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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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