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A Case of Sodium Oxybate Treatment of Tardive Dyskinesia and Bipolar Disorder
J Clin Psychiatry 2008;69:862-862 [letter]
Copyright 2008 Physicians Postgraduate Press, Inc.
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Letter to the Editor
Sir: Sodium oxybate is increasingly being used off-label
to treat the fibromyalgia syndrome defined by pain, fatigue,
nonrefreshing sleep, and fluency loss. This compound has a
complicated mechanism of action with agonist binding on
?-aminobutyric acid (GABA)-B receptor, agonist binding on the
?-hydroxybutyrate (GHB) receptor, and possible stoichiometric
signaling effects as an intermediary in GABA and glutamate
metabolism. Its clinical effect is a profound increase in the duration
of stage III and IV slow wave sleep. This case describes
a profound effect of oxybate on bipolar disorder and tardive
dyskinesia presenting jointly with fibromyalgia.