Gammahydroxybutyrat (GHB) ist in der Drogen- und Partyszene weit verbreitet. Psychiatrische Kliniken und Rettungsstellen werden daher zunehmend mit Problemen rund um die Substanz konfrontiert. Dieser Artikel informiert über die Wirkungen von GHB sowie die Behandlungsoptionen bei Intoxikation und Entzug.
Literatur
Nemeth Z, Kun B, Demetrovics Z. The involvement of gamma-hydroxybutyrate in reported sexual assaults: a systematic review. J Psychopharmacol 2010;24(9): 1281–7.
Europäische Beobachtungsstelle für Drogen und Drogensucht (EMCDDA). Europäischer Drogenbericht 2016. Verfügbar: https://doi.org/www.emcdda.europa.eu/publications/edr/trends-developments/2016 (letzter Zugriff: 31.01.2017).
Dines AM, Wood DM, Yates C et al. Acute recreational drug and new psychoactive substance toxicity in Europe: 12 months data collection from the European Drug Emergencies Network (Euro-DEN). Clin Toxicol 2015, 53(9): 893–900.
Nelson T, Kaufman E, Kline J et al. The extraneural distribution of gamma-hydroxybutyrate. J Neurochem 1981; 37(5): 1345–8.
Corkery JM, Loi B, Claridge H et al. Gamma hydroxybutyrate (GHB), gamma butyrolactone (GBL) and 1,4-butanediol (1,4-BD; BDO): A literature review with a focus on UK fatalities related to non-medical use. Neuroscience Biobehavioral Rev 2015;53: 52–78.
Carai MA, Colobo G, Reali R et al. Central effects of 1,4-butanediol are mediated by GABA(B) receptors via its conversion into gamma-hydroxybutyric acid. Eur J Pharmacol 2002;441(3):157–63.
Galloway GP, Frederick SL, Staggers Jr, FE et al. Gamma-hydroxybutyrate: An emerging drug of abuse that causes physical dependence. Addiction 1997;92(1):89–96.
Palatini P, Tedeschi L, Frison G et al. Dose-dependent absorption and elimination of gamma-hydroxybutyric acid in healthy volunteers. Eur J Clin Pharmacol 1993;45(4):353–6.
Brenneisen R, Elsohly MA, Murphy TP et al. Pharmacokinetics and excretion of gamma-hydroxybutyrate (GHB) in healthy subjects. J Anal Toxicol 2004;28: 625–30.
Roth RH, Delgado JMR, Giarman NJ. γ-Butyrolactone and ?-hydroxybutyric acid - II. The pharmacologically active form. Int J Neuropharmacol 1966: 5(6): 421–8.
Hoes MJ, Vree TB, Guelen PJ. Gamma-hydroxybutyric acid as hypnotic. Clinical and pharmacokinetic evaluation of gamma-hydroxybutyric acid as hypnotic in man. Encephale 1980;6(1):93–9.
Lettieri J, Fung HL. Improved pharmacological activity via pro-drug modification: Comparative pharmacokinetics of sodium gamma-hydroxybutyrate and gamma-butyrolactone. Res Commun Chem Pathol Pharmacol 1978;22(1):107–18.
Arena C, Fung HL. Absorption of sodium gamma-hydroxybutyrate and its prodrug gamma-butyrolactone: Relationship between in vitro transport and in vivo absorption. J Pharm Sci 1980;69(3):356–8.
Thai D, Dyer JE, Jacob P et al. Clinical pharmacology of 1,4-butanediol and gamma-hydroxybutyrate after oral 1,4-butanediol administration to healthy volunteers. Clin Pharm Ther 2007;81(2): 178–84.
Galldiks N, Kadow I, Bechdolf A et al. Symptomvielfalt nach Konsum der Droge Gamma-Hydroxybuttersäure (GHB). Fortschr Neurol Psychiatr 2011;79: 21–5.
Madea B, Musshoff F. K.-o.-Mittel: Häufigkeit, Wirkungsweise, Beweismittelsicherung. Dtsch Arztebl 2009;106: 341–7.
Freudenmann RW, Baumgarten E, Hawlik AE et al. Liquid ecstasy in general psychiatry: A case series. Fortschr Neurol Psychiat 2013; 81: 88–94.
