Psychosis in the Context of Sodium Oxybate Therapy

Langford, J; Gross, William L.

doi:10.5664/jcsm.1478

Cited by 19 publications

(13 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Butyrate is in use for urea cyclus disorders and sickle cell anemia, which is normally an intermediate metabolite. Chemically‐related gamma‐hydroxybutyrate misused in clubbers to induce energy and euphoria (Gonzalez and Nutt, 2005) strongly induces HbF (Zitnik et al, 1995; Fathallah et al, 2007) and may cause psychosis (Langford and Gross, 2011).…”

Section: Background: New Evidence Suggest That Hemoglobins (Hbs) Are mentioning

confidence: 99%

Hemoglobins emerging roles in mental disorders. Metabolical, genetical and immunological aspects

Altinöz¹,

Ince

2017

Intl J of Devlp Neuroscience

View full text Add to dashboard Cite

Hemoglobin (Hb) expression in the central nervous system is recently shown. Cooccurences of mental disorders (mainly bipolar disorder (BD) and tic disorders) with β- or α-thalassemia trait or erythrocytosis were witnessed, which may be due to peripheral or central hypoxia/hyperoxia or haplotypal gene interactions. β-Globin genes reside at 11p15.5 close to tyrosine hydroxylase, dopamine receptor DRD4 and Brain Derived Neurotrophic Factor, which involve in psychiatric diseases. α-Globin genes reside at 16p13.3 which associates with BD, tic disorders, ATR-16 Syndrome and Rubinstein Taybi Syndrome (RTS). CREB-Binding Protein (CEBBP)-gene is mutated in RTS, which commonly associates with mood disorders. 16p13.3 region also contains GRIN2A gene encoding N-methyl-d-aspartate receptor-2A and SSTR5 (Somatostatin Receptor-5), again involving in mental disorders. We demonstrated a protective role of minor HbA2 against post-partum episodes in BD and association of higher minor HbF (fetal hemoglobin) levels with family history of psychosis in a BD-patient cohort. HbA2 increases in cardiac ischemia and in mountain dwellers indicating its likely protection against ischemia/hypoxia. HMGIY, a repressive transcription factor of δ-globin chain of HbA2 is increased in lymphocytes of schizophrenics. In autism, deletional mutations were found in BCL11A gene, which cause persistence of HbF at high levels in adulthood. Also, certain polymorphisms in BCL11A strongly associate with schizophrenia. Further, many drugs from anabolic steroids to antimalarial agents elevate HbF and may cause mania. We ascribe a protective role to HbA2 and a maladaptive detrimental role to HbF in psychopathology. We believe that future studies on hemoglobins may pave to discover novel pathogenesis mechanisms in mental disorders.

show abstract

Section: Background: New Evidence Suggest That Hemoglobins (Hbs) Are mentioning

confidence: 99%

Hemoglobins emerging roles in mental disorders. Metabolical, genetical and immunological aspects

Altinöz¹,

Ince

2017

Intl J of Devlp Neuroscience

View full text Add to dashboard Cite

show abstract

“…There are issues around withdrawal of GHB (Langford and Gross, 2011;McDaniel and Miotto, 2001;van Noorden et al, 2014), both from clinical doses as well as recreational doses. Severe cases of withdrawal can feature extreme agitation, delirium and rhabdomyolysis and should be regarded as medical emergencies (van Noorden et al, 2014).…”

Section: Drug Effects and Mental Health Issuesmentioning

confidence: 99%

“…Case studies indicate that sodium oxybate on its own has led to depression and anxiety with suicidal ideation (Ortega-Albás et al, 2010), psychosis (visual hallucinations, paranoid delusions, derealisation, hyper-religiosity, and anxiety;Langford and Gross, 2011) and traumatic suicide attempts (Chien et al, 2013). In conjunction with modafinil this may lead to depression, derealisation, and suicidal ideation (Rossetti et al, 2010).…”

Section: Drug Effects and Mental Health Issuesmentioning

confidence: 99%

Gamma hydroxybutyrate (GHB), gamma butyrolactone (GBL) and 1,4-butanediol (1,4-BD; BDO): A literature review with a focus on UK fatalities related to non-medical use

