Regular consumption of gamma-hydroxybutyrate (GHB) may result in a dependence syndrome that can lead to withdrawal symptoms. There are limited data on medications to manage GHB withdrawal.

Key Points
• Source: Psychopharmacology
• Conclusions: “This study adds to the literature in support of the safety and feasibility of diazepam and baclofen for the management of GHB withdrawal. Prospective, randomised trials are required.”
• In the current retrospective study, Australian researchers analyzed 135 admissions for GHB withdrawal, including delirium and discharge against medical advice. Almost all patients received diazepam and about half were discharged home on continuing baclofen (i.e., GABA-B receptor agonist) treatment.
• “The procedure for dosing diazepam and baclofen was safe and feasible in this sample; intensive care admission was rare, and delirium uncommon,” the authors wrote. “In an exploratory analysis, delirium was associated proportionally with the amount of GHB consumed, while the duration of GHB use, concomitant methamphetamine use, and earlier diazepam dosing were inversely related. Discharge against medical advice was less likely amongst females and those who received a loading dose of baclofen, while participants who had a longer time from the presentation to the first dose of baclofen were more likely to discharge against medical advice.”
• Limitations of the current study include its retrospective nature, lack of a validated withdrawal measure, and holes in documentation.