What Is Gamma-Hydroxybutyrate (GHB)? Other Names: 4-Hydroxybutanoate, Cherry Meth, Ecstasy Liquide

What is Gamma-Hydroxybutyrate (GHB)?

This post was written with Consensus AI Academic Search Engine – please read our Disclaimer at the end of this article. Gamma-Hydroxybutyrate (GHB) is a naturally occurring substance in the mammalian brain that has gained attention for its diverse applications and effects. It is both a therapeutic agent and a substance of abuse, with a complex pharmacological profile. Other names include: 4-Hydroxybutanoate, 4-Hydroxy Butyrate, 4-hydroxybutyric acid, Acide 4-hydroxybutanoïque, Acide Gamma-Hydroxybutyrique, Acide Gamma-Hydroxy-Butyrique, Cherry Meth, Ecstasy Liquide, Fantasy G, Gamma Hydrate, Gamma-Hydroxybutyrate, Gamma-Hydroxy-Butyrate, Gamma Hydroxy-Butyrate de Sodium, Gamma Hydroxybutyrate Sodium, Gamma Hydroxybutyric Acid, Gamma-Hidroxibutirato, Gamma-OH, GHB, Grievous Bodily Harm, Liquid Ecstacy, Liquid X, Oxybate de Sodium, Oxybutyrate de Sodium, Scoop, Sodium 4-hydroxybutyrate, Sodium gamma-hydroxybutyrate, Sodium Oxybate, Sodium Oxybutyrate, Vita-G.

Pharmacodynamics and Pharmacokinetics

GHB acts as a GHB-/GABA-B receptor agonist, which contributes to its mixed stimulant-sedative effects. It is known to produce dose-dependent changes in subjective experiences, such as euphoria and sedation, which are closely related to its plasma concentrations1 5. The drug is rapidly metabolized, leading to challenges in detection, especially in forensic contexts3.

Therapeutic Uses of Gamma-Hydroxybutyrate (GHB)

Clinically, GHB is used to treat conditions like narcolepsy due to its ability to consolidate sleep and reduce excessive daytime sleepiness. It enhances slow-wave sleep and can improve REM sleep efficiency, making it beneficial for sleep disorders2 6. Additionally, GHB has been explored for potential therapeutic effects in neuropsychiatric disorders, including depression and fibromyalgia, due to its impact on neuro-immunological processes7.

Effects on Mood and Behavior

GHB is reported to enhance mood and prosocial behavior, inducing feelings of euphoria and vitality without significantly affecting social hormones like oxytocin and testosterone5. It also increases body and emotion awareness, which may contribute to its abuse potential9.

Abuse Potential

Despite its therapeutic benefits, GHB has a high potential for abuse. It is often used recreationally for its euphoric and sedative effects, and its ability to enhance social interactions. The drug’s reinforcing properties are dose-dependent, and it is frequently chosen over placebo by users, indicating its strong appeal10.

Challenges in Detection

The rapid metabolism of GHB results in narrow detection windows, complicating its identification in cases of drug-facilitated crimes. Recent studies have focused on identifying new urinary markers to improve detection reliability3.

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Adverse Effects of Gamma-Hydroxybutyrate (GHB)

Respiratory and Cardiovascular Effects: GHB can decrease oxygen saturation, leading to potential respiratory issues. When combined with ethanol, it can cause hypotension and further decrease oxygen saturation, indicating a compounded risk when used with other depressants1.

Gastrointestinal Disturbances: GHB use, particularly in combination with ethanol, can lead to gastrointestinal issues such as vomiting1.

Psychomotor and Balance Impairment: GHB has a mixed stimulant-sedative effect, initially causing euphoria followed by sedation, which can impair psychomotor performance and balance2.

Immune System Impairment: Acute GHB intake can impair immune function, as evidenced by a decrease in the CD4 T/CD8 T-cell ratio and a reduction in natural killer cells, potentially increasing vulnerability to infections3.

Sedative and Hypnotic Effects: GHB can cause significant sedation, which is exacerbated by testosterone treatment, leading to increased sedative effects and altered toxicokinetics6.

Potential for Abuse and Dependence: GHB has a high abuse liability, with dose-dependent subjective effects that can lead to dependence2 4.

