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

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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.

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Notes

  1. In the UK, Estonia, Italy, the Netherlands, Belgium, Sweden, Finland, Ukraine, France, Spain, Switzerland, Czech Republic, Romania, Norway and Denmark.

  2. α amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor.

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Authors and Affiliations

  1. Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Toernooiveld 5, 6525 ED, Nijmegen, The Netherlands

    Rama M. Kamal, Harmen Beurmanjer, Boukje A. G. Dijkstra & Arnt Schellekens

  2. Novadic-Kentron Addiction Care Network, Hogedwarsstraat 3, PO Box 243, 5260 AE, Vught, The Netherlands

    Rama M. Kamal & Harmen Beurmanjer

  3. Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands

    Martijn S. van Noorden

  4. Scientific Research Committee IrisZorg, Kronenburgsingel 545, 6831 GM, Arnhem, The Netherlands

    Wim Wannet

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  1. Rama M. Kamal
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The authors Rama Kamal, Martijn van Noorden, Wim Wannet, Harmen Beurmanjer, Boukje Dijkstra and Arnt Schellekens declare that they have no conflicts of interest related to this review.

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Kamal, R.M., van Noorden, M.S., Wannet, W. et al. Pharmacological Treatment in γ-Hydroxybutyrate (GHB) and γ-Butyrolactone (GBL) Dependence: Detoxification and Relapse Prevention. CNS Drugs 31, 51–64 (2017). https://doi.org/10.1007/s40263-016-0402-z

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