PsychonautWiki Archive

GHB: Difference between revisions

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fixed myths in lead section about use as a "date rape" drug - citation needed tag has been visible forever because no good evidence exists to support widespread use in this way
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{{SubstanceBox/GHB}}
{{SubstanceBox/GHB}}


'''GHB''' (also known as '''γ-Hydroxybutyric acid''' and '''4-hydroxybutanoic acid''') is a naturally occurring [[psychoactive class::depressant]] substance which is found naturally in the human central nervous system as well as in wine, beef, some citrus fruits, and in almost all animals (in small amounts).<ref>Weil, Andrew; Winifred Rosen (1993). "Depressants". From Chocolate to Morphine (2nd ed.). Boston/New York: Houghton Mifflin Company. p. 77. ISBN 0-395-66079-3.</ref>  
'''gamma-Hydroxybutyric acid''' (also known as and '''4-hydroxybutanoic acid''' and '''GHB''') is a naturally occurring [[psychoactive class::depressant]] substance. GHB is found naturally in the human central nervous system as well as in wine, beef, some citrus fruits, and in almost all animals (in small amounts).<ref>Weil, Andrew; Winifred Rosen (1993). "Depressants". From Chocolate to Morphine (2nd ed.). Boston/New York: Houghton Mifflin Company. p. 77. ISBN 0-395-66079-3.</ref>  


GHB as the sodium salt, known by the trade name Xyrem,<ref>http://www.reuters.com/finance/stocks/companyProfile?rpc=66&symbol=JAZZ.O</ref> is a prescription sleep-aid which is used to treat various medical conditions such as cataplexy<ref>Sodium Oxybate | http://www.nlm.nih.gov/medlineplus/druginfo/meds/a605032.html</ref> and excessive daytime sleepiness in patients with narcolepsy.<ref>United States Patent | Patent Number: US4738985 | Pharmaceutical composition and treatment of narcolepsy (Erowid) | https://www.erowid.org/chemicals/ghb/ghb_patent2.shtml</ref> It has also been used in a medical setting as a general anesthetic to treat conditions such as insomnia, clinical depression, and alcoholism,<ref>United States Patent | Patent Number: US4983632 | Use of Gamma-Hydroxybutyric Acid Salts for Preparing Pharmaceutical Compositions for Use in the Treatment of Alcoholism, and the Compositions Obtained (Erowid) | https://www.erowid.org/chemicals/ghb/ghb_patent.shtml</ref> and to improve athletic performance.  
GHB as the sodium salt, known by the trade name Xyrem,<ref>http://www.reuters.com/finance/stocks/companyProfile?rpc=66&symbol=JAZZ.O</ref> is a prescription sleep-aid which is used to treat various medical conditions such as cataplexy<ref>Sodium Oxybate | http://www.nlm.nih.gov/medlineplus/druginfo/meds/a605032.html</ref> and excessive daytime sleepiness in patients with narcolepsy.<ref>United States Patent | Patent Number: US4738985 | Pharmaceutical composition and treatment of narcolepsy (Erowid) | https://www.erowid.org/chemicals/ghb/ghb_patent2.shtml</ref> It has also been used in a medical setting as a general anesthetic to treat conditions such as insomnia, clinical depression, and alcoholism,<ref>United States Patent | Patent Number: US4983632 | Use of Gamma-Hydroxybutyric Acid Salts for Preparing Pharmaceutical Compositions for Use in the Treatment of Alcoholism, and the Compositions Obtained (Erowid) | https://www.erowid.org/chemicals/ghb/ghb_patent.shtml</ref> and to improve athletic performance.  


