title: Baclofen and γ-hydroxybutyrate (GHB), a dangerous combination.
abstract: Baclofen is a γ-aminobutyric acid (GABA)-β receptor agonist with a muscle relaxant effect. It increases GABA activity and reduces the production of glutamate and dopamine. The GABA precursor γ-hydroxybutyrate (GHB) has gained popularity as a drug of abuse. For the first time, we report a case of a GHB-dependent patient, who ingested several days' doses of baclofen (80 mg) simultaneously with 0.3 L (215 g) of illicit GHB. Baclofen (40 mg/d) was prescribed to prevent relapse after a successful detoxification. The patient developed a rapid coma (E2M5V1 with oxygen support), bradypnea, and hypotonia. Physicians should be alert to the danger of this combination because of the hazards of coma and respiratory distress.
authors.affiliation: From the Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA) (RMK, CAJDJ), Vught, the Netherlands; and Novadic-Kentron Addiction Care Network (RMK, RQ), Vught, the Netherlands.
authors.forename: Rama M
authors.initials: RM
authors.lastname: Kamal
authors.forename: Rouhollah
authors.initials: R
authors.lastname: Qurishi
authors.forename: Cornelis A J
authors.initials: CA
authors.lastname: De Jong
mesh_terms: D001418:Baclofen / Q000009:adverse effects*; D003128:Coma / Q000139:chemically induced*; D005260:Female; D058786:GABA-B Receptor Agonists / Q000009:adverse effects*; D006801:Humans; D009123:Muscle Hypotonia / Q000139:chemically induced*; D012128:Respiratory Distress Syndrome / Q000139:chemically induced*; D012978:Sodium Oxybate / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D058786:GABA-B Receptor Agonists; D012978:Sodium Oxybate; D001418:Baclofen