Gammahydroxybutyrate

General information

Sodium gammahydroxybutyrate (GHB or sodium oxybate) is an endogenous compound, a precursor of GABA, which increases the release of dopamine and acetylcholine in the brain. It was first synthesized in 1960 as a potential anesthetic, and was popular in the late 1980s and early 1990s as a dietary supplement (as a replacement for l -tryptophan after it had been recalled from the market), an aid to sleep, and a bodybuilding agent. It was subsequently used in the treatment of narcolepsy. However, it has also been used as a party drug, since it causes alcohol-like effects and aroused sexuality. In large doses it can cause disorientation, nausea and vomiting, and muscle spasms. It is also known as BDO, Blue Nitro, Enliven, GBH, Liquid ecstasy, Midnight Blue, RenewTrient, Reviarent, Serenity, and SomatoPro. An analogue, gammavalerolactone (GVL), is a precursor and has also been used recreationally, but it is very expensive.

In 1990 the FDA limited the availability of gammahydroxybutyrate, and in March 2000, the Drug Enforcement Agency made it a Schedule I drug. In 2001 the Expert Advisory Committee on Drugs (EACD) in New Zealand advised the New Zealand Medicines and Medical Devices Safety Authority to schedule gammahydroxybutyrate under the Misuse of Drugs Act 1975 [ ]. In June 2003 gammahydroxybutyrate was categorized as a Class C drug in the UK.

Ingestion of 0.5–3 teaspoons of sodium gammahydroxybutyrate can produce vomiting, drowsiness, hypotonia, and/or vertigo; loss of consciousness, irregular respiration, tremors, or myoclonus can follow. Seizure-like activity, bradycardia, hypotension, and/or respiratory arrest have also been reported. The severity and duration of symptoms depend on the dose and on the presence of other nervous system depressants, such as alcohol.

In a double-blind, randomized, placebo-controlled, crossover study in 24 patients with narcolepsy, gammahydroxybutyrate 60 mg/kg in a single night-dose for 4 weeks reduced the daily number of hypnagogic hallucinations, daytime sleep attacks, and the severity of subjective daytime sleepiness, and tended to reduce the number of daily attacks of cataplexy [ ]. It reduced the percentage of wakefulness during REM sleep and the number of awakenings out of REM sleep, and tended to increase slow wave sleep. Adverse events were few and mild.

Organs and systems