It is used as a recreational drug for its [[chemical class::alcohol]]-like effects. While a common recreational dose is 3g, a dose of 5g - 10g can result in convulsions, unconsciousness (a coma-like state) and vomiting. Doses above 10g+ are associated with a risk of death.<ref name="cite">GHB Dosage by Erowid | https://www.erowid.org/chemicals/ghb/ghb_dose.shtml</ref> It is important to start with a low dose and work your way up slowly by increasing the dosage in small increments.
GHB is used as a recreational substance for its [[chemical class::alcohol]]-like effects. While a common recreational dose is 3 grams, a dose of 5 - 10 grams can result in convulsions, unconsciousness (a coma-like state) and vomiting. Doses above 10 grams are associated with a risk of death.<ref name="cite">GHB Dosage by Erowid | https://www.erowid.org/chemicals/ghb/ghb_dose.shtml</ref> As a result, users are commonly advised to start with a low dose and work their way up slowly by increasing the dose in small increments.
 
GHB, along with [[GBL]], has acquired a reputation as a "date rape drug," in which it is purportedly secretly placed into alcoholic drinks.{{citation needed}} There is very limited evidence to suggest that this actually happens but care should always be taken when accepting drinks from strangers.  


GHB, and sometimes [[GBL]] have acquired a reputation as "date rape drugs," in which they are purportedly secretly put dropwise into drinks.{{citation needed}} There is very limited evidence to suggest that this actually happens but care should always be taken when accepting drinks from strangers.
==Chemistry==
==Chemistry==
GHB, or gamma-Hydroxybutanoic acid, is a carboxylic acid substituted with an additional hydroxy group. GHB contains a four carbon chain with a terminal carbon bonded to a hydroxy group (OH-) and double bonded to an oxygen group to form a carboxyl unit; this is butanoic acid. At the other end of the four carbon change at R<sub>γ</sub>, GHB is substituted with a hydroxy group.
GHB, or gamma-Hydroxybutanoic acid, is a carboxylic acid substituted with an additional hydroxy group. GHB contains a four carbon chain with a terminal carbon bonded to a hydroxy group (OH-) and double bonded to an oxygen group to form a carboxyl unit; this is butanoic acid. At the other end of the four carbon change at R<sub>γ</sub>, GHB is substituted with a hydroxy group.
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GHB has at least two distinct binding sites<ref>Gammahydroxybutyrate: An endogenous regulator of energy metabolism (ScienceDirect) | http://www.sciencedirect.com/science/article/pii/S0149763489800533</ref> in the central nervous system. GHB is an [[agonist]] at the newly characterized GHB receptor, which is excitatory.<ref>γ-Hydroxybutyric acid (GHB) and γ-aminobutyric acidB receptor (GABABR) binding sites are distinctive from one another: molecular evidence (ScienceDirect) | http://www.sciencedirect.com/science/article/pii/S0028390804002527</ref><ref>A mechanism for γ-hydroxybutyrate (GHB) as a drug and a substance of abuse | http://www.medecinesciences.org/articles/medsci/abs/2005/03/medsci2005213p284/medsci2005213p284.html</ref> It is also a weak [[agonist]] at the [[GABA]]<sub>B</sub> receptor, which is inhibitory.<ref>A mechanism for γ-hydroxybutyrate (GHB) as a drug and a substance of abuse | http://www.medecinesciences.org/articles/medsci/abs/2005/03/medsci2005213p284/medsci2005213p284.html</ref>
GHB has at least two distinct binding sites<ref>Gammahydroxybutyrate: An endogenous regulator of energy metabolism (ScienceDirect) | http://www.sciencedirect.com/science/article/pii/S0149763489800533</ref> in the central nervous system. GHB is an [[agonist]] at the newly characterized GHB receptor, which is excitatory.<ref>γ-Hydroxybutyric acid (GHB) and γ-aminobutyric acidB receptor (GABABR) binding sites are distinctive from one another: molecular evidence (ScienceDirect) | http://www.sciencedirect.com/science/article/pii/S0028390804002527</ref><ref>A mechanism for γ-hydroxybutyrate (GHB) as a drug and a substance of abuse | http://www.medecinesciences.org/articles/medsci/abs/2005/03/medsci2005213p284/medsci2005213p284.html</ref> It is also a weak [[agonist]] at the [[GABA]]<sub>B</sub> receptor, which is inhibitory.<ref>A mechanism for γ-hydroxybutyrate (GHB) as a drug and a substance of abuse | http://www.medecinesciences.org/articles/medsci/abs/2005/03/medsci2005213p284/medsci2005213p284.html</ref>


