We report two cases from Kansas City where the patients presented in, or developed profound coma. [ncbi.nlm.nih.gov]

• Falling

  Small doses produce relaxation, tranquility and drowsiness which make it extremely easy to fall asleep naturally. Higher doses increase the drowsiness effect and decrease the time it takes to fall asleep. [diagnose-me.com]

  CAUTION GHB's dose/response curve is similar to that of alcohol : At higher doses, users fall unconscious and are temporarily unable to be awakened (coma). It may also dangerously depress breathing. Avoid Mixing With Alcohol. [erowid.org]

• Camping

  Mody, γ-Hydroxybutyrate induces cyclic AMP-responsive element-binding protein phosphorylation in mouse hippocampus: An involvement of GABAB receptors and cAMP-dependent protein kinase activation, Neuroscience, 141, 1, (269), (2006). Perry N. [doi.org]

• Nocturnal Awakening

  The meta-analysis showed that GHB reduced cataplexy attacks both on a daily (weighted mean difference (WMD) -1.10; 95% confidence interval (CI) -1.29/-0.90, p 0.00001) and a weekly basis (WMD -7.04; 95% CI -12.45/-1.63, p 0.01), subjective nocturnal awakenings [ncbi.nlm.nih.gov]

• Tachypnea

  A 27-year-old man was admitted with tremulousness, diaphoresis, tachypnea (28 breaths/min), full-body rigidity, irritability, paranoia, and auditory and visual hallucinations 2 days after stopping long-term gamma-hydroxybutyrate (GHB) and 8 hours after [ncbi.nlm.nih.gov]

  The patient was administered a repeat dose of naloxone, 2 mg intravenously, with the minimal response of a brief episode of tachypnea. [aafp.org]

• Dyspnea

  Respiratory depression Cocaine (70) Death from respiratory arrest, irregular (Cheyne-Stokes) respiration Ecstasy (MDMA a,b ) *,(71) Respiratory depression Ethanol a,(72) Respiratory depression Heroin/Opiate (73) Respiratory depression Methamphetamine *, (74) Dyspnea [ualberta.ca]

• Vomiting

  The girl had had persistent vomiting and a seizure. Urine metabolic screening tests were positive for gamma-hydroxybutyrate (GHB). Samples from toy beads ingested by both children contained 1,4-butanediol, which is metabolised to GHB in humans. [ncbi.nlm.nih.gov]

  Adverse events included 2 instances of hypotension and 6 episodes of vomiting with GHB-plus-ethanol ingestion. [doi.org]

• Nausea

  Other effects were headache, nausea, vomiting, myoclonic jerking, and short-term coma. There have been no reported deaths. If product use is discontinued, full recovery with no long-term side effects is universal. [ncbi.nlm.nih.gov]

  Effects clumsiness, diarrhoea, dizziness, drowsiness, euphoria, headache, increased sex drive, lowered heart rate, lowered inhibitions, lowered temperature, memory lapses, nausea, urinary incontinence. [adf.org.au]

  Negative effects may include sweating, loss of consciousness, nausea, hallucinations, amnesia, and coma, among other side effects. [drugs.com]

• Persistent Vomiting

  The girl had had persistent vomiting and a seizure. Urine metabolic screening tests were positive for gamma-hydroxybutyrate (GHB). Samples from toy beads ingested by both children contained 1,4-butanediol, which is metabolised to GHB in humans. [ncbi.nlm.nih.gov]

• Seizure

  Coma and seizures have been reported following abuse of GHB, but dependence liability has received little attention. [ncbi.nlm.nih.gov]

  Furthermore, these GHB-induced electroencephalogram-behavioral changes can be blocked by anticonvulsant drugs, which are specific in their action against petit-mal seizures. [jpet.aspetjournals.org]

• Amnesia

  Among the possible described side-effects after the continued consumption of GHB are amnesia and deterioration of memory. Likewise, recent studies indicate the existence of neurotoxicity in certain brain regions after its prolonged treatment. [ncbi.nlm.nih.gov]

  Negative effects may include sweating, loss of consciousness, nausea, hallucinations, amnesia, and coma, among other side effects. [drugs.com]

  In higher dosages it may induce amnesia, drowsiness, nausea, agitation, visual problems, unconsciousness, and even death. [about-addiction.com]

  Amnesia is mainly present when GHB and benzodiazepines have been used; in particular, 1,4-benzodiazepines like flunitrazepam are more likely to cause amnesia than 1,5-benzodiazepines like clobazam ( 12 ). [doi.org]

• Insomnia

  The most common patient symptoms were tremor (67%), hallucinations (63%), tachycardia (63%) and insomnia (58%). Seizures and rhabdomyolysis each occurred in 7% of cases, but only 1 death occurred. [ncbi.nlm.nih.gov]

