After more than six decades with benzodiazepines, the U.S. healthcare system has a seemingly love/hate relationship with them. However, these drugs wouldn’t exist if it wasn’t for their more potent predecessor, the barbiturate, which revolutionized medicine. Throughout the course of the 20th century, more than 2,500 barbiturates were synthesized, of which 50 were employed clinically.
The use of these drugs was widespread, and many of them are still used today. Despite their ability to treat insomnia and seizure disorders, doctors realized these were some of the most dangerous drugs in existence. It pushed scientists to develop what they thought would be a safer alternative – benzodiazepines. Librium was the first benzodiazepine created in 1955, followed by Xanax In 1981. Knowing the similarities, differences, and potency is important.
Benzodiazepines were developed as a less addictive alternative to barbiturates, which are notorious for their brutal side effects. Hoffman-La Roche chemist Leo Sternbach identified the first benzodiazepine, Librium, which was thought to be a medical breakthrough. Benzodiazepines first appeared to be less toxic and less likely to cause dependence than barbiturates. The specific improvement was the lack of respiratory depression.
The medical community met benzodiazepines with great enthusiasm, and the drugs’ demand and popularity skyrocketed among patients. In the mid-to-late 1970s, benzodiazepines topped the most prescribed medications list.
Unfortunately, by the 1980s, concerns about the drugs began to grow, and clinical enthusiasm began to wane. Benzodiazepines like Librium and Xanax were given specific guidelines on their use. A particular concern was focused on older adult patients, showing that their demographic had a lesser therapeutic response and heightened sensitivity to these drugs and should be taken with caution.
Today, the benzodiazepine story continues. Xanax is still one of the top 10 most prescribed drugs. Therefore, it is important to understand the differences between these two medications and how they interact with our bodies. While there are some similarities, there are also many differences. These drugs have the potential to be extremely dangerous and cause addiction. Let’s delve a little deeper.
What Is Xanax?
Xanax is a potent benzodiazepine medication that treats panic disorders, anxiety, and depression. The drug is responsible for “balancing out” the chemicals in the brain. It is the most prescribed anxiety medication in the United States.
Xanax increases the number of neurotransmitters in the brain that help someone relax. Xanax’s main role is to help someone calm down and feel better during a panic attack. When used as prescribed, the drug is effective and safe. It slows the amount of movement of brain chemicals that are out of balance, resolving the symptoms of anxiety and tension.
Xanax is made up of alprazolam, which falls under a class of drugs known as central nervous system (CNS) depressants. These work in the brain by suppressing excitability in the central nervous system and function similarly to alcohol and barbiturates. It can produce feelings of sleepiness, anxiety relief, euphoria, and more. While some benzodiazepines are ideal as sleep aids, Xanax is not.
The medication works similarly to other depressants and increases the efficiency of GABA, a neurotransmitter in the brain. The chemical is responsible for the nervous system’s ability to regulate and manage excitability. Xanax binds to GABA receptors and modulates the function, and makes it more efficient, resulting in anxiety suppression, sedation, and muscle relaxation. It produces effects similar to alcohol, which is why it’s sought out by addicts. When used recreationally or in higher doses than prescribed, users report memory loss, slurred speech, respiratory depression, and confusion.
Side effects of Xanax include:
- Weak or shallow breathing
- Double vision
- Feeling like you might pass out
- Decreased energy
- Poor balance or coordination
- Memory problems
- Trouble concentrating
- Slurred speech
- Loss of sex drive
What Is Librium?
Librium is a benzodiazepine that treats acute alcohol withdrawal and anxiety. The drug can be given to patients before surgery to relieve fear and anxiety. Like Xanax, it belongs to the same class of drugs that work on the brain to produce a calming effect on the body. It works by enhancing the effects of GABA in the brain. Librium was the first benzodiazepine ever created and has a long track record of success.
Unlike Xanax, Librium is also an ideal drug for managing sleep disorders. Xanax is considered a short-acting benzodiazepine, whereas Librium lasts in the body much longer. It has a long half-life, another reason it’s used to treat symptoms of alcohol withdrawal. While it’s extremely effective in treating these conditions, there are some serious side effects to mention. These include the following:
- Lack of coordination
- Liver problems
Librium abuse is also possible. The drug should only be used in the short term as long-term use is linked to worsened sleep problems and anxiety. Librium is often abused for its intoxicating effects and can lead to a potential overdose.
Xanax vs. Librium
While Xanax and Librium possess some major similarities, there are also some considerable differences.
Xanax and Librium are similar in the following ways:
- Xanax and Librium are Schedule IV controlled substances.
- Both drugs are benzodiazepines.
- Both have similar effects on the brain.
- Both drugs can be deadly when mixed with other substances like opioids, barbiturates, or alcohol.
- The U.S. Food and Drug Administration (FDA) has approved Librium to manage alcohol withdrawal symptoms, pre-operative anxiety, and anxiety. When someone is prescribed Librium for alcohol withdrawal, it’s typically taken in a medical detox setting.
- Xanax is FDA-approved to treat anxiety and panic disorders.
Duration of Action
- Librium is a long-acting medication that takes several hours before reaching its peak concentration in the bloodstream. On the other hand, Xanax works immediately, which is why it’s ideal for panic attacks. Due to Librium’s long-acting status, it’s beneficial for alcohol detox. It manages withdrawal symptoms over longer periods of time.
- Xanax is a short-acting drug. It reaches peak concentration in the bloodstream in as little as one or two hours. Due to its short onset, it also leaves the body much faster than Librium.
- Librium has an incredibly long half-life. The half-life of a drug refers to how long it takes for half of the dose to exit your system. For Librium, that is anywhere from 24 to 48 hours, depending on your metabolism. It typically takes five half-lives for any drug to completely leave your system, meaning Librium can remain for a week or longer in your body.
- Xanax is a drug known for its short half-life. The drug typically exits the body in a few days. The half-life of Xanax is 11.2 hours. Since it takes five half-lives to leave the body, it’s out within three days.
Both drugs can be addictive. Since Xanax and Librium produce euphoria, they have a high potential for misuse and abuse, which is why they’re classified as Schedule IV substances. Despite the similarities, physicians prescribe them for different reasons, and they have different durations of action.
Another similarity is the withdrawal syndrome benzodiazepines produce. Unfortunately, despite being a top 10 prescribed drug, Xanax is one of the most dangerous drugs to withdraw from, as well as Librium. The number of people filling benzodiazepine prescriptions has increased dramatically over the past several years, leading to widespread abuse and dependence. When you become physically dependent on Xanax or Librium, your body will not function normally without it in your system. If you stop or reduce the dose, you’ll experience withdrawal symptoms, which can be fatal.
Benzodiazepine withdrawal is more than challenging – it’s incredibly risky, especially if you’re alone. You can expect to feel anxious, depressed, and on edge for several weeks. You’ll also become irritable and develop hypersensitivity to anything around you. Sleep will also be hard to come by. If you struggle with insomnia and take benzodiazepines to help you sleep, you can expect to develop rebound symptoms, which is a return of your insomnia worse than before treatment. During the first week, you can expect hand tremors, headaches, and
Benzo withdrawal can be managed through tapering, which leads to milder symptoms that come and go. If you’ve been taking these drugs for more than six months, abrupt cessation can lead to seizures and delirium. For this reason, you must seek professional addiction treatment to stop safely.