A case of withdrawal from the GHB precursors gamma-butyrolactone and 1,4-butanediol

J Emerg Med. 2001 Jul;21(1):31-3. doi: 10.1016/s0736-4679(01)00324-9.

Abstract

We describe a case of withdrawal from the gamma hydroxybutyric acid (GHB) precursors gamma butyrolactone and 1,4-butanediol. Symptoms included visual hallucinations, tachycardia, tremor, nystagmus, and diaphoresis. Administration of benzodiazepines and phenobarbital successfully treated the withdrawal symptoms. As predicted from the metabolism of gamma butyrolactone and 1,4-butanediol to GHB, the symptoms were nearly identical to those reported from GHB withdrawal. Because GHB is now illegal in the United States, individuals have begun abusing the legal and easier to acquire GHB precursors. More frequent cases of both abuse and withdrawal from these GHB precursors can be expected.

Publication types

  • Case Reports

MeSH terms

  • 4-Butyrolactone / adverse effects*
  • Adult
  • Anticonvulsants / therapeutic use
  • Diazepam / therapeutic use
  • Drug Therapy, Combination
  • Emergencies
  • Humans
  • Lorazepam / therapeutic use
  • Male
  • Phenobarbital / therapeutic use
  • Substance Withdrawal Syndrome / drug therapy
  • Substance Withdrawal Syndrome / etiology*
  • United States

Substances

  • Anticonvulsants
  • Lorazepam
  • 4-Butyrolactone
  • Diazepam
  • Phenobarbital