Abstract
1. Chlordiazepoxide (Librium) was studied in a setting which was called “multi-blind” because of the establishment of (a) a pharmacotherapeutic blind unit, and (b) multiple observer assessment.
2. Ninety-two patients (75 neurotics and 17 psychotics) received Librium with an average daily dose of 70 mgm. for an average period of three weeks. A second group of 92 patients (75 neurotics and 17 psychotics) received placebo. The selection of patients was at random. Fifteen additional patients were taken as their own control and received placebo and Librium sequentially. The common major target symptoms in all patients were anxiety and tension, and the aim of the study was to determine the effect of Librium on these symptoms.
3. Out of 75 neurotics receiving Librium, 35 patients (46.3%) showed from marked to moderate improvement, while out of 75 patients receiving placebo, 6 (8%) showed comparable degree of improvement. X2 analysis of the data indicated that the results with Librium were significant at P < 0.001 level. Divided into sub-groups, only anxiety states and mixed states showed statistically significant degree of improvement (0.01 > P > 0.001).
Out of 17 psychotics in both categories, the degree of improvement was not significant.
In 15 patients taken as their own control, Librium showed a statistically significant superiority over placebo at 0.01 level.
4. Side effects were rather mild in the majority of cases and consisted of head-aches, dizziness, tremors, weakness, drowsiness, nausea and vomiting, and palpitations. One patient developed ataxia, which disappeared after the discontinuation of the drug.
5. The general conclusion was that Librium is an adequate anti-anxiety and anti-tension substance in neurotic patients, solely in anxiety reactions and mixed states.