Chlordiazepoxide anxiety

Medical use of benzodiazepines has been declining. Prescribing trends show an overall decline in the number of all benzodiazepine prescriptions written, with a market shift to increased prescribing of short elimination half-life agents (lorazepam, alprazolam), compared with long-elimination half-life agents (diazepam, chlordiazepoxide) (Ciraulo et al. 2004). In 2001, alprazolam was the most widely prescribed benzodiazepine (Ciraulo et al. 2004), and it also was the most widely prescribed psychiatric medication in that year for mood and anxiety disorders (Stahl 2002). 

Figure 19.1 The elevated plus-maze. (Top) The apparatus is arranged with two open arms, two closed arms and a central zone, raised above the ground. Animals are placed in the central zone (usually facing an open arm) and their movements scored for number of entries to the open and closed arms and the percentage time spent in the open arms. (Bottom) Chronic administration (5 days) of the anti-anxiety drug, chlordiazepoxide, increases the percentage time spent on the open arms to approximately 50% of the total. (Figure kindly provided by S. E. File)...

Chlordiazepoxide Librium Oral Long 15-100 Anxiety disorders, alcohol withdrawal... 

A series of tranquilizers, drugs that relieve anxiety and nervous tension without impairing consciousness, have a benzene ring fused to a seven-membered ring containing two nitrogens. As a group they are called benzodiazepines. The two most successful are diazepam (Valium ) and chlordiazepoxide (Librium ) introduced in 1964 and 1960, respectively. Flurazepam (Dalmane ), first used in 1970, is a hypnotic. 

Diazepam is used for the control of anxiety and tension, the relief of muscle spasms, and the management of acute agitation during alcohol withdrawal, but it itself may be habit-forming. Chlordiazepoxide has similar uses and its synthesis is somewhat analogous to diazepam. Flurazepam is a hypnotic, useful for insomnia treatment. It is reported to provide 7-8 hr of restful sleep. 

Oxazepam is similar to chlordiazepoxide in terms of pharmacological properties however, it has a somewhat less harsh effect, is less toxic, and exhibits a less expressed myorelax-ant effect. It is often tolerated better by patients than other tranquilizers. It is used in neurosis, conditions of anxiety, fear, stress, trouble falhng asleep, and psychovegatative disorders. The most common synonyms are nozepam and tazepam. 

Anxiety For the management of anxiety disorders or for the short-term relief of the symptoms of anxiety (anxiety associated with depression is also responsive) (alprazolam immediate-release and intensol, clorazepate, chlordiazepoxide, diazepam, lorazepam, oxazepam) for the management of anxiety, tension, agitation, and irritability in older patients (oxazepam). 

Anticonvulsant As adjunctive therapy in the management of partial seizures (clorazepate) adjunctively in status epilepticus and severe recurrent convulsive seizures (diazepam IV) adjunctively in convulsive disorders (diazepam oral). Preoperative For preoperative apprehension and anxiety (chlordiazepoxide, diazepam IV) prior to cardioversion for the relief of anxiety and tension and to diminish patient s recall (diazepam IV) adjunctively prior to endoscopic procedures for apprehension, anxiety, or acute stress reactions and to diminish patient s recall (diazepam) ... 

The withdrawal syndrome from ethanol includes anxiety, insomnia, possibly convulsions and visual hallucinations (delirium tremens - the Dts). It is treated or better still prevented by a calm environment, adequate (but not excessive) hydration, and careful monitoring, with the added use of anticon-vulsive/sedative agents, mainly benzodiazepines to prevent or treat convulsions. The preventive effects of benzodiazepines on withdrawal morbidity has been clearly demonstrated. There do not seem to be major differences between benzodiazepines, such as chlordiazepoxide or diazepam or others. Because of the abuse potential in these highly susceptible patients, these should be rapidly weaned, and proper prevention of relapse instituted. Other drugs such as meprobamate and clomethiazole (Hemineurin) are commonly used in some countries. The effectiveness... 

Withdrawal from long-term high-dose use of alcohol or sedative-hypnotic drugs can be life threatening if physical dependence is present. Benzodiazepines, such as chlordiazepoxide Librium) and diazepam Valium), are sometimes used to lessen the intensity of the withdrawal symptoms when alcohol or sedative-hypnotic drug use is discontinued. Benzodiazepines are also employed to help relieve the anxiety and other behavioral symptoms that may occur during rehabilitation. 

This difference m body temperature is called stress-induced hyperthermia (SIH) and is thought to reflect an anticipatory type of anxiety. Following pretreatment of all mice hvmg m the same cage with an anxiolytic compound (chlordiazepoxide m the example given m Fig. 10), the body temperature of the... 

Kellner R, Wilson RM, Muldawer MD, et al. Anxiety in schizophrenia the responses to chlordiazepoxide in an intensive design study. Arch Gen Psychiatry 1975 32 1246-1254. 

Azima H, Arthurs D, Silver A. The effects of chlordiazepoxide (Librium) in anxiety states. Can Psychiatr Assoc J 1962 7 44-50. 

File SE, Zharkovsky A, Hitchcott PK. Effects of nitrendepine, chlordiazepoxide, flumazenil and baclofen on the increased anxiety resulting from alcohol withdrawal. Prog Neuropsychopharmacol Biol Psychiatry 1992 16 87-93. 

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