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Case report
Severe illicit gamma-hydroxybutyric acid withdrawal in a pregnant woman: what to do?
  1. JC van Mechelen1,
  2. BAG Dijkstra2,3 and
  3. ACM Vergouwen1
  1. 1 Department of Psychiatry and Medical Psychology, OLVG Location West, Amsterdam, North Holland, the Netherlands
  2. 2 Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Radboud University, Nijmegen, Gelderland, the Netherlands
  3. 3 Research and development, Novadic-Kentron Addiction Care, Vught, Noord-Brabant, the Netherlands
  1. Correspondence to Dr JC van Mechelen; joost.c.vanmechelen{at}


This case report presents the case of a 29 weeks pregnant woman in her late twenties who was seen at the emergency department of a hospital with a seizure of unknown cause. By anamnesis and hetero-anamnesis the use of illicit gamma-hydroxybutyric acid (GHB) was revealed. Examination showed dilated pupils, sweating, tremor, tachycardia and bradyphrenic thinking. Subsequently, the seizure was indicated as a severe illicit GHB withdrawal symptom. Thereafter, treatment had to be decided on in the absence of evidence-based and practiced-based guidelines and treatment options for this specific patient population. Initially diazepam was started, which was later on substituted by sodium oxybate. Despite the critical professional situation the patient gave birth to a healthy daughter after 37 weeks of pregnancy.

  • psychiatry (drugs and medicines)
  • drugs misuse (including addiction)
  • drugs: psychiatry
  • delirium

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  • Contributors All authors, JCvM, BAGD and ACMV, were involved in the conception and design of the article. Subsequently JCvM was involved in drafting the article, whereas BAGD and ACMV were involved in critically revising the draft of the article. All authors, JCvM, BAGD and ACMV, have given final approval of the version to be published. In addition, JCvM, BAGD and ACMV have agreed to be accountable for the article and to ensure that all questions regarding the accuracy or integrity of the article are investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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