Mental Health Book

Background Information

Alcohol Use Disorders

GHB

Hallucinogen Use Disorders

Inhalants

Marijuana

Opioid

Compulsive Behavior

Sedative Abuse

Amphetamine Use Disorders

Tobacco Use Disorders

Pharmacology Chapter related topics

Examination Chapter related topics

Dermatology Chapter related topics

Sports Medicine Chapter related topics

Ophthalmology Chapter related topics

Pathology and Laboratory Medicine Chapter related topics

Neurology Chapter related topics

Obstetrics Chapter related topics

Pediatrics Chapter related topics

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GHB Withdrawal

Aka: GHB Withdrawal, Gamma Hydroxybutyrate Withdrawal
  1. See Also
    1. Gamma Hydroxybutyrate
    2. Chemical Dependency
    3. Drug Withdrawal
  2. Pathophysiology
    1. GHB Dependence is rare due to rapid elimination
    2. GHB Dependence may occur with excessive use
      1. Frequent dosing (q1-3 hours around the clock)
      2. Chronic use
  3. Symptoms: Withdrawal
    1. Early symptoms
      1. Insomnia
      2. Tremor
      3. Anxiety
      4. Confusion
      5. Nausea and Vomiting
    2. Later symptoms
      1. Agitation
      2. Vivid Hallucinations
      3. Combative behavior
      4. Disorientation
    3. Associated Symptoms: Autonomic Instability
      1. Tachycardia
      2. Hypertension
      3. Tremor
      4. Diaphoresis
  4. Differential Diagnosis
    1. Other Sedative-Hypnotic Use
    2. Alcohol Withdrawal
    3. SympathomimeticIntoxication
    4. Serotonin Syndrome
    5. Neuroleptic Malignant Syndrome
    6. Thiamine deficiency
    7. Thyrotoxicosis
    8. Pheochromocytoma
    9. Steroid Psychosis
  5. Labs
    1. See Gamma Hydroxybutyrate
  6. Management
    1. Agitation may require restraints
      1. Four point Physical Restraints
      2. See also Chemical Restraints
    2. Symptomatic management
    3. Sedation
      1. Benzodiazepine
      2. Barbiturate
  7. References
    1. Dyer (2001) Ann Emerg Med 37(2):147-52 [PubMed]

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