Psychiatria pre prax 3/2024

When benzodiazepines aren‘t enough: delirium in GHB withdrawal syndrome

GHB, or gamma-hydroxybutyric acid, is a substance originally used in medicine as an anesthetic. Currently, in the form of its sodium salt, sodium oxybate, it is registered for the treatment of narcolepsy. Due to its euphoric, relaxing, prosocial, and prosexual effects, mediated through agonism of GABAB and specific GHB receptors, it is increasingly abused as a party drug. Along with new synthetic drugs, GHB has gained popularity, especially in recent years. Keeping pace with the ever-expanding drug scene is challenging, and our clinical experience often lags behind the users. However, it is essential to be theoretically familiar with the issue, as intoxication and withdrawal from GHB can lead to potentially life-threatening complications requiring specific treatment, which we illustrate with a case study of a patient hospitalized in our department for delirium following GHB withdrawal.

Keywords: gamma-hydroxybutyric acid, withdrawal syndrome, benzodiazepines, sodium oxybate