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GHB Withdrawal
Aka: GHB Withdrawal, Gamma Hydroxybutyrate Withdrawal
- See Also
- Gamma Hydroxybutyrate
- Chemical Dependency
- Drug Withdrawal
- 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)
- Symptoms: Withdrawal
- Early symptoms
- Insomnia
- Tremor
- Anxiety
- Confusion
- Nausea and Vomiting
- Later symptoms
- Agitation
- Vivid Hallucinations
- Combative behavior
- Disorientation
- Seizures
- Associated Symptoms: Autonomic Instability
- Tachycardia
- Hypertension
- Tremor
- Diaphoresis
- Differential Diagnosis
- Other Sedative-Hypnotic Use
- Alcohol Withdrawal
- SympathomimeticIntoxication
- Serotonin Syndrome
- Neuroleptic Malignant Syndrome
- Thiamine deficiency
- Thyrotoxicosis
- Pheochromocytoma
- Steroid Psychosis
- Labs
- See Gamma Hydroxybutyrate
- 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
- Benzodiazepine
- Barbiturate
- Other symptomatic management
- Consider other GABA-B Agonists (e.g. Baclofen)
- References
- Masom and Tomaszewski (2018) Crit Dec Emerg Med 32(11): 23
- Dyer (2001) Ann Emerg Med 37(2):147-52 [PubMed]