Intoxication by gamma hydroxybutyrate and related analogues: Clinical characteristics and comparison between pure intoxication and that combined with other substances of abuse.

Miró, Òscar; Galicia, Miguel; Dargan, Paul; Dines, Alison M; Giraudon, Isabelle; Heyerdahl, Fridtjof; Hovda, Knut E; Yates, Christopher; Wood, David M; Liakoni, Evangelia; Liechti, Matthias; Jürgens, Gesche; Pedersen, Carsten Boe; O'Connor, Niall; Markey, Gerard; Moughty, Adrian; Lee, Christopher; O'Donohoe, Patrick; Sein Anand, Jacek; Puiguriguer, Jordi; ... (2017). Intoxication by gamma hydroxybutyrate and related analogues: Clinical characteristics and comparison between pure intoxication and that combined with other substances of abuse. Toxicology letters, 277, pp. 84-91. Elsevier 10.1016/j.toxlet.2017.05.030

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OBJECTIVE To study the profile of European gamma-hydroxybutyrate (GHB) and gammabutyrolactone (GBL) intoxication and analyse the differences in the clinical manifestations produced by intoxication by GHB/GBL alone and in combination with other substances of abuse. METHOD We prospectively collected data on all the patients attended in the Emergency Departments (ED) of the centres participating in the Euro-DEN network over 12 months (October 2013 to September 2014) with a primary presenting complaint of drug intoxication (excluding ethanol alone) and registered the epidemiological and clinical data and outcomes. RESULTS We included 710 cases (83% males, mean age 31 years), representing 12.6% of the total cases attended for drug intoxication. Of these, 73.5% arrived at the ED by ambulance, predominantly during weekend, and 71.7% consumed GHB/GBL in combination with other substances of abuse, the most frequent additional agents being ethanol (50%), amphetamine derivatives (36%), cocaine (12%) and cannabis (8%). Among 15 clinical features pre-defined in the project database, the 3 most frequently identified were altered behaviour (39%), reduced consciousness (34%) and anxiety (14%). The severity ranged from mild cases requiring no treatment (308 cases, 43.4%) to severe cases requiring admission to intensive care (103 cases, 14.6%) and mechanical ventilation (49 cases, 6.9%). No deaths were reported. In comparison with only GHB/GBL consumption, patients consuming GHB/GBL with co-intoxicants presented more vomiting (15% vs. 3%, p<0.001) and cardiovascular symptoms (5.3% vs. 1.5%, p<0.05), a greater need for treatment (59.8% vs. 48.3%, p<0.01) and a longer ED stay (11.3% vs. 3.6% patients with ED stay >12h, p<0.01). CONCLUSIONS The profile of the typical GHB/GBL-intoxicated European is a young male, requiring care for altered behaviour and reduced level of consciousness, mainly during the weekend. The clinical features are more severe when GHB is consumed in combination with other substances of abuse.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine

UniBE Contributor:

Liakoni, Evangelia

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0378-4274

Publisher:

Elsevier

Language:

English

Submitter:

Christine Baumgartner

Date Deposited:

02 Sep 2019 16:29

Last Modified:

25 Oct 2019 19:50

Publisher DOI:

10.1016/j.toxlet.2017.05.030

PubMed ID:

28579487

Uncontrolled Keywords:

Drug abuse Emergency department GBL GHB Gamma-butyrolactone Gamma-hydroxybutyrate Intoxication

BORIS DOI:

10.7892/boris.123622

URI:

https://boris.unibe.ch/id/eprint/123622

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