Gamma-Butyrolactone (GBL) Toxicity

Gamma-Butyrolactone (GBL) is an addictive depressant used for its euphoric and sleep inducing effects. It is a prodrug to GHB.

GBL can be synthesized from gamma-hydroxybutyric acid (GHB) by removal of water or by distillation from such a mixture.

Pathophysiology:

GBL readily crosses the blood-brain barrier with rapid onset of anxiolytic, sedative and euphoric effects. It acts in the central nervous system at the GABABB receptor and the GHB receptor.

Uses:

Recreational:

Date rape drug
Body builders

Household products:

Pain thinners, stain remover, super glue, wheel cleaner

Signs and Symptoms:

▪ Central Nervous System (CNS) depression

▪ Euphoria

▪ Sedation/ Restful sleep

▪ Insomnia

▪ Increased energy/agitation/anxiety

▪ Loss of inhibition

▪ Increased sex drive

▪ Unconsciousness/ coma/ death

▪ Hot/cold flushes

▪ Uncontrolled body movements

▪ Muscle relaxation

▪ Gastro-intestinal irritation/vomiting

▪ Respiratory failure

▪ Seizures

▪ Hypotension

▪ Addiction and dependency

Dependence and Withdrawal:

Similar to chronic alcohol dependence and benzodiazepine dependence: Symptoms include anxiety, insomnia, tremor, confusion, nausea, vomiting, hypertension and tachycardia.

Treatment:

-Benzodiazepines: (GABA-A)

-Chlordiazepoxide/Baclofen: (GABA-B)

-Gabapentin/Pregablain: (GABA-B)