Wolf Casper J H, Beurmanjer Harmen, Dijkstra Boukje A G, Geerlings Alexander C, Spoelder Marcia, Homberg Judith R, Schellekens Arnt F A
Medical Center, Department of Psychiatry, Radboud University, 6525 GA Nijmegen, The Netherlands.
Department of Cognitive Neuroscience, Donders Institute for Brain Cognition and Behaviour, Radboud University, 6525 EN, Nijmegen, The Netherlands.
J Clin Med. 2021 May 26;10(11):2333. doi: 10.3390/jcm10112333.
The gamma-hydroxybutyric acid (GHB) withdrawal syndrome can have a fulminant course, complicated by severe complications such as delirium or seizures. Detoxification by tapering with pharmaceutical GHB is a safe way to manage GHB withdrawal. However, a detailed description of the course of the GHB withdrawal syndrome is currently lacking. This study aimed to (1) describe the course of GHB withdrawal symptoms over time, (2) assess the association between vital signs and withdrawal symptoms, and (3) explore sex differences in GHB withdrawal. In this observational multicenter study, patients with GHB use disorder ( = 285) were tapered off with pharmaceutical GHB. The most reported subjective withdrawal symptoms (SWS) were related to cravings, fatigue, insomnia, sweating and feeling gloomy. The most prevalent objective withdrawal symptoms (OWS) were related to cravings, fatigue, tremors, sweating, and sudden cold/warm feelings. No association between vital signs and SWS/OWS was found. Sex differences were observed in the severity and prevalence of specific withdrawal symptoms. Our results suggest that the GHB withdrawal syndrome under pharmaceutical GHB tapering does not strongly differ from withdrawal syndromes of other sedative drugs. The lack of association between vital signs and other withdrawal symptoms, and the relative stability of vitals over time suggest that vitals are not suitable for withdrawal monitoring. The reported sex differences highlight the importance of a personalized approach in GHB detoxification.
γ-羟基丁酸（GHB）戒断综合征可能呈暴发性病程，并伴有谵妄或癫痫发作等严重并发症。通过逐渐减少药用GHB进行解毒是管理GHB戒断的一种安全方法。然而，目前缺乏对GHB戒断综合征病程的详细描述。本研究旨在：（1）描述GHB戒断症状随时间的变化过程；（2）评估生命体征与戒断症状之间的关联；（3）探讨GHB戒断中的性别差异。在这项观察性多中心研究中，对285例GHB使用障碍患者逐渐减少药用GHB用量。报告最多的主观戒断症状（SWS）与渴望、疲劳、失眠、出汗和情绪低落有关。最常见的客观戒断症状（OWS）与渴望、疲劳、震颤、出汗以及突然的冷/热感觉有关。未发现生命体征与SWS/OWS之间存在关联。在特定戒断症状的严重程度和患病率方面观察到了性别差异。我们的结果表明，在逐渐减少药用GHB用量的情况下，GHB戒断综合征与其他镇静药物的戒断综合征并无显著差异。生命体征与其他戒断症状之间缺乏关联，以及生命体征随时间的相对稳定性表明，生命体征不适用于戒断监测。报告的性别差异凸显了在GHB解毒中采用个性化方法的重要性。
