The gamma-Hydroxybutyrate Withdrawal Syndrome
by
Tarabar AF, Nelson LS.
New York City Poison Control Center,
New York, New York, USA.
Toxicol Rev. 2004;23(1):45-9


ABSTRACT

gamma-Hydroxybutyrate (GHB) is endogenous inhibitory transmitter that, when administered in pharmacological doses, has sedative-hypnotic properties. It is used in anaesthesia for the treatment of narcolepsy/catalepsy and in alcohol/opioid detoxification treatment regimens. Based on its purported anabolic effects, GHB use became established among bodybuilders. As the euphorigenic effects of GHB became publicised, attendees at dance clubs and rave parties began to use it alone or in combination with other psychoactive drugs. Following the ban of GHB in 1990, several precursor products (e.g. gamma-butyrolactone, butanediol) became widely used as replacement drugs until their ultimate proscription from lawful use in 2000. GHB and its precursors, like most sedative-hypnotic agents, can induce tolerance and produce dependence. Although many GHB users will experience a mild withdrawal syndrome upon drug discontinuation, those with chronic heavy GHB use can experience severe withdrawal. This syndrome clinically resembles the withdrawal syndrome noted from alcohol and other sedative-hypnotic drugs (e.g. benzodiazepines). Distinct clinical features of GHB withdrawal are its relatively mild and brief autonomic instability with prolonged psychotic symptoms. Patients with fulminant GHB withdrawal require aggressive treatment with cross-tolerant sedative hypnotics, such as benzodiazepines.
GHB
GABA
MDMA
Opioids
Reward
Alcohol
Dopamine
GHB and GABA
GHB and cocaine
Drugs and reward
GHB and the brain
GHB and alcoholism
GHB and narcolepsy
GHB and growth hormone
The pleasure and the pain
GHB, tryptophan and serotonin
GHB (Xyrem): tolerance and withdrawal


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