Evidence map›Paper›PMID 36508055›Full record

ArticlePsychopharmacology2023

Inpatient GHB withdrawal management in an inner-city hospital in Sydney, Australia: a retrospective medical record review.

Krista J Siefried, Georgia Freeman, Darren M Roberts, Rhiannon Lindsey, Craig Rodgers, Nadine Ezard, Jonathan Brett

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Psychopharmacology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.2field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.

  1. Guideline
  2. Toxidromes.Nature reviews. Disease primers · 2026
    Review
  3. Article
  4. Article
  5. Article
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 1 country.

Krista J SiefriedThe National Centre for Clinical Research On Emerging Drugs (NCCRED), The University of New South Wales, Randwick Campus 22/32 King St Randwick, Sydney, NSW, 2031, Australia. Krista.Siefried@svha.org.au.ORCID http://orcid.org/0000-0002-6534-3325
Georgia FreemanAlcohol and Drug Service, St Vincent's Hospital Sydney, Darlinghurst, Australia.
Darren M RobertsDepartment of Clinical Pharmacology and Toxicology, St Vincent's Hospital Sydney, Darlinghurst, Australia.ORCID http://orcid.org/0000-0001-9101-7577
Rhiannon LindseyFaculty of Medicine, Notre Dame University, Sydney, Australia.
Craig RodgersAlcohol and Drug Service, St Vincent's Hospital Sydney, Darlinghurst, Australia.
Nadine EzardThe National Centre for Clinical Research On Emerging Drugs (NCCRED), The University of New South Wales, Randwick Campus 22/32 King St Randwick, Sydney, NSW, 2031, Australia.ORCID http://orcid.org/0000-0002-7495-8305
Jonathan BrettDepartment of Clinical Pharmacology and Toxicology, St Vincent's Hospital Sydney, Darlinghurst, Australia.ORCID http://orcid.org/0000-0003-3065-7495
UNSW Sydney · AUSt Vincent's Hospital Sydney · AURoyal Prince Alfred Hospital · AUThe University of Notre Dame Australia · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

rationaleRegular consumption of gamma-hydroxybutyrate (GHB) may result in a dependence syndrome that can lead to withdrawal symptoms. There are limited data on medications to manage GHB withdrawal.

objectivesTo examine characteristics associated with delirium and discharge against medical advice (DAMA), in the context of implementing a GHB withdrawal management protocol at an inner-city hospital in 2020.

methodsWe retrospectively reviewed records (01 January 2017-31 March 2021), and included admissions that were ≥ 18 years of age, admitted for GHB withdrawal, and with documented recent GHB use. Admissions were assessed for demographics, medications administered, features of delirium, ICU admission, and DAMA. Exploratory analyses were conducted to examine factors associated (p < 0.2) with features of delirium and DAMA.

resultsWe identified 135 admissions amongst 91 patients. Medications administered included diazepam (133 admissions, 98.5%), antipsychotics (olanzapine [70 admissions, 51.9%]), baclofen (114 admissions, 84%), and phenobarbital (8 admissions, 5.9%). Features of delirium were diagnosed in 21 (16%) admissions. Delirium was associated with higher daily GHB consumption prior to admission, while duration of GHB use, time from presentation to first dose of diazepam, and concomitant methamphetamine use were inversely associated with delirium. DAMA occurred amongst 41 (30%) admissions, and was associated with a longer time from presentation to first dose of baclofen, while being female and receiving a loading dose of diazepam were inversely associated.

conclusionsThis study adds to the literature in support of the safety and feasibility of diazepam and baclofen for the management of GHB withdrawal. Prospective, randomised trials are required.

Indexed as

DeliriumSodium OxybateSubstance Withdrawal Syndrome4-ButyrolactoneBaclofenDiazepamFemaleHospitals, UrbanHumansInpatientsMaleMedical RecordsProspective StudiesRetrospective Studies4-ButyrolactoneBaclofenDiazepamSodium Oxybate1,4BD1,4-butanediolGamma-butyrolactoneGamma-hydroxybutyrateGBLGHBOxybatePharmacotherapyWithdrawal

Identifiers

PMID36508055
PMCPMC9816228
OpenAlexW4311205354

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.