II. Pathophysiology
- GHB Dependence is rare due to rapid elimination
- GHB Dependence may occur with excessive use
- Chronic use (common in bodybuilders)
- Frequent dosing (evert 1-3 hours around the clock)
III. Symptoms: Withdrawal
- Early symptoms
- Later symptoms
- Agitation
- Vivid Hallucinations
- Combative behavior
- Disorientation
- Seizures
- Associated Symptoms: Autonomic Instability
- Tachycardia
- Hypertension
- Tremor
- Diaphoresis
IV. Differential Diagnosis
V. Labs
VI. Management
-
Agitation may require initial restraints (Agitated Delirium)
- Four point Physical Restraints may be needed initially
- Treat with sedation agents below
- See Chemical Restraints
- Sedation
- Other symptomatic management
- Consider other GABA-B Agonists (e.g. Baclofen)
VII. References
- Masom and Tomaszewski (2018) Crit Dec Emerg Med 32(11): 23
- Dyer (2001) Ann Emerg Med 37(2):147-52 [PubMed]
