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Limbitrol (chlorodiazepoxide) Addiction And The Best Rehab Centers for Treatment

Isaac Alexis, M.D., AAMA, AMP-BC

Medically reviewed by

Isaac Alexis, M.D., AAMA, AMP-BC

February 1, 2019

Limbitrol is a combination medication containing the generic drugs chlordiazepoxide and amitriptyline hydrochloride. The presence of these drugs classifies it as both a tranquilizer and an antidepressant. Limbitrol is used primarily for treating moderate to severe depression resulting from anxiety of the same degree.

Both chlordiazepoxide and amitriptyline hydrochloride create their effects by affecting a person’s central nervous system. Chlordiazepoxide is a benzodiazepine drug, responsible within this combination for decreased anxiety and tension. This may be due, in part, as addressed by the FDA, to its capacity to impose an effect on a person’s limbic system, a region within the brain that is thought to be responsible for regulating and interpreting emotional responses.

On the other hand, amitriptyline is an antidepressant, and as explained by the FDA, the exact means by which this drug works is not fully understood. However, it is theorized the drug’s action occurs due to the way it inhibits the reuptake of norepinephrine, an important chemical with dual purposes, which works as both a neurotransmitter and hormone within your body.

How Is This Drug Abused?

Abuse of Limbitrol may occur several ways. An individual who uses this medication for prescribed reasons, as directed by a doctor, may independently of medical guidance choose to alter the dosage of this medication, increasing either the frequency or dose of this drug, in an attempt to self-medicate their symptoms.

An individual may obtain illicit, diverted medication off the street or from a loved one, and use it to self-medicate their mental health concerns without any supervision from a doctor, leading them to take amounts that are too high or frequent for their personal medical specifications.

A person may obtain the drug these same ways and choose to take it for recreational purposes. In order to better understand the drug’s overall potential for abuse, we will first examine the singular components of the drug and their corresponding abuse potential.

Chlordiazepoxide’s Potential For Abuse

Limbitrol’s capacity for abuse and addiction derives mainly from the chlordiazepoxide portion of this medication. As a benzodiazepine, also referred to as a benzo, chlordiazepoxide has a significant potential for abuse and addiction, largely because of this drug’s sedative properties. Even prescribed use of this drug may become habit-forming, as a physical dependence may arise. Within the context of abuse, this physical dependence, if accompanied by compulsive drug seeking and using, could become a component of addiction.

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Chlordiazepoxide’s mechanism of action is as a long-acting benzodiazepine in comparison to others within this class. What this means is that physical dependence will take longer to occur and the potential for abuse and addiction may not be as high as that which is linked to short-acting benzos with more immediate effects. Despite this, prolonged use and abuse may yet lead to addiction. An American Family Physician article on benzodiazepine addiction comments on this, noting that “Psychologically, long-term use of benzodiazepines may lead to overreliance on the need for the agent, loss of self-confidence and varying degrees of drug-seeking behavior.”

Amitriptyline’s Effect And Abuse Potential

Though not a medication that is widely cited as a drug of abuse, there are instances of amitriptyline being used in this manner. An article specifically focusing on this subject, “Abuse of Medications That Theoretically Are Without Abuse Potential,” writes that anticholinergic and tricyclics drugs, of which amitriptyline is considered to be, are abused for their euphoric effect, likely the most predominant sensation that drug abusers seek.

Supporting this, an article published by The JAMA Network details that 25 percent of study participants who were involved in a methadone maintenance program had reported using this drug to achieve a euphoric state. Lastly, amitriptyline may cause a physical dependence and symptoms of withdrawal.

Combined: A Potential For Abuse And Addiction

Using Chlordiazepoxide and amitriptyline simultaneously may produce a pleasurable effect when abused, especially when taken in higher quantities. Unpleasant withdrawal symptoms may appear when an individual abruptly discontinues using these drugs. Additionally, as noted by the Center for Substance Abuse Research, benzodiazepines may create situations of cross-tolerance, meaning that individuals may not experience the effects of certain drugs bearing the same depressant effects as acutely, again creating the potential for increased abuse, tolerance, and addiction, as they may take more to create the sought after effect.

Oftentimes, benzodiazepine drugs are combined with other drugs in instances of polysubstance abuse, in an attempt to further the high, or decrease the uncomfortable side effects associated with another drug of abuse. These drugs most notably include opioids (to enhance the effects) and alcohol (to temper effects of alcohol withdrawal or intoxication).

How Does Substance Abuse Affect A Person?

If you’re concerned that your personal use has become a problem, or if you’re fearful that a loved one may be abusing Limbitrol, it can be very beneficial to be aware of the side effects, so that you can spot any concerns of addictive behavior. Foremost, be attentive to the general behavioral cues of addictive behavior. These include a person:

  • Claiming to lose prescriptions.
  • Doctor shopping” in an attempt to obtain multiple prescriptions.
  • Hoarding pills or ensuring continued access to the drug.
  • Stealing or forging a prescription.
  • Exhibiting unpredictable, erratic, or atypical behaviors.
  • Experiencing mood changes.
  • Taking higher doses than the doctor prescribed.
  • Needing more of the drug to achieve the previous effect (tolerance).
  • Needing to take the drug on a regular basis.
  • Experiencing cravings for the drug.
  • Engaging in risky behaviors while using the drug.
  • Letting important responsibilities relating to work, school, or family fall to the wayside.
  • Finding they’re not able to stop using, despite detriment to their life.

