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
Drugs Generic
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