Narcolepsy in Children
Mark A. Richardson, Norman R. Friedman in Clinician’s Guide to Pediatric Sleep Disorders, 2016
Gamma-hydroxybutyrate (GHB) is the first substance ever approved specifically in the United States for cataplexy (53,54). The drug’s generic name is sodium oxybate. In the popular media, it has the infamous name of the “date rape drug.” Illegal use of this substance for recreational purposes has been of great concern. Important CNS adverse events associated with abuse of GHB include seizure, respiratory depression, and profound decreases in level of consciousness, with instances of coma and death. Sodium oxybate has powerful central nervous system depressant effects. GHB can increase slow wave sleep. This medication, when given at bedtime, maybe of value to reduce cataplexy. Unlike most other medications discussed, sodium oxybate is available as a liquid. This is an obvious advantage for some children. Patients may prefer this medication to other medications used for cataplexy, particularly if insomnia is also present. Dosing guidelines for patients younger than 16 years old are not established. Analogs of GHB are being studied to further refine the treatment of narcolepsy (55). Animal research to elucidate the GHB mechanism of action have been carried out but are not conclusive (56).
Addictions and dependencies: their association with offending
John C. Gunn, Pamela J. Taylor in Forensic Psychiatry, 2014
The use of drugs to facilitate sexual assault (drug-facilitated sexual assault: DFSA) has no adequate definition, according to Hall and Moore (2008) in their review of the field. They propose a distinction between proactive (planned) DFSA and opportunistic DFSA. The more popular terminology of ‘date rape drugs’ refers in the main to the use of rohypnol, together with other drugs such as gamma-hydroxybutyric acid (GHB), which can easily be concealed in alcoholic drinks. Reviews of cases of ‘date rape’ using drugs such as rohypnol have indicated that, in many cases, the level of alcohol ingested was also considerable and that the involvement of rohypnol itself may not be as central as previously believed (Advisory Council on the Misuse of Drugs, 2007a).
Hallucinogens
G. Hussein Rassool in Alcohol and Drug Misuse, 2017
GHB (gammahydroxybutyrate) is also known as liquid ecstasy, GBL, BDO, GBH, Blue Nitro, Midnight Blue, Renew Trient, Reviarent, SomatoPro, Serenity and Enliven. GHB is a central nervous system depressant. This psychoactive substance is commonly referred to as a “club drug” or “date rape” drug. It is a colourless liquid, with a slightly salty taste. GHB is also produced as a result of fermentation and so is found in small quantities in some beers and wines, particularly fruit wines with limited effect. Like MDMA, GHB is consumed by teenagers and young adults in various recreational and club settings, with users enjoying an alcohol-like high with potent positive sexual effects.
Return of the Quaaludes? Prolonged agitated delirium after intentional ingestion of the methaqualone analog SL-164 – a case report
Published in Substance Abuse, 2021
Katrin Romanek, Helena Fels, Torsten Dame, Gisela Skopp, Frank Musshoff, Hans Eiglmeier, Florian Eyer
Methaqualone (2-methyl-3-(2-methylphenyl)-4(3H)-quinazolinone) is a sedative-hypnotic, anxiolytic and muscle relaxant drug of the quinazolinone class. It acts as a GABAA receptor modulator similar to benzodiazepines and barbiturates, but with strong affinity to a different GABAA receptor subtype (α4β3δ) compared to the other mentioned sedatives.1 It was widely distributed under the brand names “Quaalude” in the USA and “Mandrax” in the UK and South Africa from the 1960s to the early 80 s. In the 1970s, ‘Quaaludes’ were one of the most frequently prescribed sedatives in the United States, originally marketed as a safe and non-habit-forming sedative-hypnotic alternative to barbiturates. This soon turned out to be incorrect as methaqualone became increasingly popular as a recreational drug due to its calming but also euphoric effects.2 The widespread abuse of methaqualone and its misuse as a date rape drug finally led to a halt in commercial production in almost all countries.
Designer benzodiazepines versus prescription benzodiazepines: can structural relation predict the next step?
Published in Critical Reviews in Toxicology, 2021
Raneem E. Moustafa, Fuad Tarbah, Huda Sulaiman Saeed, Suleiman I. Sharif
Flunitrazepam is known for possessing potent hypnotic, sedative, anxiolytic, and skeletal muscle relaxant effects as a benzodiazepine derivative that has been used for over 20 years, yet also plays on the other edge as a “date rape” drug and is one of the most widely abused benzodiazepines (Oelschläger 1989). In the United States, it is regarded as an illegal drug as it has not been approved by the Food and Drug Administration (FDA) for medical use; however, it has been marketed and licensed in Europe, Asia, and Latin America as a sedative and hypnotic drug (Bischoff 2018). Unlike flunitrazepam, its active metabolites fonazepam (desmethylflunitrazepam) and nifoxipam (3-hydroxy-desmethylflunitrazepam) have been active as NPS benzodiazepines (designer benzodiazepines) and sold on online sites for the past years while in fact they are classified as research chemicals that are not intended for use in animals or human (Katselou et al. 2017).
Post-marketing and clinical safety experience with sodium oxybate for the treatment of alcohol withdrawal syndrome and maintenance of abstinence in alcohol-dependent subjects
Published in Expert Opinion on Drug Safety, 2020
Giovanni Addolorato, Otto-Michael Lesch, Icro Maremmani, Henriette Walter, Felice Nava, Quentin Raffaillac, Fabio Caputo
GHB was originally marketed as a nutritional supplement in the 1980s, until reports of abuse for its euphoric effects (‘club drug’ and ‘date-rape drug’) led to its scheduling as a controlled substance [9]. Wang et al reviewed the cumulative postmarketing and clinical safety experience in approximately 26,000 patients with narcolepsy and concluded that there is a very low risk of abuse/misuse of SMO treatment (only 0.2% of patients reported ≥ 1 of the events studied) [10]. Moreover, several analytical reviews showed an acceptable safety and good tolerability of SMO in patients with narcolepsy [10–14].
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