GHydroxybutyrate

g-Hydroxybutyrate is a naturally occurring fatty acid derivative, derived from g-aminobutyric acid, which may function as an inhibitory chemical transmitter in the central nervous system. It was synthesized for use as an anaesthetic, although trace amounts may be found in certain fruits such as guava. It has been described as an anabolic steroid since it promotes the secretion of growth hormone during slow-wave sleep and has been abused by body builders. Other recently suggested therapeutic uses include the treatment of narcolepsy and the withdrawal from alcohol and opiates. It is colourless and odourless with an insipid taste, and is available as a liquid or occasionally in powder or capsule form. Concentrations of the drug in these preparations are variable and therefore precise dosing is difficult.

Although not controlled in the United Kingdom under the Misuse of Drugs Act, unauthorized manufacture and sale can be an offence under the Medicines Act.

The sought-after effects are sedative and euphoric as opposed to the stimulant effects described with other dance drugs. The effect begins after 10 to 40 min and lasts 8 to 24 h. At low doses euphoria and disinhibition predominate; with increasing dosage, sedative effects become more evident and there may be nausea and vomiting. There have been several reports of acute physical complications following consumption of the drug, with respiratory depression, seizures (usually petit mal type), and coma (usaully with full recovery). g-Hydroxybutyrate is not detected on routine toxicological screens. Complications are likely to be enhanced when the drug is taken with other substances, especially alcohol. A withdrawal syndrome has been described (40) characterized by insomnia, tremor and anxiety.

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