
Vertigo.
Constipation.
Urination problems: either due to difficulty or frequent urination.
Blurry vision.
Changes in sexual desire.

Between the most serious side effectss, which will require going to the health professional as quickly as possible, are:

Walking shuffling.
Balance disorders.
Coordination disorders.
Confusion.
Tremors.
Fever.
Trouble breathing and swallowing.
Urticaria.
Jaundice of the skin or eyes.
Irregular heart rhythm.
Affective blunting.
Reduced alertness.
Eat.
Depression

contraindications

The use of this drug should be avoided in those people who suffer from one or more of the following medical problems:

Myasthenia gravis.
Acute intoxication by alcohol, narcotics or other psychoactive substances.
Ataxia.
Glaucoma.
severe hypoventilation.
Hepatitis.
Hepatic cirrhosis.
severe sleep apnea.
Hypersensitivity/allergy to benzodiazepines.

Precautions for use

Treatment with chlordiazepoxide should not exceed four weeks of administration, since there is a high risk of generating tolerance and dependency.

Benzodiazepines should not be abandoned abruptly, since this type of drugs, compared to other medications are twice as likely to cause a recurrence of symptoms after discontinuation treated. Also withdrawal syndrome may occur, characterized by seeming irritability, drowsiness, and anxiety.

It should be noted that chlordiazepoxide has interactions with other substances: vitamins, nutritional supplements, herbal remedies, antihistamines, medications for depression, anticonvulsants, antiparkinsonian drugs, asthma remedies, muscle relaxants, oral contraceptives, sleeping pills, cimetidine, digoxin, disulfiram, fluoxetine, isoniazid, ketoconazole, levodopa, metropolol, propranolol, rifampicin, theophylline, valproic acid and alcohol, enhancing its depressant effect on the nervous system central.

If you have suffered from glaucoma, kidney, heart or liver failure, the doctor/psychiatrist should be informed so that other more appropriate treatment options can be considered. In case there is no other option, it is recommended that the daily doses be between 5 and 10 mg.

Its use is not recommended during pregnancy or while breastfeeding. Administered late in pregnancy, it can cause the appearance of hypothermia, hypotonia and respiratory depression in the baby. Chlordiazepoxide can be secreted through breast milk.

It should be noted that research on the effects of this drug during pregnancy is limited, for Therefore, the consumption of chlordiazepoxide should be done only if the benefits are greater than the risks. Although there are those who point out that this drug, together with diazepam, is one of the safest benzodiazepines to be used in pregnant women, there are multiple risks: miscarriage, malformations, delayed development, cancer, mutations and deficits functional.

Due to its sedative effects, it is not recommended to drive heavy machinery or drive any vehicle after taking this drug. There may be decreased reaction, which can contribute to a traffic accident.