  Features include auditory and visual hallucinations, tremors, tachycardia, hypertension, sweating, anxiety, agitation, paranoia, insomnia, disorientation, confusion, and aggression/combativeness. [doi.org]

• Tremor

  This manifested as delirium, tremor, and seizures despite only small decreases in GHB dose and treatment with benzodiazepines. [ncbi.nlm.nih.gov]

• Confusion

  The observed clinical symptoms ranged from confusion, disorientation, vomiting, and nystagmus to ataxia, sinus bradycardia, unconsciousness, and apnea. [ncbi.nlm.nih.gov]

  Vomiting Irregular or shallow breathing Confusion, irritation and agitation Hallucinations Blackouts and memory loss Unconsciousness that can last for 3 to 4 hours Death 2 Long-term effects Little is known about the long-term effects of GHB use. [adf.org.au]

  Features include auditory and visual hallucinations, tremors, tachycardia, hypertension, sweating, anxiety, agitation, paranoia, insomnia, disorientation, confusion, and aggression/combativeness. [doi.org]

• Pulmonary Infiltrate

  None demonstrated response and, further, there were associated adverse events, including atrial fibrillation (2), pulmonary infiltrates (1) and significant bradycardia (1), and hypotension (1). [ncbi.nlm.nih.gov]

Benzodiazepine treatment of life-threatening gamma-hydroxybutyrate (GHB) withdrawal is frequently unsatisfactory. Animal studies suggest strongly that treatment with GABA(B) agonists, such as baclofen, will be a more effective strategy. [ncbi.nlm.nih.gov]

Prognosis With isolated use of GHB, prognosis is normally good. Spontaneous recovery of consciousness is usual, within 2-6 hours. [ 23 ] With repeated use, evidence exists for the development of tolerance and physical dependence. [patient.info]

Prognosis The prognosis varies. Although most patients live until adulthood, neuropsychiatric symptoms can be disabling, decreasing quality of life. Early mortality, including sudden unexpected death in epilepsy patients (SUDEP), has been reported. [orpha.net]

They concluded that “the prognosis for people who experience GHB poisoning is quite good.” The degree to which the pleasant state of GHB euphoria may be psychologically addicting may not be fully appreciated. [ceri.com]

[…] metabolized to CO 2 ). 2 Gas chromatography mass spectrometry will detect GHB up to 6-8 hours post administration, however, this form of advanced analysis is rarely available onsite. 2 Patients with 6 hours of CNS depression evaluate for alternative etiologies [emdocs.net]

Etiology SSADH deficiency is due to mutations in the ALDH5A1 gene (6p22), encoding mitochondrial succinate-semialdehyde dehydrogenase, a protein involved in amino-acid degradation. [orpha.net]

Grace, The depolarization block hypothesis of neuroleptic action: implications for the etiology and treatment of schizophrenia, Advances in Neuroscience and Schizophrenia, 10.1007/978-3-7091-9211-5_6, (91-131), (1992). [doi.org]

Epidemiology. There is limited information regarding statistical trends on world-wide use of GHB and its analogs. [doi.org]

Department of Health and Human Services: National Institute on Drug Abuse Epidemiologic Trends in Drug Abuse, Volume I: Highlights and Executive Summary, June 2001, Community Epidemiology Work Group. www.drugabuse.gov/PDF/CEWG/EXSUMJune01.pdf Epidemiologic [web.archive.org]

Our understanding of the pathophysiological mechanisms of ASs has been greatly advanced by the availability of genetic and pharmacological models, in particular the γ-hydroxybutyrate (GHB) model which, in recent years, has been extensively used in studies [ncbi.nlm.nih.gov]

Some considerations on the pathophysiology of generalized bilaterally synchronous spike and wave discharge. Epilepsia 9, 249-263 (1968). 32. [books.google.com]

Emmanuel Mignot, Narcolepsy: Genetic Predisposition and Pathophysiology, Narcolepsy, 10.1007/978-1-4419-0854-4_1, (3-21), (2008). P.S. van Nieuwenhuijzen, I.S. McGregor and G.E. [doi.org]

Ketone bodies: a review of physiology, pathophysiology and application of monitoring to diabetes. Diabetes Metab Res Rev. Available online at . Accessed June 2016. [labtestsonline.it]

While the drug treatment literature has a wealth of information to draw upon, GHB-specific information may greatly assist relapse prevention. . American Academy of Addiction Psychiatry. [ncbi.nlm.nih.gov]

Objectives: To evaluate the efficacy and safety of GHB for the treatment of AWS and the prevention of relapse. [cochrane.org]