Gamma-hydroxybutyrate overdose and physostigmine: Teaching new tricks to an old drug?

Gamma-hydroxybutyrate was introduced as an anesthetic agent in the 1960s an d is still used in some countries, despite recognized disadvantages. More r ecently, it has emerged as a popular recreational drug. We report 3 cases o f gamma-hydroxybutyrale overdose, the effects of which were reversed by the administration of low-dose intravenous physostigmine. The origins of this regimen and the case for physostigmine as a potential antidote are describe d.