title: [Withdrawal syndrome after abuse of GHB (Gamma-Hydroxybutyrate) and its physiological precursors - its relevance for child and adolescent psychiatrists].
abstract: BACKGROUND
  The chronic abuse of Gamma-Hydroxybutyrate (GHB) as a designer drug as well as it's physiological precursors Gamma-Butyrolactone (GBL) and 1,4-Butandiole (1,4-BD) confronts child and adolescent psychiatrists with new challenges. The acute withdrawal of GHB with its cardiovascular and delirant symptoms is of particular importance for child and adolescent psychiatrists.
  
  
  METHODS
  In the present paper theoretical and biological aspects of acute GHB-/GBL-/1,4-BD-withdrawal syndrome are presented, and selected cases are discussed as regards potential treatment.
  
  
  RESULTS
  High dose treatment with benzodiazepines was successful in some cases of acute GHB-/GBL-/1,4-BD-withdrawal syndrome. Complications were severe dystonia under neuroleptic treatment, and also side-effects of treatment with benzodiazepines. Further problems were vegetative symptoms, electrocardiographic changes, rhabdomyolysis, acute renal failure, and death.
  
  
  CONCLUSIONS
  Acute GHB-withdrawal syndrome is a life-threatening condition which requires immediate intensive care treatment along with continuous monitoring of vital parameters. As acute GHB-withdrawal syndrome can present with symptoms close to psychotic episodes or acute alcohol withdrawal this condition is relevant for child and adolescent psychiatrists.
authors.affiliation: Klinik für Kinder- und Jugendpsychiatrie und -psychotherapie, RWTH Universität Aachen, Aachen. fzepf@ukaachen.de
authors.forename: Florian D
authors.initials: FD
authors.lastname: Zepf
authors.forename: Martin
authors.initials: M
authors.lastname: Holtmann
authors.forename: Eftichia
authors.initials: E
authors.lastname: Duketis
authors.forename: Joachim
authors.initials: J
authors.lastname: Maier
authors.forename: Daniel
authors.initials: D
authors.lastname: Radeloff
authors.forename: Shella
authors.initials: S
authors.lastname: Schirman
authors.forename: Angela
authors.initials: A
authors.lastname: Wagner
authors.forename: Fritz
authors.initials: F
authors.lastname: Poustka
authors.forename: Lars
authors.initials: L
authors.lastname: Wöckel
mesh_terms: D015107:4-Butyrolactone / Q000009:adverse effects; D000208:Acute Disease; D000293:Adolescent; D018686:Anesthetics, Intravenous / Q000009:adverse effects*; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001569:Benzodiazepines / Q000009:adverse effects / Q000627:therapeutic use; D002072:Butylene Glycols / Q000009:adverse effects; D002648:Child; D003422:Critical Care; D003702:Delusions / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D003937:Diagnosis, Differential; D004347:Drug Interactions; D006801:Humans; D011605:Psychoses, Substance-Induced / Q000175:diagnosis / Q000188:drug therapy; D012978:Sodium Oxybate / Q000009:adverse effects*; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis* / Q000188:drug therapy; D019966:Substance-Related Disorders / Q000534:rehabilitation*
chemical_list: D018686:Anesthetics, Intravenous; D014150:Antipsychotic Agents; D002072:Butylene Glycols; D001569:Benzodiazepines; D012978:Sodium Oxybate; C039681:1,4-butanediol; D015107:4-Butyrolactone