GHB induces the accumulation of either a derivative of [[tryptophan]] or [[tryptophan]] itself, possibly by increasing [[tryptophan]] transport across the blood–brain barrier. GHB-induced stimulation may be due to this increase in [[tryptophan]] transport to the brain and in its uptake by serotonergic cells. As the [[Serotonin|serotonergic]] system may be involved in the regulation of sleep, mood, and anxiety, the stimulation of this system by high doses of GHB may be involved in certain neuropharmacological events induced by GHB administration.
However, at therapeutic doses, GHB reaches much higher concentrations in the brain and activates [[GABA]]<sub>B</sub> receptors, which are primarily responsible for its sedative effects.<ref>Drosophila GABAB receptors are involved in behavioral effects of γ-hydroxybutyric acid (GHB) (ScienceDirect) | http://www.sciencedirect.com/science/article/pii/S0014299905007442</ref> GHB's sedative effects are blocked by GABA<sub>B</sub> [[antagonists]]. As the [[GABA]] system is the most prolific inhibitory receptor set within the brain, its modulation results in the [[sedating]] (or [[anxiety suppression|calming effects]]) of GHB on the nervous system. While research into the GHB receptor is limited, there is evidence that activation of the GHB receptor in some brain areas results in the release of [[glutamate]], the principal excitatory neurotransmitter.<ref>Selective γ-hydroxybutyric acid receptor ligands increase extracellular glutamate in the hippocampus, but fail to activate G protein and to produce the sedative/hypnotic effect of γ-hydroxybutyric acid | http://onlinelibrary.wiley.com/doi/10.1046/j.1471-4159.2003.02037.x/abstract</ref> Drugs that selectively activate the GHB receptor cause absence seizures in high doses, as do GHB and [[GABA]]<sub>B</sub> agonists.<ref>Selective γ-hydroxybutyric acid receptor ligands increase extracellular glutamate in the hippocampus, but fail to activate G protein and to produce the sedative/hypnotic effect of γ-hydroxybutyric acid | http://onlinelibrary.wiley.com/doi/10.1046/j.1471-4159.2003.02037.x/abstract</ref>


However, at therapeutic doses, GHB reaches much higher concentrations in the brain and activates [[GABA]]<sub>B</sub> receptors, which are primarily responsible for its sedative effects.<ref>Drosophila GABAB receptors are involved in behavioral effects of γ-hydroxybutyric acid (GHB) (ScienceDirect) | http://www.sciencedirect.com/science/article/pii/S0014299905007442</ref> GHB's sedative effects are blocked by GABA<sub>B</sub> [[antagonists]]. As the [[GABA]] system is the most prolific inhibitory receptor set within the brain, its modulation results in the [[sedating]] (or [[anxiety suppression|calming effects]]) of GHB on the nervous system.
Activation of both the GHB receptor and [[GABA]]<sub>B</sub> is responsible for the addictive profile of GHB. GHB's effect on [[dopamine]] release is biphasic.<ref>Drosophila [[GABA]]<sub>B</sub> receptors are involved in behavioral effects of γ-hydroxybutyric acid (GHB) (ScienceDirect) | http://www.sciencedirect.com/science/article/pii/S0014299905007442</ref> This means that while low concentrations stimulate [[dopamine]] release via the GHB receptor,<ref>A specific gamma-hydroxybutyrate receptor ligand possesses both antagonistic and [[anticonvulsant]] properties (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pubmed/2173754</ref> higher concentrations inhibit [[dopamine]] release via [[GABA]]<sub>B</sub> receptors.<ref>Tonic GABA-ergic modulation of striatal dopamine release studied by in vivo microdialysis in the freely moving rat (ScienceDirect) | http://www.sciencedirect.com/science/article/pii/001429999500369V</ref> After an initial phase of inhibition, [[dopamine]] release is then increased via the GHB receptor.  


