Baclofen and gamma-hydroxybutyrate withdrawal.

INTRODUCTION: Benzodiazepine treatment of life-threatening gamma-hydroxybutyrate (GHB) withdrawal is frequently unsatisfactory. Animal studies suggest strongly that treatment with GABA(B) agonists, such as baclofen, will be a more effective strategy.

METHODS: A case report from the medical intensive care unit (ICU) of the university tertiary care hospital.

RESULTS: A 61-year-old woman was admitted to the medical ICU for severe withdrawal symptoms from chronic GHB use. This manifested as delirium, tremor, and seizures despite only small decreases in GHB dose and treatment with benzodiazepines. The addition of baclofen allowed the rapid sequential decreases in the GHB dose without seizure or delirium and resulted in long-term improvement of her tremor.

CONCLUSIONS: Baclofen, a GABA(B) agonist, may be a useful agent in the treatment of severe GHB withdrawal.