Side effects - Hypernatremia and NaGHB overdose

[blackwolf]

One thing I see on GHB forums a lot is questions about weird overdose symptoms. Not the "I passed out, and woke up 4 hours later feeling great, or I mixed drug abc with NaGHB and I got sick and or died" But other symptoms, which may be attributed to the NaGHB alone, but may, and I have seen it happen and experienced it, be attributed to Hypernatremia. This is a known side effect from NaGHB overdose, yet is often overlooked, under considered, and something I am plan on learning a bit more about myself. This may also be one of the reasons for death from NaGHB alone, which I know is very rare, but has been documented to happen. Im not a scientist or a doctor, this is just my own observations and research. Just something to think about you know.

for those that do not know what Hypernatremia, Instead of making you spend the 2 minutes going to teh google, I'll save you the trouble...

From wikipedia....Hypernatremia is an electrolyte disturbance that is defined by an elevated sodium level in the blood. Hypernatremia is generally not caused by an excess of sodium, but rather by a relative deficit of free water in the body. For this reason, hypernatremia is often synonymous with the less precise term, dehydration.
Water is lost from the body in a variety of ways, including perspiration, insensible losses from breathing, and in the feces and urine. If the amount of water ingested consistently falls below the amount of water lost, the serum sodium level will begin to rise, leading to hypernatremia. Rarely, hypernatremia can result from massive salt ingestion, such as may occur from drinking seawater.

Hmmmm, massive salt ingestion, what else do I know that tastes like saltwater

Lets see what the old symptoms of Hypernatremia are...

Initial symptoms of hypernatremia include:
Loss of appetite
Nausea
Vomiting
Weakness or fatigue
Faintness
Excessive sweating
Symptoms of worsening hypernatremia include:
Muscle spasms
Muscle tremors
Irritability
Excessive sleepiness
Confusion
Coma
Death

Mortality rates of 42-75% have been reported for acute changes. [i]edit blackwolf...( Damn!) [i/]

Normally the body regulates this , by making you thirsty,, and then adjusting for the excess salt with the water you have just drank due to your thirst. When taking a excess of NaGHB, especially if you already have high sodium( which the majority of people do thanks to processed food) and have been dancing, fucking, working out, or just being loaded and not drinking water, this can happen at a accelerated pace. Another thing not mentioned above, is that the body also adjusts for this excessive sodium intake by urinating. This is often seen in acute Hypenatremia, yet normally doesn't happen while people are passed (the fuck) out. Unfortunately, one of the things GHB is really good at, is putting you into a deep sleep. I believe this may be one of the reasons people piss themselves during a ghb overdose.

So in closing, I think this is something everyone who uses GHB should consider. This is not to say GBL is better for you, which it most likely isn't and has a whole heap of other side effects to take into consideration, it also doesn't mean you should be using the potassium salt, as potassium overdose is nothing you want as well.

Basicly, Be smart, know what you put in to your body, know the side-effects, do your research and use moderation in everything.

[Pondlife]

But is the amount of sodium enough?

The molecular weight of NaGHB is 126g/mol, so 5g NaGHB = 5/126 = 0.0397 moles.
The molecular weight of Salt (NaCl) is 58.4 g/mol, so this is 0.0397 * 58.4 = 2.32 g of salt.

So in terms of salt content, 5g NaGHB is equal to about 2.3g NaCl. That doesn't sound very much to me.

[blackwolf]

Originally Posted by Pondlife

But is the amount of sodium enough?

The molecular weight of NaGHB is 126g/mol, so 5g NaGHB = 5/126 = 0.0397 moles.
The molecular weight of Salt (NaCl) is 58.4 g/mol, so this is 0.0397 * 58.4 = 2.32 g of salt.

So in terms of salt content, 5g NaGHB is equal to about 2.3g NaCl. That doesn't sound very much to me.

Thanks for working out the math for me. I was lazy and didn't include that.
You make a valid point, but it is only valid for a normal nightly dose of NaGHB( or zyrem , which most users use around 6.5g split into two doses.)
For sodium, the Recommended Daily Allowance (RDA) is to consume less than 2400 milligrams (mg) of sodium a day. Most people get as much as 10 grams a day and are fine, at least for the short term.
I only brought this up in regards to binges and OD's. Yes, you will have overdose effects from the GHB alone, but I believe this may be compounded by Hypernatremia. I have know people to go through 12-25 grams of na-ghb in a night some times more, and ending in overdoses. this is compounded by dehydration.

