Librium (chlordiazepoxide) and Xanax (alprazolam) are two benzodiazepine prescription medications. Both have anxiolytic and sedative effects, and they are prescribed for the short-term management of anxiety symptoms. They also may be prescribed as sleep aids, for the treatment of alcohol withdrawal symptoms, as muscle relaxants, and to manage seizures.
Benzodiazepines, or benzos for short, are central nervous system depressant drugs that slow respiration, reduce blood pressure, and lower heart rate while also producing calming and relaxing effects. Both Librium and Xanax are marketed as tablet or capsules that are meant to be ingested orally and digested through the gastrointestinal system.
Benzos are classified as highly addictive; therefore, neither Xanax or Librium are recommended to be taken on a long-term basis. While there are many similarities between the drugs, there also are some major differences.
Half-lives and the length of time the drugs remain active in the bloodstream
Chlordiazepoxide, the active ingredient in Librium, has a long half-life of 24 hours to 48 hours, which means it can remain active in the bloodstream for several days, the FDA explains. The active ingredient in Xanax, alprazolam, has an average half-life of a little over 11 hours, per its medication guide; therefore, it stays active in the body for about a day or two.
Xanax is marketed in 0.25 mg, 0.5 mg, 1 mg, and 2 mg tablets. Librium is marketed in 5 mg, 10 mg, and 25 mg capsules.
The primary reason they are prescribed
Xanax is primarily prescribed to manage the symptoms of anxiety and for anxiety and panic disorders as an anti-anxiety medication. Librium is often used during the treatment of alcohol dependence for the management of withdrawal symptoms and is considered a sedative-hypnotic medication.
Librium can be prescribed in doses as high as 50 mg to 100 mg at a time and even up to 300 mg per day when taken orally for the treatment of alcohol withdrawal. Xanax dosage usually ranges between 4 mg and 40 mg per day. It can even be prescribed in a dosage as low as 0.25 mg at a time.
What is a Benzodiazepine Drug?
Benzos such as Librium are beneficial in treating anxiety because they slow down overactive nerve firings and minimize the stress reaction by interacting with levels of GABA (gamma-Aminobutyric acid) in the brain. GABA acts as a natural tranquilizer, working to keep a person feeling even and balanced. When someone struggles with anxiety, nerve firings can become overactive, and a person may be in a chronic state of panic or heightened alertness. Benzos help to manage this by increasing the presence of GABA and depressing the central nervous system. This can relieve muscle tension, aid in sleep functions, promote relaxation, and minimize some of the more difficult symptoms of alcohol withdrawal.
Benzos are widely abused because of the euphoric and mellowing high they can produce when taken in higher doses or in ways other than prescribed. The Drug Enforcement Administration (DEA) classifies benzodiazepines as Schedule IV controlled substances and reports that as of the 2011 National Survey on Drug Use and Health (NSDUH), more than 20 million Americans had misused a benzo at some point in their lives.
Benzo abuse is very dangerous, and drugs like Librium and Xanax are often abused in conjunction with other drugs, medications, and alcohol. The FDA has issued the strongest possible warning—a boxed warning—for the combination of opioids and benzodiazepines because of the increased risk for a potentially life-threatening overdose. Both opioids and benzos are central nervous system depressants that slow life-sustaining functions. A combination of an opioid, or alcohol, with Librium or Xanax can raise the odds for a fatal overdose or other adverse reactions.
The National Institute on Drug Abuse (NIDA) warns that more than 10,000 people in the U.S. died from an overdose involving a benzodiazepine in 2016; this number is an eightfold increase from the rates in 2002. An overdose often causes a person to struggle with breathing, suffer from mental confusion, and become sedated, usually to the point of unconsciousness.
Regular use of a benzodiazepine medication can cause tolerance, and the same dosage will be ineffective. Increasing dosage ups the odds for drug dependence. Benzo dependence can happen quickly, and when the brain gets used to the drug being active and interfering with its regular chemical makeup, dangerous withdrawal symptoms can occur when the drug processes out of the body. The significance and intensity of the benzodiazepine withdrawal syndrome are among the reasons these drugs are considered to be so addictive.
How Librium Works
It is not entirely clear exactly how Librium works in the brain, although it is thought to block EEG arousal from stimulation and to act on the limbic system, which is responsible for emotional responses. Librium is believed to slow heightened electrical impulses in the brain, which is how it helps to reduce agitation and anxiety.
Librium doesn’t just have anti-anxiety effects. It also stimulates appetite and has a small measure of an analgesic (pain-relieving) function. It is considered to be a sedative-hypnotic medication.
As a long-acting benzodiazepine, Librium stays in the bloodstream and active for much longer than shorter-acting medications like Xanax. For this reason, it can be prescribed in higher and fewer doses each day. This makes Librium a beneficial tool for helping to manage the side effects of alcohol withdrawal that accompany alcohol dependence.
