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Gamma-hydroxybutyrate detoxification by titration and tapering
Cor A J de Jong1, Rama Kamal, Boukje A G Dijkstra
1Nijmegen Institute for Scientist Practitioners in Addiction, Nijmegen, The Netherlands. nispa.dejong@gmail.com
Objective:
To determine the effectiveness and safety of a new detoxification procedure in γ-hydroxybutyrate (GHB)-dependent patients. GHB is an endogenous inhibitory neurotransmitter and anesthetic agent that is being abused as a club drug. In many GHB-dependent patients a severe withdrawal syndrome develops that does not respond to treatment with high dosages of benzodiazepines and often requires an admission to an intensive care unit.
Methods:
Based on the knowledge of detoxification procedures in opioid and benzodiazepine dependence, we developed a titration and tapering procedure. A consecutive series of 23 GHB-dependent inpatients were transferred from illegal GHB (mostly self-produced) in various concentrations to pharmaceutical GHB. They were given initial doses that resulted in a balance between sedation and withdrawal symptoms. After this titration period, patients were placed on a 1-week taper.
Results:
We have found that after titration the patients experienced a low level of withdrawal symptoms. During tapering these symptoms decreased significantly and no patient developed a delirium or a psychosis. None of the patients had to be transferred to a medium or intensive care unit.
Conclusions:
This detoxification procedure proved to be safe and convenient in patients with moderate to severe GHB dependence.
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