The widespread abuse of the recreational drug gamma-hydroxybutyric acid has
resulted in several reports of overdose leading to coma. The use of a shor
t-acting anticholinesterase agent such as physostigmine as a potential reve
rsal agent has been proposed previously. We report 2 cases of gamma-hydroxy
butyric acid-induced coma that rapidly reversed with intravenous administra
tion of physostigmine.