Center for Treatment of Drug Addiction, University Psychiatric Clinic Ljubljana, Grabloviceva 48, 1000 Ljubljana, Slovenia,
Psychiatr Danub. 2019 Sep;31(Suppl 3):354-356.
Gamma-hydroxybutyrate (GHB) and its precursor gamma-butyrolactone (GBL) are popular drugs of abuse used for their euphoric, (potential) anabolic, sedative, and amnestic properties. Daily use of GHB/GBL can lead to addiction and the possibility of withdrawal syndrome on cessation which results in tremor, tachycardia, insomnia, anxiety, hypertension, delirium, coma.
To describe the baseline characteristics, treatment and retention in patients admitted for GHB/GBL withdrawal management.
A retrospective review of 4 consecutive cases of patients reporting GHB/GBL addiction who were admitted for inpatient management of withdrawal syndrome.
All patients were using GHB/GBL daily, 1-1.5 ml per hour. One of them was using cannabis additionally, others were using alcohol, cocaine and amphetamine type stimulants. Psychiatric comorbidities as personality disorders, depression, anxiety and bigorexia were recognized. Patients were treated with benzodiazepines and/or clomethiazole, atypical and typical antipsychotics and beta-blockers. Delirium was developed in two patients. One patient completed detoxification and finished the treatment program. One patient completed detoxification but stopped his treatment earlier, two patients did not completed detoxification and left the program.
GHB/GBL withdrawal can be severe and retention in program is poor. Polysubstance use, psychiatric co-morbidities and heavier GHB/GBL use as possible predictors of poor treatment outcome need consideration in treatment planning.
γ-羟基丁酸（GHB）及其前体γ-丁内酯（GBL）是流行的滥用药物，因其欣快、（潜在）合成代谢、镇静和健忘特性而被使用。GHB/GBL 的每日使用会导致成瘾，并且在停止使用时可能会出现戒断综合征，导致震颤、心动过速、失眠、焦虑、高血压、谵妄、昏迷。
描述因 GHB/GBL 戒断而接受入院管理的患者的基线特征、治疗和保留情况。
对连续 4 例报告 GHB/GBL 成瘾并因戒断综合征入院接受住院管理的患者进行回顾性审查。
所有患者均每天使用 GHB/GBL，每小时 1-1.5 毫升。其中一人还同时使用大麻，其他人则使用酒精、可卡因和苯丙胺类兴奋剂。识别出精神共病，如人格障碍、抑郁、焦虑和大肌症。患者接受苯二氮䓬类药物和/或氯美噻唑、非典型和典型抗精神病药物和β受体阻滞剂治疗。两名患者出现谵妄。一名患者完成了戒毒并完成了治疗计划。一名患者完成了戒毒但提前停止了治疗，两名患者未完成戒毒并离开了治疗计划。
GHB/GBL 戒断可能很严重，且治疗保留率较差。多物质使用、精神共病和更大量的 GHB/GBL 使用可能是治疗结果不佳的预测因素，在治疗计划中需要考虑这些因素。
