Sleep Medicine
Volume 10, Issue 4 , Pages 490-493, April 2009

Three deaths associated with use of Xyrem®

  • Deborah L. Zvosec

      Affiliations

    • Department of Emergency Medicine, Hennepin County Medical Center, 701 Park Avenue South, Minneapolis, MN 55415, USA
    • Corresponding Author InformationCorresponding author. Tel.: +1 612 823 6068; fax: +1 612 904 4241.
    • ,
  • Stephen W. Smith

      Affiliations

    • Department of Emergency Medicine, Hennepin County Medical Center, 701 Park Avenue South, Minneapolis, MN 55415, USA
    • ,
  • Brad J. Hall

      Affiliations

    • Chief Forensic Toxicologist, Travis County Office of the Medical Examiner, 1213 Sabine Street, P.O. Box 1748, Austin, TX 78767, USA

Received 2 December 2008; received in revised form 10 January 2009; accepted 14 January 2009.

Abstract 

Fatalities resulting from popular use of gamma hydroxybutyrate (GHB) have previously been reported. We report three deaths associated with use of Xyrem® (sodium oxybate), a pharmaceutical preparation of GHB initially approved for treatment of narcolepsy with cataplexy. One death appears associated with Xyrem® abuse, with extremely high postmortem blood GHB levels documented. Although postmortem blood GHB levels in two other deaths are consistent with therapeutic levels, cause and effect cannot be established. We discuss these cases and factors which may have exerted contributory respiratory depressant effects, singly or in combination, including concurrent use of sedative hypnotics, obstructive sleep apnea, and obesity.

Keywords: Gamma hydroxybutyrate, Xyrem®, Fatalities, Sodium oxybate, GHB, Deaths, Fatal outcome, Overdose

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PII: S1389-9457(09)00013-6

doi:10.1016/j.sleep.2009.01.005

Sleep Medicine
Volume 10, Issue 4 , Pages 490-493, April 2009

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