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Fortschr Neurol Psychiatr 2013; 81(2): 88-94
DOI: 10.1055/s-0032-1330508
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Liquid Ecstasy in der Allgemeinpsychiatrie: eine Fallserie

Liquid Ecstasy in General Psychiatry: A Case Series
R. W. Freudenmann
,
E. Baumgarten
,
A. E. Hawlik
,
M. Gahr
,
C. J. Schönfeldt-Lecuona
Further Information

Publication History

Publication Date:
14 February 2013 (online)

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Zusammenfassung

Hintergrund: In der Intensivmedizin ist Liquid Ecstasy (LE), der Straßenname für GHB, GBL oder 1,4-B, mittlerweile gut als Ursache schwerer Intoxikationen und Entzugssyndrome bekannt, weniger dagegen in der Allgemeinpsychiatrie. Daher war es unser Ziel, Informationen über die Bedeutung von LE in der Allgemeinpsychiatrie, typische User und häufige klinische Probleme bei ihrer Versorgung zu sammeln.

Methoden: Es wurden alle an der Ulmer Universitätspsychiatrie von 1998 – 2011 behandelten Fälle mit anamnestischem LE-Gebrauch retrospektiv identifiziert und ausgewertet.

Ergebnisse: Im Suchzeitraum von 14 Jahren wurden 19 Patienten mit LE-Konsum gefunden, der erste Fall aus dem Jahr 2005. Vornehmlich wurde ein GBL-Konsum angegeben (63 %), seltener GHB, 1,4-B nie. Es handelte es sich überwiegend um junge Männer (medianes Alter 25 J., 79 % Männer) mit polytoxikomanem Hintergrund. Zehn Patienten hatten LE nur früher eingenommen, 9 nahmen es zum Zeitpunkt der Vorstellung. Von diesen musste jeder dritte Patient vorübergehend auf der Internistischen Intermediate Care-Station versorgt werden, meist wegen plötzlicher schwerer Entzugssyndrome. Sonst war die Entgiftung in der Psychiatrie mit Benzodiazepinen in teils hoher Dosis möglich. Bei 3 Patienten bestand eine Abhängigkeit von GBL.

Schlussfolgerungen: Seit einigen Jahren werden LE-User auch in der Allgemeinpsychiatrie in begrenzter Zahl vorstellig. Das Problem ist weniger die Zahl der Fälle als die Schwere der Entzugssyndrome, die eine enge Kooperation mit der Intensivmedizin nötig macht. Bei plötzlichen unklaren Bewusstlosigkeiten und rasch entstehenden Entzugsdelirien sollte an den Gebrauch bzw. Entzug von LE gedacht werden. Viele der klinischen Probleme resultieren auch aus der Nichtnachweisbarkeit von LE im Routinedrogenscreening. Unserer Erfahrung nach lassen sich LE-Entzugssyndrome mit Benzodiazepinen gut kupieren.

Abstract

Background: In emergency medicine and anesthaesiology liquid ecstasy (LE), the street name for GHB, GBL or 1,4-B, has become infamous for causing severe intoxications and withdrawal. In general psychiatry, however, it is little known. Therefore, we set out to gather data about the role of LE in general psychiatry, typical users and common clinical problems associated with the use of LE.

Methods: We retrospectively identified and studied all patients with a reported the use of LE seen at the Department of Psychiatry, University of Ulm, Germany, between 1998 and 2011.

Results: In 14 years, 19 users of LE were identified, the first dating from 2005. The majority reported a use of GBL (63 %), GHB was less common, and 1,4-B was not reported. Patients were predominantly young men (median age 25 years, 79 % men) with a history of multiple substance abuse. Ten patients had only a former use of LE, the other nine patients used it at the time of presentation. Of these, every third patient had to be transiently treated in an intermediate care unit, usually because of very severe and sudden withdrawal symptoms. Otherwise, detoxification was possible in psychiatry, but often required high doses of benzodiazepines. Three patients met the criteria for dependence from GBL.

Conclusions: In recent years, a small number of users of LE is seen also in general psychiatry, The problem is rather the severity of withdrawal than the number of cases. Close cooperation with intermediate care units is needed. In any case of coma of unknown origin or delirium with sudden onset LE use or withdrawal has to be taken into consideration, respectively. Many clinical problems result from the fact that LE cannot be detected in routine drug screenings. According to our experience, withdrawal from LE can be controlled with benzodiazepines.

Schlüsselwörter

Liquid Ecstasy - Lösungsmittel - Gamma-Hydroxybutyrat (GHB) - Gamma-Butyrolacton (GBL) - Allgemeinpsychiatrie

Key words

liquid ecstasy - solvents - gamma-hydroxybutyric acid (GHB) - gamma-butyrolactone (GBLK) - general psychiatry
 

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