Successful treatment of severe, treatment resistant GHB withdrawal through thiopental-coma

Subst Abus. 2021;42(1):33-38. doi: 10.1080/08897077.2020.1827124. Epub 2020 Oct 12.

Abstract

In patients with gamma-hydroxybutyrate (GHB) use disorder (GUD), withdrawal can have a fulminant course with rapid progression of severe, potentially life-threatening complications. Case: We present a 45-year old man with severe GHB withdrawal, resistant to conventional treatment with pharmaceutical GHB, high doses of benzodiazepines and baclofen. GHB withdrawal finally responded to thiopental-induced coma therapy, with burst suppression pattern on electroencephalography (EEG). The patient fully recovered, without withdrawal or residual neuropsychiatric symptoms. Discussion: To our knowledge, this is the first case report in which barbiturates were used to induce a coma to treat severe, treatment resistant GHB withdrawal. This case suggests barbiturate coma therapy might be considered in severe GHB withdrawal which does not respond to conventional treatment.

Publication types

  • Case Reports

MeSH terms

  • Benzodiazepines
  • Coma / chemically induced
  • Coma / drug therapy
  • Humans
  • Male
  • Middle Aged
  • Sodium Oxybate* / therapeutic use
  • Substance Withdrawal Syndrome* / drug therapy
  • Thiopental / therapeutic use

Substances

  • Benzodiazepines
  • Sodium Oxybate
  • Thiopental