Neurological Effects: In severe intoxication cases, GHB can lead to seizures and other neurological symptoms, especially when combined with other substances like physostigmine7.

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How has Gamma-Hydroxybutyrate (GHB) Improved Patient Outcomes?

Narcolepsy

GHB significantly improves nocturnal sleep quality in narcolepsy patients by increasing delta sleep and reducing awakenings, which helps decrease cataplexy episodes1.

It enhances sleep continuity without suppressing REM sleep, contributing to better daytime alertness1.

Opiate Withdrawal

GHB effectively suppresses withdrawal symptoms in heroin and methadone users, providing relief within 15 minutes and maintaining symptom suppression over several days2.

Patients reported feeling well, and no withdrawal symptoms recurred after treatment cessation2.

Major Depressive Disorder (MDD)

In MDD patients, GHB promotes slow-wave sleep (SWS) and improves sleep efficiency, reducing next-day sleepiness and enhancing vigilance compared to trazodone and placebo3.

Alcohol Withdrawal Syndrome (AWS)

GHB is as effective as benzodiazepines in managing AWS, with quicker reductions in anxiety, agitation, and depression4.

It promptly reduces withdrawal symptoms such as tremors, sweating, and restlessness, with dizziness as the only noted side effect6.

Schizophrenia

In a pilot study, GHB showed limited efficacy in treating schizophrenia, with mixed responses among patients5.

Sleep in Healthy Individuals

GHB enhances slow-wave sleep and reduces wake time after sleep onset in healthy subjects, suggesting its potential to mimic physiological sleep enhancement7 9.

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Gamma-Hydroxybutyrate (GHB) Mechanisms of Action

Receptor Agonism: GHB functions as an agonist at both GHB-specific and GABAB receptors. This dual action is central to its effects on the central nervous system, including its sedative and euphoric properties3 4 9.

Sleep Modulation: GHB enhances slow-wave sleep (SWS) by increasing delta-theta activity and reducing spindle frequency activity, which is associated with improved sleep consolidation and reduced daytime sleepiness1 4. It also affects REM sleep by increasing its efficiency and slightly decreasing REM latency1 4.

Neuroendocrine Effects: GHB stimulates growth hormone (GH) secretion, likely through GABA receptor pathways, as evidenced by the antagonistic effects of flumazenil, a benzodiazepine receptor antagonist, on GH secretion2 7. It also influences prolactin and cortisol levels, although these effects are transient and not directly linked to sleep stages7.

Mood and Behavior: GHB induces mood-enhancing and prosocial effects, potentially through its action on GHB/GABAB receptors and modulation of progesterone levels, without significantly affecting oxytocin or testosterone3.

Prosexual Effects: GHB is reported to enhance libido and lower attractiveness standards, possibly by increasing activation in brain regions associated with reward and sexual arousal8.

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Common Complaints Associated with Gamma-Hydroxybutyrate (GHB) Use

Gastrointestinal Disturbances: GHB use, especially when combined with ethanol, can lead to gastrointestinal issues such as vomiting1.

Cardiovascular Effects: GHB alone does not significantly affect heart rate or blood pressure. However, when combined with ethanol, it can cause hypotension (low blood pressure)1.

Respiratory Effects: GHB can decrease oxygen saturation levels, an effect that is exacerbated when combined with ethanol1.

Subjective Effects: Users often report a mixed pattern of stimulant and sedative effects. Initially, there may be feelings of euphoria and a sense of being “high,” followed by sedation and impaired performance and balance2.

Dose-Dependent Effects: The physiological and subjective effects of GHB are dose-dependent, with higher doses leading to more pronounced effects2.

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Disclaimer

The content presented in this blog is generated by Consensus, an AI-powered academic search engine, and is based on publicly available scientific literature. While every effort is made to provide accurate, up-to-date, and well-researched information, the content is intended for informational and educational purposes only. It does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional before making any decisions regarding medical conditions, treatments, or medications. The AI system’s analysis may not cover all perspectives, emerging research, or individual cases, and it is not a substitute for professional expertise. Neither the blog publisher nor the developers of the AI-powered search engine are responsible for any actions taken based on the information provided in this content. Use of this information is at your own risk. Citations to the original scientific studies are included for reference, but these studies should be reviewed in full and interpreted with the guidance of a healthcare or research professional.

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