RT Journal Article
SR Electronic
T1 Accidental calcium, magnesium, potassium and sodium oxybates (Xywave) overdose: mistiming of a single night’s narcolepsy medication leading to respiratory failure requiring mechanical ventilation
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e260025
DO 10.1136/bcr-2024-260025
VO 17
IS 5
A1 McIntosh, Braden W
A1 Mayeux, Charles
YR 2024
UL http://casereports.bmj.com/content/17/5/e260025.abstract
AB While typically thought of as an illicit substance, oxybate salts or gamma-hydroxybutyrate (GHB) has more recently been prescribed to treat narcolepsy by enhancing night-time sleep resulting in decreased daytime drowsiness. This case involves a college-aged female with prescribed GHB for narcolepsy who took her second nightly dose too early. This resulted in mental depression, respiratory failure, intubation and mechanical ventilation. The patient was successfully extubated in the intensive care unit several hours later with no residual morbidity. We were unable to identify any prior reports of mixed-salt oxybate toxicity following mistimed drug administration. This case should serve as a warning to emergency physicians to be on the lookout for GHB as part of the differential diagnosis for patients with narcolepsy presenting with altered mental status. It should also serve as a warning to patients and prescribers that this medication can have outcomes that require immediate medical intervention.