Zepf Florian D, Holtmann Martin, Duketis Eftichia, Maier Joachim, Radeloff Daniel, Schirman Shella, Wagner Angela, Poustka Fritz, Wöckel Lars
Klinik für Kinder- und Jugendpsychiatrie und -psychotherapie, RWTH Universität Aachen, Aachen.
Z Kinder Jugendpsychiatr Psychother. 2009 Sep;37(5):413-20. doi: 10.1024/1422-4917.37.5.413.
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.
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.
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.
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.
γ-羟基丁酸（GHB）作为一种合成毒品被长期滥用，以及其生理前体γ-丁内酯（GBL）和1,4-丁二醇（1,4-BD），给儿童和青少年精神科医生带来了新的挑战。GHB急性戒断时出现的心血管症状和谵妄症状，对儿童和青少年精神科医生尤为重要。
本文介绍了GHB/GBL/1,4-BD急性戒断综合征的理论和生物学方面，并就潜在治疗方法对所选病例进行了讨论。
高剂量苯二氮䓬类药物治疗在一些GHB/GBL/1,4-BD急性戒断综合征病例中取得了成功。并发症包括抗精神病药物治疗下的严重肌张力障碍，以及苯二氮䓬类药物治疗的副作用。其他问题包括植物神经症状、心电图改变、横纹肌溶解、急性肾衰竭和死亡。
GHB急性戒断综合征是一种危及生命的疾病，需要立即进行重症监护治疗，并持续监测生命参数。由于GHB急性戒断综合征可能出现类似于精神病发作或急性酒精戒断的症状，因此这种疾病与儿童和青少年精神科医生相关。
