Pharmacological Treatment in γ-Hydroxybutyrate (GHB) and γ-Butyrolactone (GBL) Dependence: Detoxification and Relapse Prevention

CNS Drugs. 2017 Jan;31(1):51-64. doi: 10.1007/s40263-016-0402-z.

Abstract

The misuse of γ-hydroxybutyrate (GHB) for recreational purposes has resulted in an increase in GHB-related problems such as intoxications, dependence and withdrawal in several countries in Europe, Australia and the US over the last decade. However, prevalence rates of misuse of GHB and its precursor, γ-butyrolactone (GBL), are still relatively low. In this qualitative review paper, after a short introduction on the pharmacology of GHB/GBL, followed by a summary of the epidemiology of GHB abuse, an overview of GHB dependence syndrome and GHB/GBL withdrawal syndrome is provided. Finally, the existing literature on management of GHB detoxification, both planned and unplanned, as well as the available management of GHB withdrawal syndrome, is summarized. Although no systematic studies on detoxification and management of withdrawal have been performed to date, general recommendations are given on pharmacological treatment and preferred treatment setting.

Publication types

  • Review

MeSH terms

  • 4-Butyrolactone / adverse effects*
  • Animals
  • Humans
  • Inactivation, Metabolic / drug effects
  • Secondary Prevention / methods
  • Sodium Oxybate / adverse effects*
  • Substance Withdrawal Syndrome / drug therapy*
  • Substance Withdrawal Syndrome / therapy*
  • Substance-Related Disorders / drug therapy*
  • Substance-Related Disorders / therapy*

Substances

  • Sodium Oxybate
  • 4-Butyrolactone