INTRODUCTION: Gamma-hydroxybutyric acid (GHB, "liquid ecstasy") and its legal pro-drugs gamma-butyrolactone and 1,4-butanediol are gaining in importance as recreational drugs in Germany. The effects of these substances are comparable with those of alcohol or benzodiazepines. Because of the wide availability of GHB physicians are increasingly being confronted with cases of intoxication. METHODS: This review is based on a selective literature search as well as on the authors' own experience and on information provided by the GIZ-Nord Poisons Centre, Göttingen, Germany. RESULTS: Consumption of a high dose of GHB or its prodrugs leads to severe intoxication with respiratory depression and coma. Only supportive therapy can be offered; no antidote is available. DISCUSSION: In any patient with impaired consciousness of unknown cause, the possibility of intoxication with GHB must be considered. Chemical detection of GHB in blood or urine is possible only using specific analytical methods and only within a short time frame (