There has been somewhat limited research into the GHB receptor; however, there is evidence that activation of the GHB receptor in some brain areas results in the release of [[glutamate]], the principal excitatory neurotransmitter.<ref>Selective γ-hydroxybutyric acid receptor ligands increase extracellular glutamate in the hippocampus, but fail to activate G protein and to produce the sedative/hypnotic effect of γ-hydroxybutyric acid | http://onlinelibrary.wiley.com/doi/10.1046/j.1471-4159.2003.02037.x/abstract</ref> Drugs that selectively activate the GHB receptor cause absence seizures in high doses, as do GHB and [[GABA]]<sub>B</sub> agonists.<ref>Selective γ-hydroxybutyric acid receptor ligands increase extracellular glutamate in the hippocampus, but fail to activate G protein and to produce the sedative/hypnotic effect of γ-hydroxybutyric acid | http://onlinelibrary.wiley.com/doi/10.1046/j.1471-4159.2003.02037.x/abstract</ref>
GHB induces the accumulation of either a derivative of [[tryptophan]] or [[tryptophan]] itself, possibly by increasing [[tryptophan]] transport across the blood–brain barrier. GHB-induced stimulation may be due to this increase in [[tryptophan]] transport to the brain and in its uptake by serotonergic cells. As the [[Serotonin|serotonergic]] system may be involved in the regulation of sleep, mood, and anxiety, the stimulation of this system by high doses of GHB may be involved in certain neuropharmacological events induced by GHB administration.


Activation of both the GHB receptor and [[GABA]]<sub>B</sub> is responsible for the addictive profile of GHB. GHB's effect on [[dopamine]] release is biphasic.<ref>Drosophila [[GABA]]<sub>B</sub> receptors are involved in behavioral effects of γ-hydroxybutyric acid (GHB) (ScienceDirect) | http://www.sciencedirect.com/science/article/pii/S0014299905007442</ref> This means that while low concentrations stimulate [[dopamine]] release via the GHB receptor,<ref>A specific gamma-hydroxybutyrate receptor ligand possesses both antagonistic and [[anticonvulsant]] properties (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pubmed/2173754</ref> higher concentrations inhibit [[dopamine]] release via [[GABA]]<sub>B</sub> receptors.<ref>Tonic GABA-ergic modulation of striatal dopamine release studied by in vivo microdialysis in the freely moving rat (ScienceDirect) | http://www.sciencedirect.com/science/article/pii/001429999500369V</ref> After an initial phase of inhibition, [[dopamine]] release is then increased via the GHB receptor.
These findings may explain the paradoxical mix of sedative and stimulatory properties of GHB as well as the so-called "rebound" effect reported by individuals using GHB as a sleeping agent wherein they awake suddenly after several hours of GHB-induced deep sleep. Over time, the concentration of GHB in the system decreases below the threshold for significant [[GABA]]<sub>B</sub> receptor activation and activates predominantly the GHB receptor, leading to wakefulness.
 
This explains the paradoxical mix of sedative and stimulatory properties of GHB as well as the so-called "rebound" effect experienced by individuals using GHB as a sleeping agent wherein they awake suddenly after several hours of GHB-induced deep sleep. Over time, the concentration of GHB in the system decreases below the threshold for significant [[GABA]]<sub>B</sub> receptor activation and activates predominantly the GHB receptor, leading to wakefulness.


