The pharmaceutical drug sodium oxybate or gamma hydroxybutyrate (GHB) -- sold under the brand name of Xyrem -- is a prescription medication that can treat the excessive daytime sleepiness and cataplexy associated with narcolepsy.
Uses of Xyrem
Xyrem is a drug that acts directly on the central nervous system, specifically the brain. It is prescribed to treat narcolepsy. In particular, it is helpful in treating the symptoms of excessive daytime sleepiness and cataplexy associated with the disorder. As GHB can cause unconsciousness and memory loss in normal people, it has been abused as a "date rape drug." Therefore, only specially enrolled medical providers can prescribe this medication.
How Does Xyrem Work?
Xyrem is believed to affect the neurotransmitters within the brain. Neurotransmitters are the chemical messengers that travel between nerve cells (neurons). It may inhibit receptors for GHB and another chemical in the brain called GABA. The exact way that Xyrem works is not known.
Who Should Not Use Xyrem?
There are certain situations where Xyrem should not be used or used with caution. It should not be used with other sedative medications or with alcohol. If you have a rare deficiency in an enzyme called succinic semialdehyde dehydrogenase, Xyrem should not be used. If you have problems with your liver, lungs, heart, or kidneys you should be cautious in using the medication. Specifically, caution is needed if you have heart failure or high blood pressure. If you have a history of depression, drug abuse, psychiatric illness, or seizures, further caution is needed. Finally, individuals with a history of urinary incontinence also should be cautious in using Xyrem.
What Are Common Side Effects of Xyrem?
There is the potential for side effects with any drug and Xyrem is no exception. Although you would likely not experience most side effects -- and may indeed not have any of them -- some that commonly occur include:
- Pharyngitis (sore throat)
- Flu syndrome
- Accidental injury
- Urinary incontinence
- Rhinitis/sinusitis (nasal/sinus symptoms)
- Stomach upset
- Abnormal dreams
What Are Potential Serious Reactions of Xyrem?
As with any drug, there is also the risk of serious side effects that occur more rarely. The potential serious reactions with the use of Xyrem include:
- Breathing suppression
- Risk of abuse/dependence
- Suicidal thoughts
What Safety Precautions Need to Be Taken with Xyrem?
Xyrem should only be used in pregnancy if clearly needed and its safety in breastfeeding is unknown. Some people, as mentioned above, should use the medication with caution or not at all. No routine monitoring is necessary during Xyrem’s use. However, if you experience any difficulties, you should be in close contact with your primary health provider.
"Xyrem." Epocrates Essentials. Version 3.16, 2011. Epocrates, Inc. San Mateo, California.