Clinical features and management of gamma-hydroxybutyrate (GHB) withdrawal: a review

Drug and Alcohol Dependence
Michael McDonoughJenny Bearn

Abstract

To examine the clinical course of gamma-hydroxybutyrate (GHB) withdrawal and generate management guidelines. Review and analysis of all published reports of GHB or GHB precursor withdrawal identified from electronic searches. In total, 38 cases of GHB (n = 28) or GHB precursor (n = 10) withdrawal were identified, 36 of which were from the US. A rapidly deteriorating course into delirium (53% of cases) was typical for heavily dependent users. Symptoms were broadly similar to alcohol withdrawal but often occurred earlier in usage with delirium being associated with severe dependence as determined by more frequent ingestion. High dose benzodiazepines were effective in pharmacological management of GHB withdrawal. In benzodiazepine refractory cases withdrawal responded to other sedative agents, mainly pentobarbital or chloral hydrate. No withdrawal seizures but one death was recorded. GHB withdrawal is potentially life threatening and requires vigorous clinical management, preferably as an inpatient for severe cases. A management algorithm is proposed.

Citations

Feb 13, 2008·Neurocritical Care·Jennifer L LeTourneauStephen M Smith
May 12, 2005·Brain Research. Brain Research Protocols·Mauro A M CaraiGiancarlo Colombo
Jul 1, 2005·The New England Journal of Medicine·O Carter Snead, K Michael Gibson
Dec 28, 2007·Journal of Psychoactive Drugs·W R Murray BennettPeter P Roy-Byrne
Dec 16, 2011·Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine·Jody Langford, William L Gross
Jul 24, 2014·Case Reports in Neurological Medicine·Rafael MeyerSoenke Boettger
Apr 22, 2009·Expert Opinion on Investigational Drugs·Giovanni AddoloratoAntonio Gasbarrini
Jul 29, 2005·Substance Use & Misuse·Jane Carlisle Maxwell
Jun 7, 2005·Expert Opinion on Emerging Drugs·Raye Z LittenMark Egli
Jul 4, 2012·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Leo J SchepBruno Mégarbane
Feb 15, 2008·The World Journal of Biological Psychiatry : the Official Journal of the World Federation of Societies of Biological Psychiatry·Michael SoykaUNKNOWN WFSBP Task Force on Treatment Guidelines for Substance Use Disorders
Feb 22, 2012·Neuroscience and Biobehavioral Reviews·Jan G C van AmsterdamRaymond J M Niesink
Jan 31, 2012·Medicina clínica·Albert BatallaVictoria Soler
Sep 19, 2009·La Presse médicale·Laurent KarilaMichel Reynaud
Jun 27, 2009·General Hospital Psychiatry·Martijn S van NoordenTon A C M Vergouwen
Nov 18, 2008·Pharmacology & Therapeutics·Lawrence P CarterCharles P France
Mar 29, 2006·Clinics in Laboratory Medicine·Brandon Wills, Timothy Erickson
Aug 17, 2006·Acta Neurologica Scandinavica·K R DrasbekK Jensen
Oct 1, 2011·Drug Testing and Analysis·Laurent Karila, Michel Reynaud
Oct 12, 2010·Addiction·James Bell, Rodney Collins
Jan 1, 2014·Journal of Clinical Nursing·Maja-Klara LundahlKarl-Gustaf Norbergh
Jan 25, 2005·Drug and Alcohol Dependence·G AddoloratoM Bernardi
Oct 18, 2005·The Medical Clinics of North America·Brandon Wills, Timothy Erickson
Sep 10, 2009·Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie·Florian D ZepfLars Wöckel
Apr 23, 2015·Journal of Clinical Psychopharmacology·Rama M KamalCornelis A J De Jong
Jan 2, 2014·Drug and Alcohol Dependence·Rama M KamalCornelis A J de Jong
Mar 24, 2012·Regulatory Toxicology and Pharmacology : RTP·Jan G C van AmsterdamWim van den Brink
Sep 11, 2014·Regulatory Toxicology and Pharmacology : RTP·Jan van AmsterdamWim van den Brink
Feb 26, 2010·Cases Journal·Michael A KuiperE Christiaan Boerma
Jul 24, 2014·Journal of Psychoactive Drugs·Rebekah Brennan, Marie Claire Van Hout

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