title: Psychosis in the context of sodium oxybate therapy.
abstract: Sodium oxybate (brand name Xyrem) is a sodium salt of gamma-hydroxybutyric acid (GHB), an endogenous CNS depressant, which is an effective treatment of narcolepsy. As a drug of abuse, GHB produces severe psychiatric side effects and withdrawal. However, there are no reports of these effects when using clinically recommended doses. This paper presents a case of a patient who developed altered mental status while taking the recommended dose of sodium oxybate and subsequently became psychotic upon abrupt discontinuation of the medication. It is important for prescribers of sodium oxybate to be aware of the possibility of significant psychiatric side effects of this medication, as well as withdrawal symptoms, even at clinical doses.
authors.affiliation: Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Jody
authors.initials: J
authors.lastname: Langford
authors.forename: William L
authors.initials: WL
authors.lastname: Gross
mesh_terms: D000328:Adult; D002492:Central Nervous System Depressants / Q000009:adverse effects* / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D009290:Narcolepsy / Q000175:diagnosis / Q000188:drug therapy; D011618:Psychotic Disorders / Q000209:etiology* / Q000503:physiopathology; D018570:Risk Assessment; D012720:Severity of Illness Index; D012978:Sodium Oxybate / Q000009:adverse effects* / Q000627:therapeutic use; D013375:Substance Withdrawal Syndrome / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology
chemical_list: D002492:Central Nervous System Depressants; D012978:Sodium Oxybate