Bourne A, Reid D, Hickson F et al. The Chemsex Study: Drug Use in Sexual Settings Among Gay and Bisex-ual Men in Lambeth, Southwark & Lewisham. Sigma Research, LondonSchool of Hygiene & Tropical Medicine, London 2014. Available at: https://doi.org/www.sigmaresearch.org.uk/projects/project59/ (letzter Zugriff 31.01.2017).
Andresen H, Sprys N, Schmoldt A et al. Gamma-hydroxybutyrate in urine and serum: Additional data supporting current cut-off recommendations. Forensic Sci Int 2010; 200(1-3): 93–9.
Schütz H, Jansen M, Verhoff M. Vom Alkohol zum Liquid Ecstasy (GHB) - ein Überblick über alte und moderne K.-o.-Mittel - Teil 3: Gamma-Hydroxybuttersäure (GHB, “Liquid Ecstasy”). Arch Kriminol 2011; 228: 151–9.
Snead OC 3rd, Gibson KM. Gamma-hydroxybutyric acid. N Engl J Med 2005; 352: 2721–32.
van Amsterdam JGC, van Laar M, Brunt JM et al. Risk assessment of gamma-hydroxybutyric acid (GHB) in the Netherlands. Regul Toxicol Pharmacol 2012; 63(1): 55–63.
Schep LJ, Knudsen K, Slaughter RJ et al. The clinical toxicology of gamma-hydroxybutyrate, gamma-butyrolactone and 1,4-butanediol. Clin Toxicol 2012: 50: 458–70.
Tancredi DN, Shannon MW. Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 30 - 2003. A 21-year-old man with sudden alteration of mental status. N Engl J Med 2003; 349: 1267–75.
Chin RL, Sporer KA, Cullison B et al. Clinical course of gamma-hydroxybutyrate overdose. Ann Emerg Med 1998;31:716–22.
Liechti ME, Kunz I, Greminger P et al. Clinical features of gamma-hydroxybutyrate and gamma-butyrolactone toxicity and concomitant drug and alcohol use. Drug Alcohol Depend 2006; 81: 323–6.
Suner S, Szlatenyi CS, Wang RY. Pediatric gamma hydroxybutyrate intoxication. Acad Emerg Med 1997; 4: 1041–5.
Zvosec DL, Smith SW, McCutcheon JR et al. Adverse events, including death, associated with the use of 1,4-butanediol. N Engl J Med 2001; 344: 87–94.
Thomas G, Bonner S, Gascoigne A. Coma induced by abuse of gamma-hydroxybutyrate (GBH or liquid ecstasy): A case report. Br Med J 1997; 314: 35–6.
Caldicott DG, Kuhn M. Gamma-hydroxybutyrate overdose and physostigmine: Teaching new tricks to an old drug? Ann Emerg Med 2001; 37: 99–102.
Yates SW, Viera AJ. Physostigmine in the treatment of gammahydroxybutyric acid overdose. Mayo Clin Proc 2000; 75: 401–2.
Bania TC, Chu J: Physostigmine does not effect arousal but produces toxicity in an animal model of severe gamma-hydroxybutyrate intoxication. Acad Emerg Med 2005; 12: 185–9.
Van Noorden MS, van Dongen L, Zitman FG et al. Gamma-hydroxybutyrate withdrawal syndrome: Dangerous but not well-known. Gen Hosp Psychiatry 2009; 31: 394–6.
Rosenberg MH, Deerfield LJ, Baruch EM. Two cases of severe gamma-hydroxybutyrate withdrawal delirium on a psychiatric unit: Recommendations for management. Am J Drug Alcohol Abuse 2003; 29: 487–96.
de Jong CAJ, Kamal R, Dijkstra BAG et al. Gamma-hydroxybutyrate detoxification by titration and tapering. Eur Addict Res 2012; 18: 40–5.
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Neu, P. Gammahydroxybutyrat und seine psychiatrischen Implikationen. DNP 18, 22–26 (2017). https://doi.org/10.1007/s15202-017-1673-z
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DOI: https://doi.org/10.1007/s15202-017-1673-z