Gamma hydroxybutyrate withdrawal: Difference between revisions
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==Evaluation== | ==Evaluation== | ||
*Typically a clinical diagnosis | |||
==Management== | ==Management== | ||
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==See Also== | ==See Also== | ||
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*[[Toxicology (main)]] | *[[Toxicology (main)]] | ||
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==References== | ==References== | ||
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[[Category:Toxicology]] | |||
Latest revision as of 05:55, 12 July 2016
Background
- Abbreviation: GHB
- Frequently referred to as the "date rape drug"
- Central nervous system depressant
- GABA-B agonist (as opposed to GABA-A agonists - alcohol, benzodiazepines, etc)
- Abused for:
- Body building or sleep enhancement
- euphoric, sexual, stimulant, and relaxant effects
- Surreptitious drugging to facilitate sexual assault
- Also used therapeutically in the treatment of narcolepsy[1]
Pharmacokinetics
- Effects start in 15-20 minutes, peak in 30-60 minutes,
- Lipid soluble, readily crosses the blood brain barrier
- Elimination is dose-dependent; half-life of 20-50 minutes
- The duration of GHB's clinical effects depends upon the dose, and ranges from 2.5-4 hours
Pharmacology
- Is a metabolite and precursor of GABA
- Interacts with GHB-specific receptors and also acts as a direct agonist of GABA-B receptors
- Affects multiple neurotransmitter systems, including those of opioids, dopamine, serotonin, glutamate, and acetylcholine
- Gamma butyrolactone (GBL) and 1,4 butanediol (BD) are GHB analogs that are rapidly metabolized to GHB after ingestion, with the same toxic and recreational effects
Clinical Features
- Similar to alcohol withdrawal
- tremor, agitation, hallucinations, tachycardia, hypertension
- Withdrawal only if have long term use, not episodic binging
- Occur a few hours after use
Differential Diagnosis
Sedative/hypnotic withdrawal
- Toxic alcohols
- Benzodiazepines
- Flunitrazepam (Rohypnol)
- Gamma hydroxybutyrate (GHB)
- Baclofen
- Barbiturates
- Opioids
- Chloral hydrate
Evaluation
- Typically a clinical diagnosis
Management
- Benzodiazepines (may need large doses)
- Neuroleptics
- Beta-blockers
Disposition
See Also
External Links
References
- ↑ Mamelak M, Scharf MB, Woods M. Treatment of narcolepsy with gamma-hydroxybutyrate. A review of clinical and sleep laboratory findings. Sleep. 1986;9(1 Pt 2):285-289. doi:10.1093/sleep/9.1.285