British Columbia Centre on Substance Use, Vancouver, BC, Canada (SH, KA, MM, MES); Department of Family Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada (SH, KA, MM); Vancouver Detox, Vancouver Coastal Health, Vancouver, BC, Canada (SH, KA, MM); Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada (MES).
J Addict Med. 2019 Sep/Oct;13(5):415-417. doi: 10.1097/ADM.0000000000000514.
Gamma-hydroxybutyrate (GHB)-a GABA-B agonist-can lead to a use disorder, and a withdrawal syndrome similar to that of alcohol. At present, evidence is lacking for how to best manage GHB withdrawal, and often clinicians rely on alcohol withdrawal management approaches, using medications like benzodiazepines (BZD). However, BZD doses needed to control GHB withdrawal symptoms are typically much higher than those required for alcohol, posing significant safety risks. Novel approaches include the use of baclofen as an adjunct to BZD, allowing reductions in BZD requirements. While the use of baclofen as monotherapy may result in even greater risk reductions, research to support this approach is limited.
We present a case of a 26-year-old female with severe GHB use disorder and history of severe withdrawal symptoms, whose withdrawal was successfully, managed using baclofen alone.
In keeping with other case reports, baclofen appears to have potential to be used in the management of GHB withdrawal. Here, we presented a case of severe GHB withdrawal which was managed solely by baclofen. Clinical research is needed to evaluate baclofen's potential as a standalone treatment for GHB withdrawal.
γ-羟基丁酸(GHB)是一种 GABA-B 激动剂,可导致使用障碍和类似于酒精的戒断综合征。目前,缺乏如何最好地管理 GHB 戒断的证据,临床医生通常依赖于酒精戒断管理方法,使用苯二氮䓬类药物(BZD)等药物。然而,控制 GHB 戒断症状所需的 BZD 剂量通常比酒精高得多,带来重大的安全风险。新方法包括将巴氯芬用作 BZD 的辅助药物,以减少 BZD 的需求。虽然 BZD 单一疗法的使用可能会带来更大的风险降低,但支持这种方法的研究有限。
我们报告了一例 26 岁女性,患有严重的 GHB 使用障碍和严重戒断症状史,其戒断成功地通过单独使用巴氯芬来管理。
与其他病例报告一致,巴氯芬似乎有可能用于 GHB 戒断的管理。在这里,我们报告了一例严重的 GHB 戒断病例,仅通过巴氯芬进行管理。需要进行临床研究来评估巴氯芬作为 GHB 戒断的单一治疗方法的潜力。