Clinical management of gamma-hydroxybutyrate (GHB) withdrawal delirium with CIWA-Ar protocol
Journal
Journal of the Formosan Medical Association
Journal Volume
117
Journal Issue
12
Pages
1124-1127
Date Issued
2018
Author(s)
Abstract
Gamma-hydroxybutyrate (GHB) is a synthetic drug used mainly for recreational purpose. Although the prevalence of GHB abuse is low in Taiwan, GHB has become increasingly popular in certain subpopulations such as clubbers and men who have sex with men (MSM). GHB dependence could be associated with severe withdrawal syndrome including hallucinations and delirium. Despite systematic studies on detoxification and management of GHB withdrawal have been performed, no validated measurement for severity of GHB withdrawal syndrome is available. Here we present a case of GHB withdrawal delirium that was treated successfully with fixed and symptom-triggered benzodiazepine dosing regimen based on Clinical Institute Withdrawal Assessment for Alcohol–Revised (CIWA-Ar) scale. The utilization of CIWA-Ar in such cases could offer useful guidance for benzodiazepine dosing. To the best of our knowledge, this is the first case report of GHB withdrawal delirium in Taiwan. ? 2018
Subjects
CIWA-Ar; Gamma-hydroxybutyrate; GHB; Withdrawal delirium
SDGs
Other Subjects
4 hydroxybutyric acid; ketamine; lorazepam; midomafetamine; olanzapine; benzodiazepine derivative; oxybate sodium; adult; agitation; alcohol consumption; alcohol tolerance; alcohol withdrawal syndrome; alcoholism; amnesia; anxiety; Article; attention; attention disturbance; auditory hallucination; behavior disorder assessment; boredom; case report; clinical article; Clinical Institute Withdrawal Assessment for Alcohol Score; delirium; depression; disorientation; drinking behavior; drug craving; drug dependence; drug dose increase; electrocardiogram; euphoria; guilt; hangover; human; hypokalemia; insomnia; male; medical history; nausea; orientation; restlessness; scoring system; traffic accident; tremor; visual hallucination; withdrawal syndrome; chemically induced; delirium; disease management; drug administration; severity of illness index; Taiwan; withdrawal syndrome; Adult; Benzodiazepines; Delirium; Disease Management; Drug Administration Schedule; Humans; Male; Severity of Illness Index; Sodium Oxybate; Substance Withdrawal Syndrome; Taiwan
Publisher
Elsevier B.V.
Type
journal article