title: Baclofen and gamma-hydroxybutyrate withdrawal.
abstract: BACKGROUND
  Benzodiazepine treatment of life-threatening gamma-hydroxybutyrate (GHB) withdrawal is frequently unsatisfactory. Animal studies suggest strongly that treatment with GABA(B) agonists, such as baclofen, will be a more effective strategy.
  
  
  METHODS
  A case report from the medical intensive care unit (ICU) of the university tertiary care hospital.
  
  
  RESULTS
  A 61-year-old woman was admitted to the medical ICU for severe withdrawal symptoms from chronic GHB use. This manifested as delirium, tremor, and seizures despite only small decreases in GHB dose and treatment with benzodiazepines. The addition of baclofen allowed the rapid sequential decreases in the GHB dose without seizure or delirium and resulted in long-term improvement of her tremor.
  
  
  CONCLUSIONS
  Baclofen, a GABA(B) agonist, may be a useful agent in the treatment of severe GHB withdrawal.
authors.affiliation: Division of Pulmonary & Critical Care Medicine and Center for Intensive Care Research, Department of Medicine, Oregon Health & Science University, Biomedical Research Building (UHN-67), 3181 SW Sam Jackson Park Road, Portland, OR 97239-3098, USA.
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: LeTourneau
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Hagg
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Smith
mesh_terms: D000759:Adjuvants, Anesthesia / Q000009:adverse effects*; D001418:Baclofen / Q000008:administration & dosage*; D001569:Benzodiazepines / Q000627:therapeutic use; D003693:Delirium / Q000139:chemically induced / Q000188:drug therapy; D004827:Epilepsy / Q000139:chemically induced / Q000188:drug therapy; D005260:Female; D018755:GABA Agonists / Q000008:administration & dosage*; D006801:Humans; D008875:Middle Aged; D012978:Sodium Oxybate / Q000009:adverse effects*; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy*; D014202:Tremor / Q000139:chemically induced / Q000188:drug therapy
chemical_list: D000759:Adjuvants, Anesthesia; D018755:GABA Agonists; D001569:Benzodiazepines; D012978:Sodium Oxybate; D001418:Baclofen