CNS Drugs

, Volume 31, Issue 1, pp 51–64 | Cite as

Pharmacological Treatment in γ-Hydroxybutyrate (GHB) and γ-Butyrolactone (GBL) Dependence: Detoxification and Relapse Prevention

  • Rama M. KamalEmail author
  • Martijn S. van Noorden
  • Wim Wannet
  • Harmen Beurmanjer
  • Boukje A. G. Dijkstra
  • Arnt Schellekens
Review Article


The misuse of γ-hydroxybutyrate (GHB) for recreational purposes has resulted in an increase in GHB-related problems such as intoxications, dependence and withdrawal in several countries in Europe, Australia and the US over the last decade. However, prevalence rates of misuse of GHB and its precursor, γ-butyrolactone (GBL), are still relatively low. In this qualitative review paper, after a short introduction on the pharmacology of GHB/GBL, followed by a summary of the epidemiology of GHB abuse, an overview of GHB dependence syndrome and GHB/GBL withdrawal syndrome is provided. Finally, the existing literature on management of GHB detoxification, both planned and unplanned, as well as the available management of GHB withdrawal syndrome, is summarized. Although no systematic studies on detoxification and management of withdrawal have been performed to date, general recommendations are given on pharmacological treatment and preferred treatment setting.


Baclofen Withdrawal Symptom Relapse Prevention Withdrawal Syndrome Sodium Oxybate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Compliance with Ethical Standards

Conflict of interest

The authors Rama Kamal, Martijn van Noorden, Wim Wannet, Harmen Beurmanjer, Boukje Dijkstra and Arnt Schellekens declare that they have no conflicts of interest related to this review.


There was no external funding received for the preparation of this manuscript.


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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Rama M. Kamal
    • 1
    • 2
    Email author
  • Martijn S. van Noorden
    • 3
  • Wim Wannet
    • 4
  • Harmen Beurmanjer
    • 1
    • 2
  • Boukje A. G. Dijkstra
    • 1
  • Arnt Schellekens
    • 1
  1. 1.Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA)NijmegenThe Netherlands
  2. 2.Novadic-Kentron Addiction Care NetworkVughtThe Netherlands
  3. 3.Leiden University Medical CentreLeidenThe Netherlands
  4. 4.Scientific Research Committee IrisZorgArnhemThe Netherlands

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