That is where moderation comes into play. This is not something people experience unless they take large, and most likely repeated doses.

[Pondlife]

Originally Posted by blackwolf

I have know people to go through 12-25 grams of na-ghb in a night some times more

Bloody hell, I didn't realise anyone did that much. This chap I know does around 3.5g in a night, maybe up to 5g max, and that's over the course of an hour or two. He says that he's done a bit more a couple of times, but at 5g it's like he's walking across the deck of a ship in a heavy sea.

For people who take heroic doses, and especially if they are already close to their maximum sodium intake, then I think your point is valid.

[MrG]

Actually the sodium issue is pretty much negligible when it comes to NaGHB and Hypernatremia is hardly going to concern people who are perfectly able to tell when they need a drink given that this condition is primarily related to an inadequate intake of water, typically in elderly or otherwise disabled patients who are unable to take in water as their thirst dictates. This is the most common cause of hypernatremia.

Even if you are referring to NaGHB being a hypertonic fluid (a fluid with a higher concentration of solutes than the remainder of the body), it would take a ridiculously high rate of ingestion, more even than that of a 24/7 GHB addict, coupled with a poor intake of fluids before this condition would become an issue.

http://www.fda.gov/OHRMS/DOCKETS/dockets/05n0479/05N-0479-EC9-Attach-2.pdf

Table 5
Sodium Content per Total Nightly Dose
Xyrem Dose (g) Sodium Content/Dose
3---------------------------- 546 mg
4.5-------------------------- 819 mg
6--------------------------- 1092 mg
7.5------------------------- 1365 mg
9--------------------------- 1638 mg

[blackwolf]

Again, I was bringing this up as more a note of side-effects from NaGHB Overdoses This is most likely not a problem for swim if they are using reasonable amounts of Ghb, and even maybe if they are 24/7

It is a fact that this happens occasionally from NaGHB, and there is literature to back it up.

Excepts from (WO/2001/019361) THERAPEUTIC USES OF POLYMERS AND OLIGOMERS COMPRISING GAMMA-HYDROXYBUTYRATE
hxxp://www.wipo.int/pctdb/en/wo.jsp?IA=US2000025261&DISPLAY=DESC

While significant progress has clearly been made in the development of therapeutic and experimental uses for GHB, there have been a number of problems associated with the development of these uses which have hindered or prevented further progress, or made treatment difficult or more burdensome to manage. These problems include the development of hypernatremia and metabolic alkalosis as a result of delivering large doses of GHB, which is administered as a sodium salt rather than a free acid, especially over prolonged periods (Entholzner, E. et al., Anaesthesist, 44: 345-50 (1995)).

From later in the paper

It would also be desirable to develop new compositions and methods to deliver therapeutic amounts of GHB in vivo that provide a means to control delivery of GHB and plasma levels of GHB more precisely. Such compositions could be useful to raise effective dosages in vivo, as well as to prevent the development of hypernatremia and metabolic alkalosis at current dosage levels.

It is also listed in the Xyrem Prescribing info as a infrequent side-effect under Metabolism and nutrition disorders.
hxxp://www.fda.gov/OHRMS/DOCKETS/dockets/05n0479/05N-0479-EC9-Attach-2.pdf

Obviously it is not a frequent side-effect, but if you overdose, and especially if the overdose has followed a escalating doses over the period of a night, it is definitely a possibility.

I have a long story I posted once about swin's first bottle of G 12 years ago, and how they went through around 5-6 doses each in 4 or 5 hours, and then started swilling from the bottle. It resulted in the biggest , and stupidist trainwreck escapade of my life, i'll try and find it and bump it for you guys. Anyways I am fairly certain that on that night two of the three of us had multiple signs of hypernatremia, as well as GHB overdose.

The reason behind this thread was not a attempt to sway people from NaGHB( I would be the last person in the world to do that) but just to point out a side-effect that is known to happen to some people with overdoses, but is not often brought up.

Cheers!