==Subjective effects==
==Subjective effects==
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*'''[[Effect::Stimulation]]''' & '''[[Effect::Sedation]]''' - At lower doses, GHB is physically stimulating, encouraging movement and wakefulness. At higher doses, however, it becomes physically sedating, encouraging sleep and lethargy.
*'''[[Effect::Stimulation]]''' & '''[[Effect::Sedation]]''' - At lower doses, GHB is physically stimulating, encouraging movement and wakefulness. At higher doses, however, it becomes physically sedating, encouraging sleep and lethargy.
*'''[[Effect::Respiratory depression]]''' - In cases of GHB overdoses, many reportedly experience an abnormal pattern of breathing characterized by progressively deeper and sometimes faster breathing followed by a gradual decrease that results in a temporary stop in breathing called an apnea.
*'''[[Effect::Respiratory depression]]''' - In cases of GHB overdoses, many reportedly experience an abnormal pattern of breathing characterized by progressively deeper and sometimes faster breathing followed by a gradual decrease that results in a temporary stop in breathing called an apnea.
*'''[[Effect::Muscle relaxation]]'''
*'''[[Effect::Muscle relaxation]]''' - GHB induces profound muscle relaxation similar to, but more intense than, the relaxation produced by [[benzodiazepines]] and [[alcohol]]. This muscle relaxation is accompanied with a general loss of motor control, which may put the user at increased risk of physical injury.
*'''[[Effect::Dehydration]]'''
*'''[[Effect::Dehydration]]'''
*'''[[Effect::Dizziness]]'''
*'''[[Effect::Dizziness]]''' - Dizziness is a common side effect of GHB and can occur with normal recreational doses. Users may also suddenly feel light-headed or faint, and feel a strong urge to lie down. Colloquially known as "the spins".
*'''[[Effect::Motor control loss]]'''
*'''[[Effect::Motor control loss]]'''  
*'''[[Effect::Nausea]]'''
*'''[[Effect::Nausea]]'''
*'''[[Effect::Muscle cramps]]'''
*'''[[Effect::Muscle cramps]]'''
*'''[[Effect::Optical sliding]]'''
*'''[[Effect::Optical sliding]]'''
*'''[[Effect::Increased salivation]]'''  
*'''[[Effect::Increased salivation]]'''
*'''[[Effect::Pupil dilation]]'''
*'''[[Effect::Pupil dilation]]'''


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*'''[[Effect::Analysis suppression]]'''
*'''[[Effect::Analysis suppression]]'''
*'''[[Effect::Anxiety suppression]]'''  
*'''[[Effect::Anxiety suppression]]'''  
*'''[[Effect::Cognitive euphoria|Cognitive Euphoria]]'''
*'''[[Effect::Cognitive euphoria]]''' - GHB produces intense states of euphoria comparable to that of [[cocaine]], [[MDMA]], and [[opiates]]. For this reason, it is sometimes called "liquid ecstasy". It is commonly described as a more euphoric and disinhibiting version of alcohol. While this may be accurate, it is also far easier to overdose on.
*'''[[Effect::Disinhibition]]'''
*'''[[Effect::Disinhibition]]''' - Social and behavioral disinhibition on GHB is extremely powerful and perhaps its most prominent feature. Users are more liable to exhibit impaired decision-making and engage in risky activities such as unprotected sex or unsafe substance combinations. Users are advised to only take GHB in safe environments with people they trust not to take advantage of their vulnerable state.
*'''[[Effect::Empathy, affection, and sociability enhancement]]''' - GHB presents strong [[entactogenic]] effects which, although weaker than that of [[MDMA]], are still prominent and well defined.
*'''[[Effect::Empathy, affection, and sociability enhancement]]''' - GHB presents strong [[entactogenic]] effects which, although weaker than that of [[MDMA]], are still prominent and well defined.
*'''[[Effect::Immersion enhancement]]'''
*'''[[Effect::Immersion enhancement]]'''
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There are currently no anecdotal reports which describe the effects of this compound within our [[experience index]]. Additional experience reports can be found here:
There are currently no anecdotal reports which describe the effects of this compound within our [[experience index]]. Additional experience reports can be found here:
* [https://www.erowid.org/experiences/subs/exp_GHB.shtml Erowid Experience Vaults: GHB]
* [https://www.erowid.org/experiences/subs/exp_GHB.shtml Erowid Experience Vaults: GHB]
GHB is also referred to as "'''K.-o.-Tropfen'''" (K.-o.-drops) in German-speaking countries.


