{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T12:17:19Z","timestamp":1756383439068,"version":"3.44.0"},"reference-count":18,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,11,15]]},"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:p>This case report presents the case of a 29 weeks pregnant woman in her late twenties who was seen at the emergency department of a hospital with a seizure of unknown cause. By anamnesis and hetero-anamnesis the use of illicit gamma-hydroxybutyric acid (GHB) was revealed. Examination showed dilated pupils, sweating, tremor, tachycardia and bradyphrenic thinking. Subsequently, the seizure was indicated as a severe illicit GHB withdrawal symptom. Thereafter, treatment had to be decided on in the absence of evidence-based and practiced-based guidelines and treatment options for this specific patient population. Initially diazepam was started, which was later on substituted by sodium oxybate. Despite the critical professional situation the patient gave birth to a healthy daughter after 37 weeks of pregnancy.<\/jats:p>","DOI":"10.1136\/bcr-2019-230997","type":"journal-article","created":{"date-parts":[[2019,12,3]],"date-time":"2019-12-03T05:35:23Z","timestamp":1575351323000},"page":"e230997","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Severe illicit gamma-hydroxybutyric acid withdrawal in a pregnant woman: what to do?"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6686-9727","authenticated-orcid":false,"given":"JC","family":"van Mechelen","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Medical Psychology, OLVG Location West, Amsterdam, North Holland, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"BAG","family":"Dijkstra","sequence":"additional","affiliation":[{"name":"Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Radboud University, Nijmegen, Gelderland, the Netherlands"},{"name":"Research and development, Novadic-Kentron Addiction Care, Vught, Noord-Brabant, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ACM","family":"Vergouwen","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Medical Psychology, OLVG Location West, Amsterdam, North Holland, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,12,2]]},"reference":[{"key":"2025082804400682000_12.12.e230997.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2009.04.012"},{"key":"2025082804400682000_12.12.e230997.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0301-0082(96)00064-0"},{"key":"2025082804400682000_12.12.e230997.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.genhosppsych.2008.11.001"},{"key":"2025082804400682000_12.12.e230997.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0376-8716(02)00017-0"},{"key":"2025082804400682000_12.12.e230997.5","doi-asserted-by":"publisher","DOI":"10.1081\/JA-200066736"},{"key":"2025082804400682000_12.12.e230997.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2009.11.008"},{"key":"2025082804400682000_12.12.e230997.7","doi-asserted-by":"publisher","DOI":"10.1136\/emj.2008.068403"},{"key":"2025082804400682000_12.12.e230997.8","doi-asserted-by":"publisher","DOI":"10.1080\/02791072.2014.921746"},{"key":"2025082804400682000_12.12.e230997.9","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.toxlet.2017.05.030","article-title":"Intoxication by gamma hydroxybutyrate and related analogues: clinical characteristics and comparison between pure intoxication and that combined with other substances of abuse","volume":"277","author":"Mir\u00f3","year":"2017","journal-title":"Toxicol Lett"},{"key":"2025082804400682000_12.12.e230997.10","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.neubiorev.2015.03.012","article-title":"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","volume":"53","author":"Corkery","year":"2015","journal-title":"Neurosci Biobehav Rev"},{"key":"2025082804400682000_12.12.e230997.11","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.yrtph.2012.03.005","article-title":"Risk assessment of gamma-hydroxybutyric acid (GHB) in the Netherlands","volume":"63","author":"van Amsterdam","year":"2012","journal-title":"Regul Toxicol Pharmacol"},{"key":"2025082804400682000_12.12.e230997.12","unstructured":"European Monitoring Centre for Drugs and Drug Addiction . European drug report 2018: trends and developments. publications office of the European Union. 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