title: γ-Hydroxybutyric acid-induced psychosis and seizures.
abstract: Disulfiram and γ-hydroxybutyric acid (GHB) are used to treat alcohol dependence and may both increase dopamine brain levels and modulate GABAergic transmission. We describe a patient affected by bipolar disorder (on valproate as mood-stabilizing treatment) and alcohol dependence who developed a disulfiram-induced hypomanic episode and in whom the switch from disulfiram to GHB induced recurrent convulsive seizures, not responsive to treatment with diazepam, and psychosis. Seizures and psychiatric symptoms ceased after GHB discontinuation. We outline the deregulation of the neurotransmitter systems (GABAergic and dopaminergic networks) that are involved in these drug-drug interactions and that might be responsible for both psychosis and generalized tonic-clonic seizures resistant to standard treatments.
authors.affiliation: Department of Neurosciences, University of Padua Medical School, Padua, Italy. annachiara.cagnin@unipd.it
authors.forename: Annachiara
authors.initials: A
authors.lastname: Cagnin
authors.forename: Sara
authors.initials: S
authors.lastname: Pompanin
authors.forename: Valeria
authors.initials: V
authors.lastname: Manfioli
authors.forename: Chiara
authors.initials: C
authors.lastname: Briani
authors.forename: Alberto
authors.initials: A
authors.lastname: Zambon
authors.forename: Marina
authors.initials: M
authors.lastname: Saladini
authors.forename: Mauro
authors.initials: M
authors.lastname: Dam
mesh_terms: D000437:Alcoholism / Q000150:complications / Q000188:drug therapy; D001714:Bipolar Disorder / Q000150:complications / Q000188:drug therapy; D004569:Electroencephalography; D005260:Female; D006801:Humans; D006885:Hydroxybutyrates / Q000009:adverse effects*; D008875:Middle Aged; D011605:Psychoses, Substance-Induced / Q000209:etiology*; D012640:Seizures / Q000139:chemically induced*
chemical_list: D006885:Hydroxybutyrates; C111420:4-hydroxybutyric acid