A sudden awakening from a near coma after combined intake of gamma-hydroxybutyric acid (GHB) and ethanol.
OBJECTIVE
A case of a sudden awakening from a near coma after combined intake or gamma-hydroxybutyric acid (GHB) (125 micrograms/mL), ethanol (134 mg/dL), and cannabinoids is described.


METHODS
GHB was determined by gas chromatography-mass spectrometry after acetonitrile precipitation and derivation with N-methyl-N-trimethylsilyltrifluoroacetamide, using valproic acid as the internal standard.


CONCLUSIONS
The described case illustrates the consequences of GHB overdose. GHB overdose should be considered in every case of unexplained sudden coma, i.e., without any evidence of head injury, intake of coma-inducing drugs, or increasing intracranial pressure. GHB overdose will be missed by routine toxicological screening.
Louagie
H K
HK
Department of Clinical Biology, University Hospital, Ghent, Belgium. Henk.Louagie@rug.ac.be
Verstraete
A G
AG
De Soete
C J
CJ
Baetens
D G
DG
Calle
P A
PA
D000328:Adult; D018686:Anesthetics, Intravenous / Q000097:blood / Q000506:poisoning*; D002186:Cannabinoids / Q000506:poisoning*; D002492:Central Nervous System Depressants / Q000506:poisoning*; D003128:Coma / Q000139:chemically induced / Q000503:physiopathology*; D004347:Drug Interactions; D000431:Ethanol / Q000506:poisoning*; D005260:Female; D006801:Humans; D012978:Sodium Oxybate / Q000097:blood / Q000506:poisoning*; D014851:Wakefulness / Q000502:physiology
D018686:Anesthetics, Intravenous; D002186:Cannabinoids; D002492:Central Nervous System Depressants; D000431:Ethanol; D012978:Sodium Oxybate