γ-Hydroxybutyric Acid

• Published in: The New England journal of medicine Vol. 352; no. 26; pp. 2721 - 2732
• Main Authors: Snead, O. Carter, Gibson, K. Michael
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 30.06.2005
• Subjects: 4-Butyrolactone - metabolism; Animals; Biological and medical sciences; Butylene Glycols - metabolism; General aspects; Humans; Hydroxybutyrates - adverse effects; Hydroxybutyrates - metabolism; Hydroxybutyrates - pharmacology; Medical sciences; Receptors, Cell Surface - metabolism; Receptors, Dopamine - drug effects; Receptors, Dopamine - metabolism; Receptors, GABA - metabolism; Substance Withdrawal Syndrome; Substance-Related Disorders; Medicine; Acids
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMra044047

The short-chain fatty acid γ-hydroxybutyric acid (GHB), which is synthesized as an analogue of γ-aminobutyric acid (GABA) that would cross the blood–brain barrier, has found limited clinical use as an anesthetic agent and as treatment for narcolepsy and alcoholism. However, during the past decade, GHB has emerged as a major recreational drug in the United States. This review article discusses the mechanisms of action and presents an approach to the treatment of overdose, abuse, and addiction. During the past decade, GHB has emerged as a major recreational drug in the United States. This review article discusses the mechanisms of action and presents an approach to the treatment of overdose, abuse, and addiction. The short-chain fatty acid γ-hydroxybutyric acid (GHB) was synthesized in 1960 in an attempt to create an analogue of the ubiquitous inhibitory brain neurotransmitter γ-aminobutyric acid (GABA) that would cross the blood–brain barrier. 1 GHB turned out to have sedative properties similar to those that had been reported for γ-butyrolactone 13 years earlier. 2 In fact, γ-butyrolactone has since been shown to be biologically inactive, 3 , 4 since all its biologic and behavioral effects are due to its rapid conversion to GHB by an active lactonase. 5 Although GHB has found limited clinical use as an anesthetic agent 6 – 8 and in the treatment of . . .