RESUMO
Gamma-hydroxybutyrate (GHB) is a central nervous system (CNS) depressant with limited clinical use but has been misused in the last few decades. During intoxication, the patient may develop CNS depression and may have agitation, while during withdrawal, the patient can present with severe agitation or delirium. Here, we report the case of a 30-year-old Saudi male patient who was brought by his brother to the emergency department (ED) with agitation and delirium. The patient's friend stated the patient had been misusing GHB mixed with alcohol for the last seven months, with the last use occurring 24 hours before the ED presentation. The patient was put on a five-point restraint for safety concerns and received supportive therapy. After two days of admission, the patient completely recovered. As the patient provided a limited history of his GHB misuse, the clinician lacked sufficient information to determine whether the patient was intoxicated or withdrawing. Clinicians in Saudi Arabia need to be highly suspicious of GHB misuse when treating patients with drug intoxication or withdrawal.
RESUMO
We describe a case of a 51-year old man who used GHB only in the afternoon and evening during 10 consecutive days in a recreational way: 20 ml a day in 4 ml per 2-3 hrs. He developed an excited delirium syndrome at the second day after stopping. Apparently even after relatively short recreational use severe disruptive behavior can develop. This is a unique case in literature. References are provided.