Historique
Article de Périodique
Gamma-butyrolactone (GBL) dependence and withdrawal (2011)
Auteur(s) :
BELL, J. ;
COLLINS, R.
Année
2011
Page(s) :
442-447
Langue(s) :
Anglais
Refs biblio. :
11
Domaine :
Drogues illicites / Illicit drugs
Thésaurus mots-clés
ETUDE DE CAS
;
GBL
;
GHB
;
DEPENDANCE
;
PRISE EN CHARGE
;
TRAITEMENT
;
SEVRAGE
;
TRAITEMENT AMBULATOIRE
Note générale :
Commentary: Out-patient management of gamma-hydroxy butyric acid (GHB) withdrawal - an alternative strategy for the future? ZEPF F.D., p.448.
Résumé :
AIM: To describe morbidity associated with gamma-butyrolactone (GBL) dependence, and outcomes of withdrawal.
DESIGN: Case series.
SETTING: Specialist out-patient clinic and affiliated in-patient detoxification unit. Patients with home support were offered the option of out-patient withdrawal management, based on high-dose diazepam and baclofen, titrated against withdrawal severity in an initial session lasting approximately 4 hours. Patients were then reviewed daily during the first 3 days of treatment, offered weekly follow-up for 4 weeks, and telephoned 2-4 months later.
PARTICIPANTS: People dependent on GBL seeking detoxification.
MEASUREMENTS: Drug history and social functioning were obtained by self-report in clinical interviews with a single clinician. Treatment completion, outcomes and adverse events associated with withdrawal are reported.
FINDINGS: Patients reported impaired social functioning associated with GBL dependence and difficulty in accessing treatment. Nineteen patients commenced detoxification; 17 initially declined admission and were treated as out-patients. Mean diazepam dose in the first 24 hours was 75 mg (range 40-110 mg). Sixteen patients completed withdrawal, although several had lapses to GBL use during treatment. One patient developed delirium and required transfer to the in-patient detoxification unit. Most patients had persisting insomnia, anxiety and depression for weeks after withdrawal.
CONCLUSIONS: GBL withdrawal can be managed in ambulatory settings, but needs to be backed up with seamless access to in-patient treatment if required.
DESIGN: Case series.
SETTING: Specialist out-patient clinic and affiliated in-patient detoxification unit. Patients with home support were offered the option of out-patient withdrawal management, based on high-dose diazepam and baclofen, titrated against withdrawal severity in an initial session lasting approximately 4 hours. Patients were then reviewed daily during the first 3 days of treatment, offered weekly follow-up for 4 weeks, and telephoned 2-4 months later.
PARTICIPANTS: People dependent on GBL seeking detoxification.
MEASUREMENTS: Drug history and social functioning were obtained by self-report in clinical interviews with a single clinician. Treatment completion, outcomes and adverse events associated with withdrawal are reported.
FINDINGS: Patients reported impaired social functioning associated with GBL dependence and difficulty in accessing treatment. Nineteen patients commenced detoxification; 17 initially declined admission and were treated as out-patients. Mean diazepam dose in the first 24 hours was 75 mg (range 40-110 mg). Sixteen patients completed withdrawal, although several had lapses to GBL use during treatment. One patient developed delirium and required transfer to the in-patient detoxification unit. Most patients had persisting insomnia, anxiety and depression for weeks after withdrawal.
CONCLUSIONS: GBL withdrawal can be managed in ambulatory settings, but needs to be backed up with seamless access to in-patient treatment if required.
Affiliation :
King's College London, Addictions Department, Institute of Psychiatry and South London and Maudsley NHS Foundation Trust, Camberwell, London, UK
Cote :
Abonnement