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Gamma-hydroxybutyrate withdrawal syndrome.

J E Dyer¹, B Roth, B A Hyma

¹California Poison Control System, San Francisco Division, San Francisco General Hospital, CA 94110, USA. jodyer@itsa.ucsf.edu

Annals of Emergency Medicine

|February 15, 2001

Summary

Gamma-hydroxybutyrate (GHB) withdrawal syndrome presents significant challenges in emergency departments. This severe dependence can lead to prolonged, intense withdrawal symptoms including psychosis and delirium.

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Area of Science:

Emergency Medicine
Toxicology
Psychiatry

Background:

Gamma-hydroxybutyrate (GHB) withdrawal is an emerging clinical concern in emergency settings.
Frequent, around-the-clock GHB use can lead to severe dependence.

Observation:

This case series reviewed 8 patients with GHB withdrawal.
Patients experienced psychosis, severe agitation, and required sedation and physical restraint.

Findings:

Withdrawal symptoms manifested rapidly (1-6 hours) and lasted 5-15 days.
Common symptoms included prolonged delirium, hallucinations, anxiety, insomnia, and tremor.
Cardiovascular effects like tachycardia and hypertension were noted; one death occurred.

Implications:

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Recognizing and managing GHB withdrawal is crucial for emergency physicians.
Severe GHB dependence necessitates prompt medical intervention to prevent complications.
Understanding the prolonged and severe nature of GHB withdrawal is vital for patient care.