Key takeaways
Chlordiazepoxide (Librium) and alprazolam (Xanax) are both benzodiazepines used to treat anxiety, but they have some key differences. Chlordiazepoxide is used for short-term relief of anxiety symptoms and alcohol withdrawal, while alprazolam is approved for generalized anxiety disorder (GAD) and panic disorder. Chlordiazepoxide takes up to 4 hours to reach maximum levels in your blood and can stay in your system for over 10 days, whereas alprazolam starts working within 30 minutes and typically clears out in 2-3 days. Both medications are available as lower-cost generics, while alprazolam is available in both immediate-release and extended-release forms. Both medications can cause drowsiness and confusion, but alprazolam has a higher incidence of memory problems and other side effects like irritability and appetite changes. Both should be used short-term due to the risk of addiction and withdrawal symptoms, and neither is recommended during pregnancy.
