Gamma-hydroxybutyrate withdrawal syndrome: dangerous but not well-known.
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.
van Noorden
Martijn S
MS
Department of Psychiatry, Leiden University Medical Center, Leiden 2333 ZA, The Netherlands. msvannoorden@gmail.com
van Dongen
Lieselotte C A M
LC
Zitman
Frans G
FG
Vergouwen
Ton A C M
TA
D000293:Adolescent; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D003693:Delirium / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D003937:Diagnosis, Differential; D018450:Disease Progression; D005260:Female; D006207:Half-Life; D006769:Hospitals, General; D006801:Humans; D008140:Lorazepam / Q000627:therapeutic use; D008297:Male; D011570:Psychiatry; D012978:Sodium Oxybate / Q000378:metabolism / Q000506:poisoning*; D015813:Substance Abuse Detection; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D019966:Substance-Related Disorders / Q000150:complications*; D013997:Time Factors; D055815:Young Adult
D014151:Anti-Anxiety Agents; D012978:Sodium Oxybate; D008140:Lorazepam