[Sodium gamma-hydroxybutyrate. Certainties and therapeutic potentialities]

Gamma hydroxybutyrate (GHB) is a simple four carbon molecule which is a natural constituent of many mammalian tissues in the central nervous system (CNS) and in several tissues of the body. The synthesis of GHB is not the same in the central nervous system and in peripheral tissues. GHB modifies the rates and/or the levels of the synthesis of several neurotransmitters. Its natural presence in the CNS, its pharmacological effects and its action on various behaviours have raised the problem of GHB as a neurotransmitter. GHB can reduce energy substrate consumption in both brain and peripheral tissues and it can protect these tissues from the damaging effects of anoxia. In conditions of anoxia or excessive metabolic demand endogenous GHB levels rise. GHB seems to act through the endogenous opioid system. GHB natural function would be to induce the state of hibernation in which one can evidence a trance-like state and hypothermia with high rates of GHB. The synthesis of GHB through a reductive process and breakdown through oxidation suggest that it accumulates under hypoxic conditions. On top of its present clinical use as hypnotic, general anesthetic and in neurotraumatology, GHB would have therapeutic applications in states of anoxia that generates amino-acid excitators and free radicals.