Skip to content

Chlordiazepoxide/Amitriptyline

    Brands

    DEA Class;  Rx

    Common Brand Names; Limbitrol, Limbitrol DS

    • Antidepressants, TCAs; 
    • Anxiolytics, Benzodiazepines; 
    • Psychotherapeutic Combos

    Oral antidepressant/anti-anxiety combination product.
    Amitriptyline is a tricyclic antidepressant (TCA), chlordiazepoxide is a benzodiazepine.
    Common ADRs include anticholinergic effects and drowsiness.

    Indicated for the treatment of moderate to severe depression with concurrent symptoms of moderate to severe anxiety in adult patients.

    Hypersensitivity

    Severe cardiovascular disorders

    Angle clossure glaucoma

    Within 14 days of MAOIs

    Any drugs or conditions that prolong QT interval

    Acute recovery post-MI

    • Drowsiness
    • Dry mouth
    • Constipation
    • Blurred vision
    • Dizziness
    • Bloating
    • Vivid dreams
    • Impotence
    • Tremor
    • Confusion
    • Nasal congestion
    • Edema
    • Syncope
    • Ataxia
    • EEG abnormalities
    • Menstrual irregularities
    • Blood dyscrasias (agranulocytosis)
    • Hepatic dysfunction (jaundice)

    Caution in BPH, urinary/GI retention, increased IOP, thyroid dysfunction, open-angle glaucoma, seizure disorders, brain tumor, respiratory impairment, respiratory disease,

    Clinical worsening & suicide ideation may occur despite medication in adolescents & young adults (aged 18-24 yr)

    Write prescription for smallest effective dose

    Risk of anticholinergic side-effects

    May cause orthostatic hypotension

    Paradoxical reactions including hyperactive or aggressive behavior reported

    Both agents may cause sedation and impair ability to perform tasks requiring mental alertness

    SIADH and hyponatremia reported with therapy

    Some patients may experience a large increase in amitriptyline concentration in presence of topiramate; any adjustments in amitriptyline dose should be made according to patient’s clinical response and not on basis of plasma level

    Pregnancy Category: D

    Lactation: Excretion in milk unknown; not recommended

    Adults

    60 mg/day PO chlordiazepoxide and 150 mg/day PO amitriptyline.

    Geriatric

    60 mg/day PO chlordiazepoxide and 150 mg/day PO amitriptyline; however, lower total daily doses are usually recommended in the elderly versus younger adults.

    Adolescents

    Safety and efficacy have not been established.

    Children

    Safety and efficacy have not been established.

    Amitriptyline hydrochloride/Chlordiazepoxide

    tablet: Schedule IV

    • 5mg/12.5mg
    • 10mg/25mg