A SUDDEN AWAKENING FROM A NEAR COMA AFTER COMBINED INTAKE OF GAMMA-HYDROXYBUTYRIC ACID (GHB) AND ETHANOL

Objective: A case of a sudden awakening from a near coma after combine d intake of gamma-hydroxybutyric acid (GHB) (125 mu g/mL), ethanol (13 4 mg/dL), and cannabinoids is described. Methods: GHB was determined b y gas chromatography-mass spectrometry after acetonitrile precipitatio n and derivation with N-methyl-N-trimethylsilyltrifluoroacetamide usin g valproic acid as the internal standard. Conclusion: The described ca se illustrates the consequences of GHB overdose, GHB overdose should b e considered in every case of unexplained sudden coma, i.e., without a ny evidence of head injury, intake of coma-inducing drugs, or increasi ng intracranial pressure, GHB overdose will be missed by routine toxic ological screening.