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[既往酒精依赖情况下的γ-羟基丁酸(GHB)依赖与戒断]

[Gamma-hydroxybutyrat (GHB)-dependence and -withdrawal in the case of previous alcohol dependence].

作者信息

Richter Christoph, Romanowski Alexander, Kienast Thorsten

机构信息

Klinik für Psychiatrie und Psychotherapie, Charité Campus Mitte, Charité Universitätsmedizin, Berlin.

出版信息

Psychiatr Prax. 2009 Oct;36(7):345-7. doi: 10.1055/s-0028-1090089. Epub 2009 Jan 27.

Abstract

OBJECTIVE

gamma-Hydroxybutyrat (GHB) is used medically for narcolepsy and as a narcotic. It is also a rare illegal drug. In this case report the development of a GHB-dependency against the background of a primary alcohol dependency is described.

METHODS

Based on established alcohol withdrawal scales (AWSS by Wetterling, CIWA) and neuropsychological testing procedures (CGI, GAF, SKID-II, PISQ, analog-scale for Craving), the initial situation, the development of psychopathological findings, and the course of detoxification were shown.

RESULTS/CONCLUSION: The combined detoxication of GHB and alcohol was successfully finished by a reduction schedule of diazepam. Withdrawal-assessment scales for alcohol were helpful, but show limitations for GHB-withdrawal symptoms. The patient suffers, according to ICD-10, from a multiple drug dependence (alcohol, GHB, abstinence from amphetamines). Symptoms of insomnia, major depression, and generalized anxiety disorder can be associated with the use of GHB.

摘要

目的

γ-羟基丁酸(GHB)在医学上用于发作性睡病治疗且作为一种麻醉剂使用。它也是一种罕见的非法药物。在本病例报告中,描述了在原发性酒精依赖背景下GHB依赖的发展情况。

方法

基于既定的酒精戒断量表(韦特林的酒精戒断症状量表、临床研究所用酒精戒断评估量表)和神经心理学测试程序(临床总体印象量表、大体功能评定量表、药物成瘾严重程度评定量表-II、问题解决能力量表、渴求模拟量表),展示了初始情况、精神病理学发现的发展过程以及脱毒过程。

结果/结论:通过地西泮递减方案成功完成了GHB和酒精的联合脱毒。酒精戒断评估量表有帮助,但对GHB戒断症状存在局限性。根据国际疾病分类第10版,该患者患有多种药物依赖(酒精、GHB、苯丙胺戒断)。失眠、重度抑郁症和广泛性焦虑症的症状可能与GHB的使用有关。

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