51. [Withdrawal syndrome after abuse of GHB (Gamma-Hydroxybutyrate) and its physiological precursors - its relevance for child and adolescent psychiatrists].
- Author
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Zepf FD, Holtmann M, Duketis E, Maier J, Radeloff D, Schirman S, Wagner A, Poustka F, and Wöckel L
- Subjects
- 4-Butyrolactone adverse effects, Acute Disease, Adolescent, Antipsychotic Agents adverse effects, Antipsychotic Agents therapeutic use, Benzodiazepines adverse effects, Benzodiazepines therapeutic use, Butylene Glycols adverse effects, Child, Critical Care, Delusions diagnosis, Delusions drug therapy, Diagnosis, Differential, Drug Interactions, Humans, Psychoses, Substance-Induced diagnosis, Psychoses, Substance-Induced drug therapy, Substance Withdrawal Syndrome drug therapy, Anesthetics, Intravenous adverse effects, Delusions chemically induced, Sodium Oxybate adverse effects, Substance Withdrawal Syndrome diagnosis, Substance-Related Disorders rehabilitation
- Abstract
Background: The chronic abuse of Gamma-Hydroxybutyrate (GHB) as a designer drug as well as it's physiological precursors Gamma-Butyrolactone (GBL) and 1,4-Butandiole (1,4-BD) confronts child and adolescent psychiatrists with new challenges. The acute withdrawal of GHB with its cardiovascular and delirant symptoms is of particular importance for child and adolescent psychiatrists., Methods: In the present paper theoretical and biological aspects of acute GHB-/GBL-/1,4-BD-withdrawal syndrome are presented, and selected cases are discussed as regards potential treatment., Results: High dose treatment with benzodiazepines was successful in some cases of acute GHB-/GBL-/1,4-BD-withdrawal syndrome. Complications were severe dystonia under neuroleptic treatment, and also side-effects of treatment with benzodiazepines. Further problems were vegetative symptoms, electrocardiographic changes, rhabdomyolysis, acute renal failure, and death., Conclusion: Acute GHB-withdrawal syndrome is a life-threatening condition which requires immediate intensive care treatment along with continuous monitoring of vital parameters. As acute GHB-withdrawal syndrome can present with symptoms close to psychotic episodes or acute alcohol withdrawal this condition is relevant for child and adolescent psychiatrists.
- Published
- 2009
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