Agitation is common in γ-hydroxybutyrate toxicity

Deborah L. Zvosec, Stephen W. Smith

Research output: Contribution to journalArticlepeer-review

22 Scopus citations

Abstract

γ-Hydroxybutyrate (GHB)-related compounds are most commonly described as depressants, with emphasis on somnolence, obtundation, stupor, and coma (SOSC). We sought to demonstrate the full spectrum of clinical presentations of GHB intoxication, including agitation and other nonsedative effects. Our observational study identified 66 patients with GHB toxicity, 40 of whom manifested agitation; 25 had agitation before or after SOSC, 10 had agitation alternating abruptly with SOSC, and 5 had agitation only. Fourteen presentations also included "bizarre" or self-injurious behaviors. Of 40 presentations with agitation, 19 had stimulant co-intoxicants confirmed by screen (14) or history (5). The remaining 21 patients with agitation were negative for stimulants by screen (12) or history (9). Gas chromatography/mass spectrometry detected GHB in 25 cases; 12 manifested agitation, 4 of which also screened negative for stimulants. Clinicians should broaden their definitions of GHB toxicity to include nonsedative effects such as agitation, combativeness, and bizarre or self-injurious behavior.

Original languageEnglish (US)
Pages (from-to)316-320
Number of pages5
JournalAmerican Journal of Emergency Medicine
Volume23
Issue number3
DOIs
StatePublished - May 2005

Bibliographical note

Copyright:
Copyright 2008 Elsevier B.V., All rights reserved.

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