Beyond this, each drug of abuse induces symptoms and risks that are specific to the chemical impact it imparts on a person’s physiological and mental states, in the case of Limbitrol, these may include:

  • Dry mouth
  • Headaches or blurred vision
  • Feeling weak or fatigued
  • Drowsiness or dizziness
  • Nausea or vomiting
  • Diarrhea or constipation
  • Disrupted appetite
  • A confused or disorientated state
  • Cognitive and memory impairment
  • Trouble speaking
  • Muscle weakness or tremors
  • Decreased coordination and reflexes
  • Restlessness or unable to sit still
  • Changes to vision
  • Heart rate becomes irregular
  • Respiratory depression
  • Becoming hostile or acting unexpectedly
  • In rare cases, seizure or hallucinations
  • Addiction
  • Overdose

Both components of Limbitrol can cause dependence, and hence, withdrawal. Should your loved one exhibit nausea, headache, irritability, anxiousness, sleeplessness, or a lack of energy after abruptly ceasing use of the drug, addiction could be a concern. In the long term, research shows that benzodiazepine abuse may cause memory loss, and possibly the development of Alzheimer’s disease.

How To Address A Limbitrol Addiction

Any situation pertaining to drug addiction, whether it be withdrawal or treatment, is better approached under the guidance of a trained professional. This expert perspective and direction helps to ensure that you, or your loved one, has the highest chance of obtaining sobriety. In most cases, a person struggling with addiction should choose to enter an inpatient drug rehab center.

Inpatient programs may serve a Limbitrol addicted individual than an intensive outpatient program (IOP) better for two reasons. First, many abusers of this drug may have begun their abuse in an attempt to moderate their depression, and a good treatment program needs to address this and any other co-occurring disorder to be maximally effective. Second, as is common with benzodiazepine-based addictions, polysubstance abuse often warrants the more intensive forms of treatment that inpatient residential programs offer. In either case, if an individual is experiencing a moderate to severe form of addiction, they may greatly benefit from a medical detox.

Medical-Assisted Detoxification for Limbitrol

During a medically-assisted detox, certain medications may be used to help reduce the uncomfortable symptoms of withdrawal. In some cases, as recommended by the World Health Organization’s “Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings,” a gradual taper from a benzo may be best, while achieved by the introduction of decreased amounts of diazepam, another benzodiazepine. In addition, other non-addictive medications may be used to combat other pressing withdrawal symptoms, or preexisting co-occurring conditions, such as depression or anxiety.

Of particular concern, with certain instances of benzodiazepine addiction, is protracted withdrawal, a situation that occurs when certain symptoms of withdrawal persist over a longer period. This does not occur with everyone but may include irritability, anxiety, depression, and sleep disruption. Because of this, effective and integrated treatment and relapse prevention is essential in helping an individual to develop coping skills to deal with this situation, should it arise.

Comprehensive Addiction Treatment Programs

After a person successfully detoxes, treatment begins. A comprehensive treatment program will utilize a variety of behavioral therapies tailored to fit a person’s specific needs, including any concerns of co-occurring disorders. Cognitive behavioral therapy (CBT) has been proven to be an effective therapy for benzodiazepine-related addictions. Additionally, research illustrates that CBT holds great promise when accompanying treatment for withdrawal, witnessing a 76 percent success rate for benzodiazepine discontinuation versus that of a slow taper alone, at only 25 percent.

Accompanying these behavioral therapies are various other treatment modalities, including any combination of the following: intensive counseling sessions, integrated in both an individual and group setting; access to family therapy and support, 12 step support groups; exciting alternative programs, including wilderness therapy, equine assisted therapy, holistic therapies; relapse prevention, aftercare support and outreach services, and numerous diverse other activities.

Transform Your Life

Whether you’ve let your personal prescription get out of control, or if you’re using illicitly obtained Limbitrol, we want to help you get clean and live a sober life. If you’re suffering from depression, we can help you to examine your other options for treatment. employs only the most informed and caring staff to help you obtain a drug-free life. Contact us today.

American Family Physician - Addiction: Part I. Benzodiazepines—Side Effects, Abuse Risk and Alternatives

Medscape - Limbitrol

JAMA Network - Abuse of Amitriptyline

NCBI - Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings

NCBI - Discontinuation of benzodiazepine treatment: efficacy of cognitive-behavioral therapy for patients with panic disorder.

MedlinePlus - Amitriptyline

MedlinePlus - Chlordiazepoxide

U.S. Food and Drug Administration - Limbitrol

Center for Substance Abuse Research - Benzodiazepines

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