GHB: what psychiatrists need to know

by Dr Matthew Goldin and Dr Jenny Bearn


Published: June 2013


Gamma-hydroxybutyrate (GHB) is an endogenous brain compound. In pharmacological doses it is a rapidly acting central nervous system depressant.


Although in the past GHB has been used for various clinical reasons, its recreational use is now increasing (along with the use of its precursors, gamma-butyrolactone and 1,4-butanediol). Medical literature reports rising cases of GHB intoxication, dependence and severe withdrawal, which are potentially fatal, and the clinical effects of the drug can be unpredictable and difficult to diagnose.

This module outlines the history, epidemiology and pharmacology of GHB, and provides a summary of the medico-legal issues associated with the drug. By the end of the module you should be able to recognise the clinical features of GHB intoxication, dependence and withdrawal, and be aware of the clinical management options available.


Start the module


Please note: This module was published in 2013. A revision is being worked on, but in the meantime please be aware when completing the module that some of the guidance may have changed.


If you like this module, you may also be interested in:


Buprenorphine in opioid dependence by Dr Lucinda M. Cockayne and Ms Elizabeth Hutchings


Stimulants: epidemiology and impact on mental health by Professor Fabrizio Schifano and Dr Antonio Albanese


Stimulants: treatment approaches and organising services by Professor Fabrizio Schifano and Dr Antonio Albanese


Drug Misuse: Psychosocial Interventions – The NICE Guideline (book from RCPsych Publications)



Download take-home notes to print and annotateDownload take-home notes to print and annotate


© 2021 Royal College of Psychiatrists