Suicidal Ideation Secondary to Sodium Oxybate

Ortega-Albás, Juan José; López-Bernabé, Roberto; García, Angel Luis Serrano; Gómez, Jose Ramón Díaz

doi:10.1176/jnp.2010.22.3.352.e26

Cited by 11 publications

(3 citation statements)

References 5 publications

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“…Suicidality 85,86,[102][103][104] Several studies show an increased risk of suicide in patients with narcolepsy, but the underlying relationship is complex. Sleep disturbances and EDS have been shown to be risk factors for suicide and lower levels of cerebrospinal fluid (CSF) hypocretin have been observed in depressed patients with suicidal behavior.…”

Section: Symptom or Disorder Commentsmentioning

confidence: 99%

Recognizing the Symptom Spectrum of Narcolepsy to Improve Timely Diagnosis: A Narrative Review

Quaedackers¹,

Pillen²,

Overeem³

2021

NSS

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Narcolepsy is a chronic sleep disorder with a strong negative impact on quality of life, especially when untreated. Diagnostic delay is a persistent problem, with obvious detrimental effects on patients. A diagnosis of narcolepsy may be delayed because of its broad symptom presentation which is much more encompassing than the classical "tetrad" of sleepiness, cataplexy, hallucinations, and sleep paralysis. Furthermore, symptoms can vary over time. Presentation of symptoms can also be markedly different between children and adults. Finally, common sleep-related comorbidities increase the risk of narcolepsy being masked by overlapping symptoms or treatment. In this review, we provide a detailed description of the broad and dynamic symptom spectrum of narcolepsy, with specific attention to the different manifestations in both adults and children. The overarching goal is to help not only sleep specialists, but general practitioners, pediatricians, and other caregivers with early recognition and prompt diagnosis of this severe but treatable disorder.

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Section: Symptom or Disorder Commentsmentioning

confidence: 99%

Recognizing the Symptom Spectrum of Narcolepsy to Improve Timely Diagnosis: A Narrative Review

Quaedackers¹,

Pillen²,

Overeem³

2021

NSS

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“…It has been suggested that the anxiolytic and anti-depressant properties of GHB could contribute to its abuse potential in these patients [70,71]. However, other case studies indicated that sodium oxybate, the pharmaceutical sodium salt of GHB, can also induce depressive symptoms, suicidal ideation and anxiety when used in a dose of 6-9 mg per day [72][73][74]. Several other factors contribute to the highly addictive properties of GHB, including global availability via the internet, web marketing, easy manufacturing and low costs [52,75].…”

Section: Ghb Dependence Syndromementioning

confidence: 99%

Pharmacological Treatment in γ-Hydroxybutyrate (GHB) and γ-Butyrolactone (GBL) Dependence: Detoxification and Relapse Prevention

et al. 2016

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The misuse of γ-hydroxybutyrate (GHB) for recreational purposes has resulted in an increase in GHB-related problems such as intoxications, dependence and withdrawal in several countries in Europe, Australia and the US over the last decade. However, prevalence rates of misuse of GHB and its precursor, γ-butyrolactone (GBL), are still relatively low. In this qualitative review paper, after a short introduction on the pharmacology of GHB/GBL, followed by a summary of the epidemiology of GHB abuse, an overview of GHB dependence syndrome and GHB/GBL withdrawal syndrome is provided. Finally, the existing literature on management of GHB detoxification, both planned and unplanned, as well as the available management of GHB withdrawal syndrome, is summarized. Although no systematic studies on detoxification and management of withdrawal have been performed to date, general recommendations are given on pharmacological treatment and preferred treatment setting.

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“…Two suicides and two suicide attempts occurred in adult patients taking SXB in clinical trials ( N = 781) [ 10 ]. Some instances of depression and of depression with suicidal ideation have been reported in individuals with narcolepsy who started taking SXB; these symptoms resolved upon either reducing the SXB dose or stopping SXB completely [ 39 , 40 ]. Psychotic symptoms (e.g., daytime hallucinations) have occurred in people with narcolepsy, which also resolved upon reducing dose or stopping SXB [ 41 – 43 ].…”

Section: Resultsmentioning

confidence: 99%

Dosing Optimization of Low-Sodium Oxybate in Narcolepsy and Idiopathic Hypersomnia in Adults: Consensus Recommendations

Morse,

Bogan,

Roy

et al. 2024

Neurol Ther

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Introduction Low-sodium oxybate (LXB) is approved for treatment of narcolepsy in patients aged 7 years and older and treatment of idiopathic hypersomnia in adults. LXB contains the same active moiety with 92% less sodium than sodium oxybate (SXB). As the indication for oxybate treatment in patients with idiopathic hypersomnia is new and allows for individualized dosing optimization, guidance for beginning LXB treatment is needed. In particular, clinicians may benefit from guidance regarding treatment initiation, dosing/regimen options, potential challenges, and treatment expectations. Additionally, pharmacokinetic profiles differ slightly between both treatments, and further guidance on transitioning from SXB to LXB in patients with narcolepsy may aid clinicians. Methods An expert panel of five sleep specialists was convened to obtain consensus on recommendations for these topics using a modified Delphi process. Results Across two virtual meetings, the panel agreed on 31 recommendations with a high degree of consensus that fell into four overarching topics: (1) introducing LXB to patients; (2) initiating LXB for adult narcolepsy and idiopathic hypersomnia; (3) addressing challenges in using LXB; and (4) transitioning from SXB to LXB. The panel recommended that clinicians provide a clear overview of how LXB works for treating symptoms in narcolepsy or idiopathic hypersomnia, as appropriate for their patients, explain safety aspects, and set expectations prior to initiating LXB treatment. Strategies for initial dosing and regimen are provided. Strategies for adjusting the dose, regimen, timing, and consideration of individual factors were developed for specific instances in which patients may have trouble staying asleep or waking up, as well as guidance for addressing potential adverse events, such as nausea, dizziness, anxiety, and depression. Discussion points based on existing literature and clinical experience were included as relevant for each statement. Conclusion Clinicians may use this resource to guide LXB dosing optimization with patients. Supplementary Information The online version contains supplementary material available at 10.1007/s40120-024-00607-8.

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Suicidal Ideation Secondary to Sodium Oxybate

Cited by 11 publications

References 5 publications

Recognizing the Symptom Spectrum of Narcolepsy to Improve Timely Diagnosis: A Narrative Review

Recognizing the Symptom Spectrum of Narcolepsy to Improve Timely Diagnosis: A Narrative Review

Pharmacological Treatment in γ-Hydroxybutyrate (GHB) and γ-Butyrolactone (GBL) Dependence: Detoxification and Relapse Prevention

Dosing Optimization of Low-Sodium Oxybate in Narcolepsy and Idiopathic Hypersomnia in Adults: Consensus Recommendations

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