Gamma-hydroxybutyrate (ghb)
Gamma-hydroxybutyrate (ghb)

Background

Gamma hydroxybutyrate (GHB) is a chemical that is found in the brain and made in a lab. It has sedative effects. It's illegal for use in dietary supplements.

GHB acts on several nerve pathways in the brain and has been used in drug-facilitated sexual assault and as a party drug. Due to safety concerns, it is a Schedule I controlled substance, making it illegal.

A prescription form of GHB called sodium oxybate (Xyrem) is used for treating excessive daytime sleepiness (narcolepsy). People also use GHB for alcohol use disorder, opioid withdrawal, depression, and other conditions, but there is no good scientific evidence to support these uses.
When taken by mouth: The prescription form of GHB (sodium oxybate) is likely safe when used under the supervision of a healthcare provider for excessive daytime sleepiness (narcolepsy). Side effects may include nausea, vomiting, dizziness, and drowsiness.

GHB is unsafe and illegal for use as a dietary supplement. It can cause many serious side effects including hallucinations, confusion, memory loss, coma, and death. Long-term use can lead to addiction and withdrawal symptoms when it is stopped.

Special Precautions & Warnings:

Pregnancy and breast-feeding: GHB is unsafe. Don't use GHB if you are pregnant or breast-feeding. It's been linked with life-threatening side effects.

Slow heart rate (bradycardia): GHB should be avoided since it can slow the heart rate.

Seizure disorder (epilepsy): GHB might cause seizures in people with epilepsy. Avoid use.

Surgery: GHB can affect the central nervous system. It might cause too much sleepiness if it is used along with anesthesia and other medications used during and after surgery. Stop using GHB at least 2 weeks before a scheduled surgery. Talk to your doctor before stopping sodium oxybate (Xyrem).

A rare disorder called succinic semialdehyde dehydrogenase deficiency: People with this condition are at a greater risk for serious adverse reactions from GHB. Do not use GHB if you have this condition.

Effectiveness

NatMed Pro rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.
  • Excessive daytime sleepiness (narcolepsy). Taking a specific prescription form of GHB by mouth helps people with narcolepsy sleep at night so they are less likely to feel sleepy during the day. It is FDA approved for this use. It's not clear if GHB supplements help.
Likely effective Effectiveness definitions
Possibly effective Effectiveness definitions
  • Alcohol use disorder. Taking GHB by IV seems to reduce symptoms of alcohol withdrawal in people with alcohol use disorder. It's not clear if taking GHB by mouth helps. IV products can only be given by a healthcare provider.
There is interest in using GHB for a number of other purposes, but there isn't enough reliable information to say whether it might be helpful.
Likely ineffective Effectiveness definitions
Possibly ineffective Effectiveness definitions
Insufficient evidence Effectiveness definitions

Dosing & administration

GHB used to be available as a dietary supplement in the US, but it was taken off the market in 1990 due to safety concerns. It is now a Schedule I controlled substance, making it illegal. A prescription form of GHB called sodium oxybate (Xyrem) is available for treating excessive daytime sleepiness (narcolepsy). It is a Schedule III controlled substance, meaning it requires a prescription and close monitoring by a healthcare provider.

Interactions with pharmaceuticals

Alcohol (Ethanol)

Interaction Rating=Major Do not take this combination.

Alcohol can cause sleepiness and drowsiness. Taking GHB along with alcohol may greatly increase this effect. Do not take GHB if you have been drinking.

Amphetamines

Interaction Rating=Moderate Be cautious with this combination.

Amphetamines are drugs that can speed up your nervous system. GHB can slow down your nervous system. Taking GHB along with amphetamines can lead to serious side effects.

Diclofenac (Voltaren, others)

Interaction Rating=Minor Be watchful with this combination.

Taking diclofenac at the same time as GHB might decrease levels of GHB in the body. This might reduce the effects of GHB by a small amount.

Divalproex sodium (Depakote)

Interaction Rating=Major Do not take this combination.

Taking divalproex sodium at the same time as GHB might decrease how quickly the body gets rid of GHB. This could cause serious side effects.

Medications used to prevent seizures (Anticonvulsants)

Interaction Rating=Moderate Be cautious with this combination.

GHB may increase the risk of seizures. Therefore, taking GHB may decrease the effects of medications used to prevent seizures. This might increase the risk of seizures.

Naloxone (Narcan)

Interaction Rating=Moderate Be cautious with this combination.

GHB can affect the brain. Taking naloxone along with GHB might decrease the effects of GHB on the brain.

Ritonavir (Norvir)

Interaction Rating=Moderate Be cautious with this combination.

Ritonavir and saquinavir are commonly used together for HIV/AIDS. Taking these medications with GHB might decrease how quickly the body gets rid of GHB. This could cause serious side effects.

Saquinavir (Fortovase, Invirase)

Interaction Rating=Moderate Be cautious with this combination.

Saquinavir and ritonavir are commonly used together for HIV/AIDS. Taking both these medications with GHB might decrease how fast the body gets rid of GHB. This could cause serious side effects.

Sedative medications (CNS depressants)

Interaction Rating=Major Do not take this combination.

GHB might cause sleepiness and slowed breathing. Some medications, called sedatives, can also cause sleepiness and slowed breathing. Taking GHB with sedative medications might cause breathing problems and/or too much sleepiness.

Topiramate (Topamax)

Interaction Rating=Moderate Be cautious with this combination.

Taking topiramate plus GHB might decrease how quickly the body gets rid of GHB. This could cause serious side effects.

Interactions with herbs & supplements

Herbs and supplements with sedative properties: GHB might cause sleepiness and slowed breathing. Taking it along with other supplements with similar effects might cause too much sleepiness and/or slowed breathing in some people. Examples of supplements with this effect include hops, kava, L-tryptophan, melatonin, and valerian.

Interactions with foods

Using GHB while drinking alcohol might slow down breathing and harm brain function. Don't use this combination.
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This monograph was last reviewed on 29/12/2022 18:29:56 and last updated on 22/05/2022 01:08:35. Monographs are reviewed and/or updated multiple times per month and at least once per year.
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