Gamma-hydroxybutyrate withdrawal syndrome: dangerous but not well-known

• Published in: General hospital psychiatry Vol. 31; no. 4; pp. 394 - 396
• Main Authors: van Noorden, Martijn S., M.D, van Dongen, Lieselotte C.A.M., M.D, Zitman, Frans G., M.D., Ph.D, Vergouwen, Ton (A.)C.M., M.D., Ph.D
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.07.2009; Elsevier
• Subjects: Addictive behaviors; Adolescent; Adult and adolescent clinical studies; Anti-Anxiety Agents - therapeutic use; Biological and medical sciences; Delirium; Delirium - chemically induced; Delirium - diagnosis; Delirium - drug therapy; Diagnosis, Differential; Disease Progression; Drug addiction; Female; Gamma-hydroxybutyrate; Gamma-hydroxybutyric acid; GHB; Half-Life; Hospitals, General; Humans; Lorazepam - therapeutic use; Male; Medical sciences; Organic mental disorders. Neuropsychology; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Sodium Oxybate - metabolism; Sodium Oxybate - poisoning; Substance Abuse Detection; Substance Withdrawal Syndrome - diagnosis; Substance Withdrawal Syndrome - drug therapy; Substance Withdrawal Syndrome - etiology; Substance-Related Disorders - complications; Time Factors; Withdrawal; Young Adult; GHB; Delirium; Gamma-hydroxybutyric acid; Withdrawal; Gamma-hydroxybutyrate; Human; Clinical form; Review; Sodium oxybate; Recommendation; Organic mental disorder; Case study; Symptomatology; Treatment; General anesthetic; Young adult; Evolution; Drug of abuse; Withdrawal syndrome; Mental confusion; Recreational drug
• ISSN: 0163-8343; 1873-7714
• DOI: 10.1016/j.genhosppsych.2008.11.001

Abstract Gamma-hydroxybutyrate (GHB) is an endogenous inhibitory neurotransmitter and anesthetic agent that is being abused as a ‘club drug.’ Withdrawal symptoms after cessation of GHB use are common and depend on the intensity of use. However, GHB withdrawal syndrome and delirium are unfamiliar to most psychiatrists, probably due to the fact that neither textbooks nor guidelines cover the subject. The GHB withdrawal syndrome may have a fulminant course that progresses to delirium. In those severe cases, admission to a general hospital and involvement of a psychiatrist become necessary. We present two cases of severe GHB withdrawal delirium, provide an overview of the literature and conclude with treatment recommendations.