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Baclofen and γ-hydroxybutyrate (GHB), a dangerous combination
Rama M Kamal1, Rouhollah Qurishi, Cornelis A J De Jong
1From the Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA) (RMK, CAJDJ), Vught, the Netherlands; and Novadic-Kentron Addiction Care Network (RMK, RQ), Vught, the Netherlands.
Journal of Addiction Medicine
|December 11, 2014
Summary
Combining baclofen with gamma-hydroxybutyrate (GHB) can lead to dangerous coma and respiratory distress. Physicians must be aware of this severe drug interaction risk in patients abusing GHB.
Area of Science:
- Pharmacology
- Toxicology
- Neuroscience
Background:
- Baclofen is a muscle relaxant acting as a GABA-β receptor agonist.
- Gamma-hydroxybutyrate (GHB) is a GABA precursor increasingly used as a drug of abuse.
- Baclofen is sometimes prescribed to prevent relapse after GHB detoxification.
Observation:
- A patient dependent on GHB ingested a large dose of baclofen (80 mg) along with illicit GHB (215 g).
- The patient, previously prescribed baclofen for relapse prevention, developed rapid coma, bradypnea, and hypotonia.
- This combination occurred after successful detoxification from GHB.
Findings:
- Simultaneous ingestion of high-dose baclofen and GHB resulted in severe central nervous system depression.
- The patient presented with coma (Glasgow Coma Scale E2M5V1), respiratory depression, and muscle hypotonia.
- This case highlights a potentially life-threatening interaction between baclofen and GHB.
Implications:
- Healthcare providers should exercise caution when prescribing baclofen to patients with a history of GHB abuse.
- Awareness of this baclofen-GHB interaction is crucial for preventing severe adverse events like coma and respiratory failure.
- This case underscores the need for vigilant monitoring and risk assessment in patients undergoing GHB detoxification and relapse prevention.