title: Successful management of prolonged gamma-hydroxybutyrate and alcohol withdrawal.
abstract: A 27-year-old man was admitted with tremulousness, diaphoresis, tachypnea (28 breaths/min), full-body rigidity, irritability, paranoia, and auditory and visual hallucinations 2 days after stopping long-term gamma-hydroxybutyrate (GHB) and 8 hours after stopping alcohol intake. He received intravenous fluids and tapering dosages of lorazepam to control agitation and rigidity, and recovered with no significant sequelae after 8 days. Abrupt cessation of GHB after high-dosage abuse can precipitate a clinically significant withdrawal syndrome. Lorazepam should be considered for treatment of GHB withdrawal. Concomitant alcohol abuse may mask early GHB withdrawal symptoms and exacerbate withdrawal.
authors.affiliation: Department of Pharmacy Practice, School of Pharmacy, University of Missouri-Kansas City, Western Missouri Mental Health Center, USA.
authors.forename: T M
authors.initials: TM
authors.lastname: Bowles
authors.forename: R W
authors.initials: RW
authors.lastname: Sommi
authors.forename: M
authors.initials: M
authors.lastname: Amiri
mesh_terms: D000328:Adult; D018686:Anesthetics, Intravenous / Q000009:adverse effects; D000927:Anticonvulsants / Q000627:therapeutic use*; D002492:Central Nervous System Depressants / Q000009:adverse effects; D000431:Ethanol / Q000009:adverse effects; D005440:Fluid Therapy; D006212:Hallucinations / Q000139:chemically induced / Q000188:drug therapy; D006801:Humans; D008140:Lorazepam / Q000627:therapeutic use*; D008297:Male; D009127:Muscle Rigidity / Q000139:chemically induced / Q000188:drug therapy; D012978:Sodium Oxybate / Q000009:adverse effects; D013375:Substance Withdrawal Syndrome / Q000523:psychology / Q000628:therapy*
chemical_list: D018686:Anesthetics, Intravenous; D000927:Anticonvulsants; D002492:Central Nervous System Depressants; D000431:Ethanol; D012978:Sodium Oxybate; D008140:Lorazepam