Neu Peter
Jüdisches Krankenhaus Berlin - Akademisches Lehrkrankenhaus, Charité - Universitätsmedizin Berlin, Heinz-Galinksi-Str. 1, 13347, Berlin, Deutschland.
Nervenarzt. 2019 May;90(5):509-515. doi: 10.1007/s00115-018-0636-8.
Gamma-hydroxybutyrate (GHB) and its precursors have gained popularity over the last decade as a drug in the party and club scene; however, the clinical knowledge of these substances is low. In the literature there have been case reports of severe dependence and withdrawal but there is a lack of systematic knowledge about the clinical course and complications of detoxification treatment.
The aim of this article is to evaluate the prevalence, treatment course, complications and compliance of GHB patients seeking inpatient qualified detoxification treatment (QDT).
A retrospective evaluation of the hospital charts of all patients admitted to this clinic in 2017 for QDT of GHB. The Jewish Hospital in Berlin (Jüdisches Krankenhaus Berlin) provides specialized inpatient units for addictive diseases and a general intensive care unit. The control population came from a prospective study of all patients with addictive diseases who were treated in the same hospital in 2012.
In 2017 a total of 18 patients with GHB addiction were treated in this hospital. This corresponds to a 1‑year prevalence of 2.28% of all addictive diseases in this year. During detoxification treatment 52% of the GHB patients had to be temporarily transferred to the intensive care unit, 5% had to be temporarily mechanically ventilated and 26% suffered from withdrawal delirium. Of the patients 42% terminated treatment prematurely against medical advice.
Withdrawal treatment from GHB is a severe and potentially dangerous condition, the prevalence of complications was higher than for most other drugs and the rate of intensive care and withdrawal delirium was very high. Further studies are urgently needed with the aim of reducing the complication rates of GHB withdrawal and enhancing therapy adherence.
在过去十年中,γ-羟基丁酸(GHB)及其前体作为一种在派对和俱乐部场合使用的毒品越来越流行;然而,人们对这些物质的临床了解较少。文献中有关于严重依赖和戒断的病例报告,但缺乏关于解毒治疗的临床过程和并发症的系统知识。
本文旨在评估寻求住院合格解毒治疗(QDT)的GHB患者的患病率、治疗过程、并发症和依从性。
对2017年因GHB的QDT入住本诊所的所有患者的医院病历进行回顾性评估。柏林犹太医院(Jüdisches Krankenhaus Berlin)提供成瘾性疾病的专门住院病房和一个普通重症监护病房。对照人群来自于2012年在同一家医院接受治疗的所有成瘾性疾病患者的前瞻性研究。
2017年,该医院共治疗了18名GHB成瘾患者。这相当于该年所有成瘾性疾病1年患病率的2.28%。在解毒治疗期间,52%的GHB患者不得不临时转入重症监护病房,5%的患者不得不临时进行机械通气,26%的患者出现戒断谵妄。42%的患者违背医嘱提前终止治疗。
GHB戒断治疗是一种严重且潜在危险的情况,并发症的患病率高于大多数其他药物,重症监护和戒断谵妄的发生率非常高。迫切需要进一步研究,以降低GHB戒断的并发症发生率并提高治疗依从性。