title: [Gamma-hydroxybutyrat (GHB)-dependence and -withdrawal in the case of previous alcohol dependence].
abstract: OBJECTIVE
  gamma-Hydroxybutyrat (GHB) is used medically for narcolepsy and as a narcotic. It is also a rare illegal drug. In this case report the development of a GHB-dependency against the background of a primary alcohol dependency is described.
  
  
  METHODS
  Based on established alcohol withdrawal scales (AWSS by Wetterling, CIWA) and neuropsychological testing procedures (CGI, GAF, SKID-II, PISQ, analog-scale for Craving), the initial situation, the development of psychopathological findings, and the course of detoxification were shown.
  
  
  CONCLUSIONS
  The combined detoxication of GHB and alcohol was successfully finished by a reduction schedule of diazepam. Withdrawal-assessment scales for alcohol were helpful, but show limitations for GHB-withdrawal symptoms. The patient suffers, according to ICD-10, from a multiple drug dependence (alcohol, GHB, abstinence from amphetamines). Symptoms of insomnia, major depression, and generalized anxiety disorder can be associated with the use of GHB.
authors.affiliation: Klinik für Psychiatrie und Psychotherapie, Charité Campus Mitte, Charité Universitätsmedizin, Berlin. ch.richter@charite.de
authors.forename: Christoph
authors.initials: C
authors.lastname: Richter
authors.forename: Alexander
authors.initials: A
authors.lastname: Romanowski
authors.forename: Thorsten
authors.initials: T
authors.lastname: Kienast
mesh_terms: D000759:Adjuvants, Anesthesia / Q000009:adverse effects; D000328:Adult; D000437:Alcoholism / Q000523:psychology / Q000534:rehabilitation*; D015897:Comorbidity; D004361:Drug Tolerance; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D009483:Neuropsychological Tests; D012978:Sodium Oxybate; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis* / Q000534:rehabilitation; D019966:Substance-Related Disorders / Q000523:psychology* / Q000534:rehabilitation*; D016896:Treatment Outcome
chemical_list: D000759:Adjuvants, Anesthesia; D013287:Illicit Drugs; D012978:Sodium Oxybate