Corkery

Loi

Claridge

et al. 2015

Neuroscience & Biobehavioral Reviews

View full text Add to dashboard Cite

Misuse of gamma hydroxybutrate (GHB) and gamma butyrolactone (GBL) has increased greatly since the early 1990s, being implicated in a rising number of deaths. This paper reviews knowledge on GHB and derivatives, and explores the largest series of deaths associated with their non-medical use. Descriptive analyses of cases associated with GHB/GBL and 1,4-butanediol (1,4-BD) use extracted from the UK's National Programme on Substance Abuse Deaths database. From 1995 to September 2013, 159 GHB/GBL-associated fatalities were reported. Typical victims: White (92%); young (mean age 32 years); male (82%); with a drug misuse history (70%). Most deaths (79%) were accidental or related to drug use, the remainder (potential) suicides. GHB/GBL alone was implicated in 37%; alcohol 14%; other drugs 28%; other drugs and alcohol 15%. Its endogenous nature and rapid elimination limit toxicological detection. Post-mortem blood levels: mean 482 (range 0-6500; SD 758)mg/L. Results suggest significant caution is needed when ingesting GHB/GBL, particularly with alcohol, benzodiazepines, opiates, stimulants, and ketamine. More awareness is needed about risks associated with consumption.

show abstract

“… 79 , 80 , 81 , 82 , 83 Psychotic symptoms have been reported (usually shortly after starting or resuming treatment). 73 , 84 , 85 , 86 , 87 Emergence or exacerbation of psychotic symptoms by sodium oxybate was retrospectively reported in 5 of 90 narcoleptic patients with no psychiatric history, 87 and 1 of 63 children in a clinical trial. 88 Mazindol , a sympathomimetic amine, reduces dopamine and norepinephrine reuptake.…”

Section: Resultsmentioning

confidence: 99%

Narcolepsy and psychosis: A systematic review

Hanin

Arnulf

Maranci

et al. 2021

Acta Psychiatr Scand

View full text Add to dashboard Cite

Objective Narcolepsy is a rare sleep disorder in which psychotic‐like symptoms can present diagnostic and therapeutic challenges. We aimed to review the association between, and medical management of, narcolepsy and psychosis in children and adults. Methods We reviewed the full text of 100 papers from 187 identified by a PubMed search on narcolepsy plus any of these keywords: psychosis , schizophrenia , delusion , side effects , safety , and bipolar disorder . Results Three relevant groups are described. (i) In typical narcolepsy, psychotic‐like symptoms include predominantly visual hallucinations at the sleep‐wake transition (experienced as “not real”) and dissociation because of intrusion of rapid eye movement (REM) sleep phenomena into wakefulness. (ii) Atypical patients (“the psychotic form of narcolepsy”) experience more severe and vivid, apparently REM‐related hallucinations or dream/reality confusions, which patients may rationalize in a delusion‐like way. (iii) Some patients have a comorbid schizophrenia spectrum disorder with psychotic symptoms unrelated to sleep. Psychostimulants used to treat narcolepsy may trigger psychotic symptoms in all three groups. We analyzed 58 published cases from groups 2 and 3 ( n = 17 and 41). Features that were reported significantly more frequently in atypical patients include visual and multimodal hallucinations, sexual and mystical delusions, and false memories. Dual diagnosis patients had more disorganized symptoms and earlier onset of narcolepsy. Conclusion Epidemiological studies tentatively suggest a possible association between narcolepsy and schizophrenia only for very early‐onset cases, which could be related to the partially overlapping neurodevelopmental changes observed in these disorders. We propose a clinical algorithm for the management of cases with psychotic‐like or psychotic features.

show abstract

Psychosis in the Context of Sodium Oxybate Therapy

Cited by 19 publications

References 10 publications

Hemoglobins emerging roles in mental disorders. Metabolical, genetical and immunological aspects

Hemoglobins emerging roles in mental disorders. Metabolical, genetical and immunological aspects

Gamma hydroxybutyrate (GHB), gamma butyrolactone (GBL) and 1,4-butanediol (1,4-BD; BDO): A literature review with a focus on UK fatalities related to non-medical use

Narcolepsy and psychosis: A systematic review

Contact Info

Product

Resources

About