Alcohol and benzos act in the brain and body in similar ways, and withdrawal symptoms can be comparable. A person can struggle with insomnia, anxiety, depression, muscle tension, tremors, and overactive functions of the central nervous system, such as racing heart rate, elevated body temperature, and shallow breathing during alcohol withdrawal, and Librium can help to manage these issues. Librium also can aid in minimizing alcohol cravings by lessening the severity of withdrawal and keeping the brain activated in a similar way. Librium can be slowly tapered off over time to avoid shocking the system.
Librium is generally thought to have a lower abuse potential than faster-acting benzodiazepines like Xanax since it takes longer for the drug to take action and is less effective in smaller doses. The euphoric high associated with abuse may not be as intense with Librium then. Even so, it is still a target for abuse and has many side effects, such as:
- Mental cloudiness and confusion
- Balance and coordination issues
- Blurred vision
- Slurred speech
- Muscle weakness
- Skin irritation
- Decreased sex drive and libido
- Disrupted menstruation
- Memory issues
- Paradoxical excitement
- Blood dyscrasias
- Extrapyramidal symptoms, including anxiety and paranoia
- Dry mouth
As with other benzodiazepine drugs, Librium is habit-forming and not designed to be taken on a long-term basis. People with compromised liver issues should not take Librium. It is also recommended that the medication is taken in the lowest dose possible for as short a period as possible. The National Library of Medicine (NLM) publishes that in general, chlordiazepoxide is taken one to four times per day by mouth; it can be taken with or without food.
Benzodiazepines like Librium are not considered to be safe options for the senior adult population, HealthDay warns. As a sedative drug, Librium can be more powerful in older adults who have lower metabolism rates. Librium can increase the risk for an older adult to suffer injuries from falls related to impaired coordination and balance and further impair a person’s memory and thinking functions. Senior individuals often take multiple medications at a time, and Librium can interact negatively with many other substances, thus increasing the risk for fatal overdose.
Though Librium has less potential for abuse than Xanax, both are considered safe and effective medications when used under the supervision of a trained medical professional and in exactly the manner and dosage prescribed.
Is Librium Like Xanax?
It’s easy to assume that because Librium and Xanax are both benzodiazepine drugs, they’re similar. You might have even asked yourself – is Librium like Xanax? Well, one way to clear that up is by thinking of it this way – is hydrocodone like oxycodone? The answer to that question is no. Although they’re both classified as depressants in the opioid category, they’re two different drugs with different potency levels and serve another purpose. With that being said, you could also wonder – is Librium stronger than Xanax? There are some notable differences between the two drugs that we’ll delve into below.
The most immediate similarities between Librium and Xanax are that they’re both considered benzodiazepines, Schedule IV substances, have similar effects on the brain and nervous system, and produce potentially deadly side effects when used in conjunction with other substances like alcohol, opioids, or barbiturates. Despite their similarities, you could also wonder if the Librium dosage vs. Xanax is the same. Well, let’s take a look at the distinct differences.
Librium is approved by the FDA to treat alcohol withdrawal symptoms, general anxiety, and pre-operative anxiety. When used for alcohol withdrawal, it’s taken in an inpatient setting. Xanax is approved by the FDA to treat panic attacks and anxiety. Librium is a long-acting benzo that takes several hours to reach peak concentration, while Xanax works quickly. Once you ingest Librium, it might take several hours to work and achieve max concentration in the blood, whereas Xanax reaches peak concentration in one to two hours. Due to its short onset, it leaves the body rapidly.
Librium, as you might expect, also has a long half-life of 24 to 48 hours, which is how long it takes for half the dose to leave your body. In most cases, it takes five half-lives for drugs to be entirely removed from your system, meaning Librium can remain in your system for several weeks or more. Xanax has a much shorter half-life and is typically out of your system in a few days.
As benzodiazepines, both drugs have a high potential for abuse and addiction. Despite the similarities, these drugs are prescribed for two different reasons and last different lengths of time. For that reason, you might wonder if you can take Librium and Xanax together. The short answer is no; you should not. However, your doctor could instruct you for another reason. You should never take drugs without your doctor’s approval.
If you’ve been using these drugs and feel that your ability to control use is spiraling out of control, it might be time to consider getting professional medical treatment. Benzodiazepines are notorious for their dangerous withdrawal symptoms, meaning your only option is to seek help. The first step is to admit you have a problem, followed by getting help. When you commit yourself to a better life, you will start the process in medical detox, where dedicated staff will ensure you’re comfortable and safe while the medication is removed from your body. This can take anywhere from a few days to a few weeks, depending on how long you’ve taken the drugs and how much.
Once you’ve accomplished this first significant milestone, you’ll be moved to the next step, which could be inpatient/residential care or an outpatient facility. Benzodiazepines are dangerous despite being prescribed by doctors and should not be overlooked. Getting help can change your life and reduce the stress of others around you who are worried about your benzodiazepine misuse. Fortunately, addiction treatment will get you back where you need to be for success.