Inpatient regimens for management of GHB withdrawal

For inpatient management of planned or unplanned withdrawal from GHB (with monitoring by staff skilled in withdrawal management), a suitable regimen isNSW Health, 2022:

diazepam 10 mg orally, 2-hourly, starting within 2 hours of the last dose of GHB if the patient does not have signs of sedation. Continue until light sedation is evident and agitation is controlled. Seek specialist advice before exceeding 60 mg on the first day. Once agitation is controlled, gradually reduce the dose over 5 to 7 days. diazepam diazepam diazepam

Baclofen can also reduce the severity of GHB withdrawal and the dose of diazepam required. Baclofen can be used concurrently with diazepam to treat GHB withdrawal in an inpatient. An example regimen isNSW Health, 2022:

baclofen 10 to 25 mg orally, 8-hourly. Gradually reduce the dose during the second week to complete treatment in 14 days. Seek expert advice if withdrawal symptoms are prolonged. baclofen baclofen baclofen

Warn patients there is an increased risk of overdose after GHB withdrawal because their tolerance will be reduced. Long-term care aims to reduce relapse and support the person to maintain good health and wellbeing.