Twenty‐three deaths with γ‐hydroxybutyrate overdose in western Sweden between 2000 and 2007

Knudsen, Kai; Jonsson, Ulrica; Abrahamsson, Jonas

doi:10.1111/j.1399-6576.2010.02278.x

Cited by 42 publications

(27 citation statements)

References 20 publications

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“…Post-mortem GHB plasma concentrations were recently reported to be 18 to 4400 mg/l, or 172 M to 42.2 mM (Zvosec et al, 2011), indicating that the GHB doses used here elicit plasma GHB concentrations that are relevant to concentrations of GHB observed in clinical cases. These data, in conjunction with the dose-normalized ECF concentration-time profiles, the partitioning time course of brain ECF to plasma, and estimated K m values from in vitro uptake studies, suggest that the distribution of GHB into the brain is saturated only at very high plasma concentrations such as those seen after toxic doses of GHB [up to 21 mM (Knudsen et al, 2010) or 42 mM (Zvosec et al, 2011)].…”

Section: Brain Uptake Of Ghbmentioning

confidence: 99%

Brain Uptake of the Drug of Abuse γ-Hydroxybutyric Acid in Rats

Roiko

Felmlee²,

Morris³

2011

Drug Metab Dispos

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ABSTRACT:␥-Hydroxybutyric acid (GHB) is an endogenous compound and a substrate for the ubiquitous monocarboxylate transporter (MCT) family. GHB is also a drug of abuse due to its sedative/hypnotic and euphoric effects, with overdoses resulting in toxicity and death. The goal of this study was to characterize the distribution of GHB into the brain using in vivo microdialysis and in vitro uptake studies and to determine concentration-effect relationships for GHB in a rat animal model. GHB was administered to rats (400, 600, and 800 mg/kg i.v.), and blood, dialysate, and urine were collected for 6 h post-GHB administration. The GHB plasma and extracellular fluid (ECF) concentration-time profiles revealed that GHB concentrations in ECF closely followed plasma GHB concentrations. Sleep time increased in a dosedependent manner (91 ؎ 18, 134 ؎ 11, and 168 ؎ 13 min, for GHB 400, 600, and 800 mg/kg, respectively). GHB partitioning into brain ECF was not significantly different at 400, 600, and 800 mg/kg. GHB uptake in rat and human brain endothelial cells exhibited concentration dependence. The concentrationdependent uptake of GHB at pH 7.4 was best-fit to a singletransporter model [K m ‫؍‬ 18.1 mM (human), 23.3 mM (rat), V max ‫؍‬ 248 and 258 pmol ⅐ mg ؊1 ⅐ min ؊1 for human and rat, respectively].These findings indicate that although GHB distribution into the brain is mediated via MCT transporters, it is not capacity-limited over the range of doses studied in this investigation.

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Section: Brain Uptake Of Ghbmentioning

confidence: 99%

Brain Uptake of the Drug of Abuse γ-Hydroxybutyric Acid in Rats

Roiko

Felmlee²,

Morris³

2011

Drug Metab Dispos

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“…In Australia, large increases in ambulance attendances related to GHB intoxication were reported between 2001 and 2005 [22,26]. Due to respiratory depression, GHB use may even be lethal [9,11]. According to figures of the Dutch Drug Incidents Monitor 2011, 740 out of 3,652 registered drug-related incidents (ambulance called and/or arrived at emergency departments) were related to the use of GHB [28].…”

Section: Introductionmentioning

confidence: 99%

“…As GHB also increases feelings like euphoria, well-being, relaxation, tranquility, sociability, sexuality, and enjoyment of dancing [7,8], it has become increasingly popular as a recreational drug, mainly as a ‘club drug', since the early 1990s [9,10,11,12,13]. For example, in the Netherlands, the use of GHB gained popularity as a recreational drug [14,15,16,17,18] as evidenced by data from a large national survey among clubbers and party goers in 2008-2009.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors of γ-Hydroxybutyrate Overdosing

et al. 2013

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The aim of this study was to identify in recreational drug users the factors which increase the risk of overdosing (OD) with γ-hydroxybutyrate (GHB). A purposive sample of 45 experienced GHB users was interviewed, equally divided into three groups (never OD, occasional OD, and repeat OD). The repeat OD group scored highest on many risk factors regarding GHB use, the occasional OD group scored intermediate, and the never OD group scored lowest. Participants, whether or not they had overdosed on GHB, most often perceived GHB use (e.g. using more GHB than usual, using GHB doses too closely together) as the main reason for GHB OD, and many participants who had overdosed on GHB reported that they had taken more GHB than usual at their most recent occasion of GHB OD. No significant differences in co-use of GHB with other substances were found between the three groups. Our findings indicate that using GHB in the company of groups of friends probably reduces, but does not eliminate, the risk of OD.

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“…Gammahydroxybutyrate (GHB) is frequently associated with other CNS active drugs such as alcohol and opiates. Data suggest that these drugs increase the toxicity of GHB and reduce fatal concentrations (Knudsen et al 2010). …”

Section: Inherent Toxicity Of a Substancementioning

confidence: 99%