Misuse, Recreational Use, and Addiction in Relation to Prescription Medicines
Ornella Corazza, Andres Roman-Urrestarazu in Handbook of Novel Psychoactive Substances, 2018
Gamma-hydroxybutyric acid (GHB) (and its prodrug gamma-butyrolactone), clinically used for a range of conditions including narcolepsy, alcohol withdrawal syndrome, and fibromyalgia (Busardo, Kyriakou, Napoletano, Marinelli, & Zaami, 2015), is also one of the most commonly misused GABAergic drugs (Davidson & Schifano, 2016). GHB is an agonist at the newly characterized GHB receptor and a weak agonist at the GABAB receptor (Brennan & Van Hout, 2014). As reviewed by Corkery et al. in 2015, at low to moderate doses, the most detected psychological effects of GHB include euphoria, calmness, disinhibition, and increased libido, while very high doses of 50–70 mg/kg lead to convulsions, amnesia, hypotonia, and coma (Corkery et al., 2015). GHB is highly addictive in both general and clinical populations, and it has been associated with many side effects and fatalities (Corkery et al., 2015). Of relevance, GHB is primarily known to the general public as a ‘rape drug’, as the drug has been used in 0.2–4.4% of reported sexual assaults to numb the other person and facilitate the rape (Nemeth, Kun, & Demetrovics, 2010).
Synthesis, Enzyme Localization, and Regulation of Neurosteroids
Sheryl S. Smith in Neurosteroid Effects in the Central Nervous System, 2003
receptors, Nature, 389, 385, 1997. Tobin, M.B., Schmidt, P.J., and Rubinow, D.R., Reported alcohol use in women with premenstrual syndrome, Am. J. Psychiatry, 151, 1503, 1994.Follesa, P., Mancuso, L., Biggio, F., Mostallino, M.C., Manca, A., Mascia, M., Busonero, F., Talani, G., Sanna, E., and Biggio, G., Gamma-hydroxybutyric acid and diazepam antagonize a rapid increase in GABA(A) receptors alpha(4) subunit mRNA abundance induced by ethanol withdrawal in cerebellar granule cells, Mol. Pharmacol., 63, 896, 2003.Nusser, Z., Sieghart, W., and Somogyi, P., Segregation of different GABA(A) receptors to synaptic and extrasynaptic membranes of cerebellar granule cells, J. Neurosci.,
Premenstrual syndrome as a risk factor for relapse in GHB dependent patients: a case series
Published in Journal of Substance Use, 2020
Rouhollah Qurishi, Marieke Arts-De Jong, Victor J. A. Buwalda, Linda Hartman, Cornelis A. J. De Jong
Gamma- Hydroxybutyric acid (GHB) dependency constitutes a comparatively small but growing public health issue in a number of Western countries, including the Netherlands (EMCDDA, 2016). In 2013, data from the Netherlands showed that 45% of GHB-dependent patients had previously undergone treatment for other addictions (Wisselink, Kuijpers, & Mol, 2014). The average GHB consumer is young, with the majority beginning use between the ages of 15–22 years (Gonzalez & Nutt, 2005). GHB tolerance develops rapidly during regular daily use resulting in physical dependence, which can produce severe withdrawal symptoms and can be life-threatening at higher doses (Zvosec, Smith, Porrata, Strobl, & Dyer, 2011). Generally, treatment of GHB dependency is difficult with a high probability of relapse after detoxification (Kamal, Schellekens, de Jong, & Dijkstra, 2015).
Investigational drugs for the treatment of binge eating disorder (BED): an update
Published in Expert Opinion on Investigational Drugs, 2019
Jose C. Appolinario, Antonio E. Nardi, Susan L. McElroy
The other agent investigated was sodium oxybate, a central nervous system depressant used for the treatment of cataplexy and extreme daytime sleepiness associated with narcolepsy. It is the sodium salt of gamma-hydroxybutyric acid (GHB), which is an endogenous compound and a metabolite of the neurotransmitter GABA [117]. GHB modulates several neurotransmitters involved in the regulation of feeding behavior, including GABA, dopamine, serotonin, opioids, and glutamate. Because of its central nervous system depressant effect and its association with misuse, use of sodium oxybate is strictly controlled. An open-label trial [118] suggested the potential positive effect of sodium oxybate in BED (NCT00514995). It reduced binge eating frequency, global severity of illness, obsessive-compulsive binge eating symptoms, food cravings, BMI, and body weight, but was associated with high a discontinuation rate.
The neurochemistry of hypnotic suggestion
Published in American Journal of Clinical Hypnosis, 2021
David J. Acunzo, David A. Oakley, Devin B. Terhune
Multiple reports imply that elevated GABA produces increased suggestibility. However, these data come from studies that lacked placebo-controlled trials and robust measures of suggestibility and thus should be considered preliminary. Early research suggested that amobarbital, a GABAA receptor agonist, increases suggestibility (Eysenck & Rees, 1945). Recent research has highlighted how the abuse of benzodiazepines, which include a large number of sedative GABAA agonists, produces automatism amnesia where individuals will perform seemingly automatic behaviors and display elevated suggestibility often followed by anterograde amnesia (Goullé & Anger, 2004; Marc et al., 2000). Benzodiazepines have also been cited as increasing suggestibility in the context of narcotherapy in functional neurological disorder (Rosebush & Mazurek, 2011). Gamma hydroxybutyric acid, a GABAB agonist used in the treatment of narcolepsy and as an anesthetic agent, has similarly been reported to increase suggestibility (e.g., Bismuth, Dally, & Borron, 1997). These encouraging, albeit preliminary, results point to a clear need to more rigorously assess the impact of GABA agonism on suggestibility, including an assessment of mediating factors to distinguish between competing interpretations of these results.
Related Knowledge Centers
- Cataplexy
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- Γ-Aminobutyric Acid
- Ghb Receptor
- General Anaesthetic