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Diazepam in the treatment of GHB dependence

Published online by Cambridge University Press:  02 January 2018

G. Addolorato ,
F. Caputo ,
E. Capristo  and
G. Gasbarrini
G. Addolorato
Affiliation:
Institute of Internal Medicine, Catholic University of Rome, Largo A, Gemelli 8, 00168 Rome, Italy
F. Caputo
Affiliation:
Institute of Internal Medicine, Catholic University of Rome, Largo A, Gemelli 8, 00168 Rome, Italy
E. Capristo
Affiliation:
Institute of Internal Medicine, Catholic University of Rome, Largo A, Gemelli 8, 00168 Rome, Italy
G. Gasbarrini
Affiliation:
Institute of Internal Medicine, Catholic University of Rome, Largo A, Gemelli 8, 00168 Rome, Italy
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Abstract

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The British Journal of Psychiatry , Volume 178 , Issue 2 , February 2001 , pp. 183
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Copyright © 2001 The Royal College of Psychiatrists 

We read with great interest the recent case reported by Price (Reference Price2000) concerning the utility of diazepam in suppressing gammahydroxybutyrate (GHB) dependence and related withdrawal symptoms. Before describing the case Price states, “I believe this to be the first reported case of in-patient detoxification”. However, the first report on the utility of the same doses of diazepam in treating GHB withdrawal syndrome was published a year earlier by our group in a patient taking about 181 g/day GHB for 4 months, for its euphoric and anxiolytic effects (Reference Addolorato, Caputo and CapristoAddolorato et al, 1999). On discontinuation of GHB, the patient showed a withdrawal syndrome consisting of high anxiety levels, tremor, sweating, tachycardia and nausea. Complete disappearance of drug withdrawal symptoms was achieved within 2 hours in the first day of treatment with diazepam 20 mg orally administered, and the patient was treated with the same dose of diazepam for another 6 days. After suspension of the diazepam, the symptoms did not recur. Also in this case, the detoxification programme was safe. We are very pleased to know that our findings are in perfect agreement with that of Price; since several cases of GHB misuse and dependence have been described in recent years (see Reference Addolorato, Caputo and CapristoAddolorato et al, 2000), we think that these reported experiences, as well as the recent case described by Hutto et al (Reference Hutto, Faichild and Bright2000) about the utility of chloral hydrate, could be of clinical relevance, particularly considering the difficult management of these patients.

References

Addolorato, G., Caputo, F., Capristo, E., et al (1999) A case of gamma-hydroxybutyric acid withdrawal syndrome during alcohol addiction treatment: utility of diazepam administration. Clinical Neuropharmacology, 22, 60–62.CrossRefGoogle ScholarPubMed
Addolorato, G., Caputo, F., Capristo, E., et al (2000) Gamma-hydroxybutyric acid: efficacy, potential abuse and dependence in the treatment of alcohol addiction. Alcohol, 20, 17–217–222.CrossRefGoogle ScholarPubMed
Hutto, B., Faichild, A. & Bright, R. (2000) Gamma-hydroxybutyrate withdrawal and chloral hydrate. American Journal of Psychiatry, 157, 1706.CrossRefGoogle ScholarPubMed
Price, G. (2000) In-patient detoxification after GHB dependence (letter). British Journal of Psychiatry, 177, 181.CrossRefGoogle Scholar
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