==Toxicity and harm potential==
==Toxicity and harm potential==
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One publication has investigated 226 deaths attributed to GHB.<ref>https://www.ncbi.nlm.nih.gov/pubmed/20825811 | Zvosec DL, Smith SW, Porrata T, Strobl AQ, Dyer JE (2011). "Case series of 226 gamma-hydroxybutyrate-associated deaths: lethal toxicity and trauma". The American Journal of Emergency Medicine 29 (3): 319–32.</ref> Seventy-one deaths (34%) were caused by GHB alone while the other deaths were from [[respiratory depression]] caused by interaction with alcohol or other drugs.
One publication has investigated 226 deaths attributed to GHB.<ref>https://www.ncbi.nlm.nih.gov/pubmed/20825811 | Zvosec DL, Smith SW, Porrata T, Strobl AQ, Dyer JE (2011). "Case series of 226 gamma-hydroxybutyrate-associated deaths: lethal toxicity and trauma". The American Journal of Emergency Medicine 29 (3): 319–32.</ref> Seventy-one deaths (34%) were caused by GHB alone while the other deaths were from [[respiratory depression]] caused by interaction with alcohol or other drugs.


To avoid a possible overdose of GHB, it is important to start with a low dose and work your way up slowly by increasing the dosage in small increments. While a common recreational dose is 3g, a dose of 5g - 10g can result in convulsions, unconsciousness and vomiting. [[toxicity::Doses above 10g+ are associated with a risk of death]].<ref name="cite" /> One must also factor in the added difficulty of knowing the purity of the product (among other problems like its hygroscopy may lower the concentration of GHB in one solution, which is the form which is commonly bought and sold in the illicit market). This makes it hard for even the experienced user to dose properly.<ref>https://www.erowid.org/chemicals/ghb/ghb_health.shtml</ref>
To avoid a possible overdose of GHB, it is important to start with a low dose and work your way up slowly by increasing the dosage in small increments. While a common recreational dose is 3g, a dose of 5g - 10g can result in convulsions, unconsciousness and vomiting. [[toxicity::Doses above 10 grams are associated with a risk of death]].<ref name="cite" /> One must also factor in the added difficulty of knowing the purity of the product (among other problems like its hygroscopy may lower the concentration of GHB in one solution, which is the form which is commonly bought and sold in the illicit market). This makes it hard for even the experienced user to dose properly.<ref>https://www.erowid.org/chemicals/ghb/ghb_health.shtml</ref>


Accidental ingestions of GHB have also occurred due to inadequate storage methods. If GHB is put into a clear liquid, glass, or bottle, it can be easily mistaken for water. It is recommended to clearly label your GHB in writing and dye the liquid with blue food coloring so it no longer resembles a drinkable beverage. It is also recommended to store your GHB in a container that no one would drink out of.
Accidental ingestions of GHB have also occurred due to inadequate storage methods. If GHB is put into a clear liquid, glass, or bottle, it can be easily mistaken for water. It is recommended to clearly label your GHB in writing and dye the liquid with blue food coloring so it no longer resembles a drinkable beverage. It is also recommended to store your GHB in a container that no one would drink out of.
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As an endogenous regulator of energy metabolism and a natural neurotransmitter, GHB is well-known to the brain and organs which are used to its effects and have highly efficient systems for metabolizing it safely.<ref>Psychotherapeutic Drugs. 1340-1375. Bibliographic information missing.</ref> The substance is eliminated (that is, back to baseline levels) in 2-4 hours and continues to be so even after twice-daily doses for a week.<ref>Ferrara, SD. Zotti, S. Tedeschi, L. Frison, G. Palatini, P. et al.. "Pharmacokinetics of gamma-hydroxybutyric acid in alcohol dependent. . .". British Journal of Clinical Pharmacology. 1992. 34. 231-235. R 31 B 93. . </ref> In one European study, no adverse effects were reported after several years of regular recreational use.<ref>Laborit H . "Correlations between protein and serotonin synthesis during various activities of the central nervous system (slow and desynchronized sleep, learning and memory, sexual activity, morphine tolerance, aggressiveness, and pharmacological action of sodium ga. RESEARCH COMMUNICATIONS IN CHEMICAL PATHOLOGY AND PHARMACOLOGY. 1972. 3(1). </ref>  
As an endogenous regulator of energy metabolism and a natural neurotransmitter, GHB is well-known to the brain and organs which are used to its effects and have highly efficient systems for metabolizing it safely.<ref>Psychotherapeutic Drugs. 1340-1375. Bibliographic information missing.</ref> The substance is eliminated (that is, back to baseline levels) in 2-4 hours and continues to be so even after twice-daily doses for a week.<ref>Ferrara, SD. Zotti, S. Tedeschi, L. Frison, G. Palatini, P. et al.. "Pharmacokinetics of gamma-hydroxybutyric acid in alcohol dependent. . .". British Journal of Clinical Pharmacology. 1992. 34. 231-235. R 31 B 93. . </ref> In one European study, no adverse effects were reported after several years of regular recreational use.<ref>Laborit H . "Correlations between protein and serotonin synthesis during various activities of the central nervous system (slow and desynchronized sleep, learning and memory, sexual activity, morphine tolerance, aggressiveness, and pharmacological action of sodium ga. RESEARCH COMMUNICATIONS IN CHEMICAL PATHOLOGY AND PHARMACOLOGY. 1972. 3(1). </ref>  


