title: Pharmacological Treatment in γ-Hydroxybutyrate (GHB) and γ-Butyrolactone (GBL) Dependence: Detoxification and Relapse Prevention.
abstract: The misuse of γ-hydroxybutyrate (GHB) for recreational purposes has resulted in an increase in GHB-related problems such as intoxications, dependence and withdrawal in several countries in Europe, Australia and the US over the last decade. However, prevalence rates of misuse of GHB and its precursor, γ-butyrolactone (GBL), are still relatively low. In this qualitative review paper, after a short introduction on the pharmacology of GHB/GBL, followed by a summary of the epidemiology of GHB abuse, an overview of GHB dependence syndrome and GHB/GBL withdrawal syndrome is provided. Finally, the existing literature on management of GHB detoxification, both planned and unplanned, as well as the available management of GHB withdrawal syndrome, is summarized. Although no systematic studies on detoxification and management of withdrawal have been performed to date, general recommendations are given on pharmacological treatment and preferred treatment setting.
authors.affiliation: Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Toernooiveld 5, 6525 ED, Nijmegen, The Netherlands. rama.kamal@novadic-kentron.nl.|Novadic-Kentron Addiction Care Network, Hogedwarsstraat 3, PO Box 243, 5260 AE, Vught, The Netherlands. rama.kamal@novadic-kentron.nl.
authors.forename: Rama M
authors.initials: RM
authors.lastname: Kamal
authors.affiliation: Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
authors.forename: Martijn S
authors.initials: MS
authors.lastname: van Noorden
authors.affiliation: Scientific Research Committee IrisZorg, Kronenburgsingel 545, 6831 GM, Arnhem, The Netherlands.
authors.forename: Wim
authors.initials: W
authors.lastname: Wannet
authors.affiliation: Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Toernooiveld 5, 6525 ED, Nijmegen, The Netherlands.|Novadic-Kentron Addiction Care Network, Hogedwarsstraat 3, PO Box 243, 5260 AE, Vught, The Netherlands.
authors.forename: Harmen
authors.initials: H
authors.lastname: Beurmanjer
authors.affiliation: Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Toernooiveld 5, 6525 ED, Nijmegen, The Netherlands.
authors.forename: Boukje A G
authors.initials: BA
authors.lastname: Dijkstra
authors.affiliation: Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Toernooiveld 5, 6525 ED, Nijmegen, The Netherlands.
authors.forename: Arnt
authors.initials: A
authors.lastname: Schellekens
mesh_terms: D015107:4-Butyrolactone / Q000009:adverse effects*; D000818:Animals; D006801:Humans; D008658:Inactivation, Metabolic / Q000187:drug effects; D055502:Secondary Prevention / Q000379:methods; D012978:Sodium Oxybate / Q000009:adverse effects*; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy* / Q000628:therapy*; D019966:Substance-Related Disorders / Q000188:drug therapy* / Q000628:therapy*
chemical_list: D012978:Sodium Oxybate; D015107:4-Butyrolactone