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Sodium Oxybate Therapy for Alcohol Withdrawal Syndrome and Keeping of Alcohol Abstinence

[ Vol. 19 , Issue. 13 ]

Author(s):

Carmen Mannucci, Simona Pichini, Elvira Ventura Spagnolo, Fabrizio Calapai, Sebastiano Gangemi, Michele Navarra and Gioacchino Calapai*   Pages 1056 - 1064 ( 9 )

Abstract:


Background: Gamma-hydroxybutyrate (GHB or sodium oxybate) is both an exogenous and endogenous molecule with neuromodulator properties. In the United States, GHB is an approved drug for the treatment of narcolepsy and narcolepsy with cataplexy in adults. In some European Union countries, sodium oxybate is applied for the treatment of opioid and alcohol withdrawal.

Objective: The aim of the present review was to describe the state of art of the pre-clinical research and the clinical evidence related to GHB used alone or in combination with other treatments in alcohol withdrawal syndrome and alcohol abstinence maintenance.

Method: Internationally published pre-clinical findings and clinical studies investigating the effects of GHB on alcohol withdrawal syndrome and alcohol abstinence maintenance were collected and described considering seven clinical studies involving GHB in the treatment of alcohol withdrawal abstinence and five clinical studies involving GHB in the treatment of alcohol abstinence maintenance. Furthermore, GHB pharmacology and characteristics of abuse were briefly detailed.

Results: Clinical evidence indicates that GHB is effective in reducing symptoms of alcohol withdrawal syndrome and produces beneficial effects comparable to those of benzodiazepines or chlometiazole. GHB proved effective in increasing alcohol abstinence maintenance and in reducing alcohol craving, but it did not show any influence in relapses of heavy drinkers when given alone. Conversely, it seems to be effective in reducing relapses in alcohol dependent patients when given in combination with naltrexone and escitalopram.

Conclusion: Despite this bunch of evidence, studies are still limited and investigations including a larger number of patients are needed. In addition, some safety concerns, such as insufficiency against hallucinations in alcohol withdrawal and potential development of GHB dependence have to be more investigated.

Keywords:

GHB, gamma-hydroxybutyrate, gamma-hydroxybutyric acid, sodium oxybate, alcohol withdrawal, alcohol abstinence.

Affiliation:

Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, National Centre on Addiction and Doping, Istituto Superiore di Sanità V. Le Regina Elena 299, Rome, Legal Medicine Section - Department for Health Promotion and Mother-Child Care, University of Palermo, Via del Vespro, 129, Palermo, Pharma.Ca Research Facility (Centro Studi Pharma.Ca), Messina, School and Division of Allergy and Clinical Immunology, Department of Clinical and Experimental Medicine, University Hospital , Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, University of Messina - Department of Biomedical and Dental Sciences and Morphofunctional Imaging Messina



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