It is strongly recommended that one use [[responsible drug use|harm reduction practices]] when using this drug.
It is strongly recommended that one use [[responsible drug use|harm reduction practices]] when using this substance.
 
===Neurotoxicity===
===Neurotoxicity===
In multiple studies, GHB has been found to impair spatial memory, working memory, learning and memory in rats with chronic administration.<ref>Adolescent γ-hydroxybutyric acid exposure decreases cortical N-methyl-d-aspartate receptor and impairs spatial learning (ScienceDirect) | http://www.sciencedirect.com/science/article/pii/S009130570400320X</ref><ref>Effects of subchronic administration of gammahydroxybutyrate (GHB) on spatial working memory in rats (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pubmed/17296081</ref><ref>γ-Hydroxybutyric Acid–Induced Cognitive Deficits in the Female Adolescent Rat | http://onlinelibrary.wiley.com/doi/10.1196/annals.1432.044/abstract</ref><ref>Neurotoxic effects induced by gammahydroxybutyric acid (GHB) in male rats | http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=6137924</ref> These effects are associated with decreased [[NMDA receptor]] expression in the cerebral cortex and possibly other areas as well.<ref>https://www.ncbi.nlm.nih.gov/pubmed/15582677 (PubMed.gov / NCBI) | https://www.ncbi.nlm.nih.gov/pubmed/15582677</ref>
In multiple studies, GHB has been found to impair spatial memory, working memory, learning and memory in rats with chronic administration.<ref>Adolescent γ-hydroxybutyric acid exposure decreases cortical N-methyl-d-aspartate receptor and impairs spatial learning (ScienceDirect) | http://www.sciencedirect.com/science/article/pii/S009130570400320X</ref><ref>Effects of subchronic administration of gammahydroxybutyrate (GHB) on spatial working memory in rats (PubMed.gov / NCBI) | http://www.ncbi.nlm.nih.gov/pubmed/17296081</ref><ref>γ-Hydroxybutyric Acid–Induced Cognitive Deficits in the Female Adolescent Rat | http://onlinelibrary.wiley.com/doi/10.1196/annals.1432.044/abstract</ref><ref>Neurotoxic effects induced by gammahydroxybutyric acid (GHB) in male rats | http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=6137924</ref> These effects are associated with decreased [[NMDA receptor]] expression in the cerebral cortex and possibly other areas as well.<ref>https://www.ncbi.nlm.nih.gov/pubmed/15582677 (PubMed.gov / NCBI) | https://www.ncbi.nlm.nih.gov/pubmed/15582677</ref>
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===Dangerous interactions===
===Dangerous interactions===
{{DangerousInteractions/Intro}}
{{DangerousInteractions/Intro}}
{{DangerousInteractions/GHB}}
{{DangerousInteractions/GHB}}
{{DangerousInteractions/Depressants}}
{{DangerousInteractions/Depressants}}


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