GHB Withdrawal: Why It Needs Medical Care

GHB withdrawal timeline at a glance

Phase	When	What you may feel	Severity	Red flags
Early withdrawal	Within hours of the last dose in frequent users (exact timing isn’t in the label)	Anxiety, restlessness; Insomnia; Tremor, sweating; Fast heart rate	Severe	Hallucinations, confusion or delirium; Severe agitation
Severe withdrawal (some people)	The following days	Confusion; Visual hallucinations; Agitation; Delirium	Can be life-threatening	Hallucinations, confusion or delirium; A seizure, confusion, or seeing or hearing things that aren’t there: call 911; Very high heart rate or fever
Easing	After the acute phase	Rebound tiredness and sleepiness	Moderate	Thoughts of suicide or self-harm: call or text 988 now

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Symptoms, phase by phase

The Xyrem label describes GHB withdrawal after abrupt discontinuation as including insomnia, restlessness, anxiety, psychosis, lethargy, nausea, tremor, sweating, muscle cramps, fast heart rate, headache, dizziness, rebound fatigue and sleepiness, confusion, and, particularly in severe withdrawal, visual hallucinations, agitation and delirium. These descriptions come largely from people who misused GHB, not from patients taking prescribed doses: in the label’s narcolepsy trials, only a few patients reported anxiety or insomnia after stopping. Published research on the exact timing is limited, so we haven’t given hour ranges.

Early withdrawal: Within hours of the last dose in frequent users (exact timing isn’t in the label)

• Anxiety, restlessness
• Insomnia
• Tremor, sweating
• Fast heart rate

Severe withdrawal (some people): The following days

• Confusion
• Visual hallucinations
• Agitation
• Delirium

Easing: After the acute phase

• Rebound tiredness and sleepiness

What makes withdrawal longer or shorter

• Dosing frequency. The Xyrem label says severe dependence and craving have been reported when GHB is taken around the clock, and withdrawal case reports involved frequent repeated doses far above the recommended range.
• Very short half-life. Levels drop fast, so symptoms start fast.
• GBL. The Xyrem label notes gamma-butyrolactone (GBL) is metabolized to sodium oxybate (GHB) in the body.
• Other sedatives. The Xyrem label says it must not be combined with alcohol or sedative hypnotics, because of the risk of CNS depression.

When to see a doctor or get help now

• If you’ve used GHB regularly and want to stop: go to an emergency department or a medically supervised detox. Don’t do it alone.
• Call 911 for a seizure, hallucinations, severe confusion, a high fever or trouble breathing.
• Call or text 988 for thoughts of suicide.

Not sure where to start? Call SAMHSA’s free, confidential helpline at 1-800-662-4357, 24/7. See Get Help.

Tapering

GHB withdrawal is managed in hospital or supervised detox. We don’t give home tapering advice for GHB.

Tips for getting through it

• Tell the medical team exactly what you’ve used and how often
• Have someone stay with you and know when to call 911
• Find treatment at FindTreatment.gov or call SAMHSA at 1-800-662-4357

Frequently asked questions

How soon does GHB withdrawal start?

Because GHB’s half-life is 30 to 60 minutes, withdrawal can start within hours in people who use it around the clock.

Can GHB withdrawal kill you?

Severe withdrawal with delirium can be life-threatening and needs medical treatment.

Is Xyrem withdrawal the same?

In the label’s clinical trials at recommended doses, only a few patients reported anxiety or insomnia after stopping. Talk to your prescriber before stopping.

Next steps

• Combine timelinesAdd other things you are stopping and see them on one chart
• Talk to othersAsk questions on our community forum (peer support, not medical advice)
• Read nextBenzo Withdrawal Timeline: Short- vs Long-Acting
• Get helpFree, confidential helplines and when to see a doctor

Related timelines

• Benzo Withdrawal Timeline: Short- vs Long-Acting
• Is Alcohol Withdrawal Dangerous? Seizures, DTs and When to Get Help
• Alcohol Withdrawal Timeline: Hour by Hour, Day by Day

Sources

1. FDA label: Xyrem (sodium oxybate) (DailyMed)
2. SAMHSA National Helpline

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Last reviewed: October 25, 2026. Researched and written by Withdrawal Timelines from the cited sources. This article has not yet been reviewed by a medical professional. See How We Review and our Medical Disclaimer. This is general information, not medical advice.