To the Editor: γ-Hydroxybutyrate (GHB), an endogenous γ-aminobutyric acid (GABA) metabolite with a short half-life, is a neurotransmitter and an emerging drug of abuse. First isolated in 1960, GHB was found to be a CNS depressant with similarities to classical sedatives/hypnotics, such as barbiturates and benzodiazepines. GHB binds reversibly to specific GHB receptors, although its mechanism of action is poorly understood (1). Clinically, it has been used as an anesthetic and to treat alcohol and opioid dependence (2), and it has been recently approved by the Food and Drug Administration for the treatment of narcolepsy. In the last decade, the use of GHB as a club drug (sold as "liquid X," "liquid ecstasy," "soap," "salty water," etc.) dramatically increased in the United States because of its mild euphoric and sedative effects. Case reports of physical dependence and of a severe withdrawal syndrome have been reported (1). We report on a patient who "successfully" self-treated his social phobia with GHB and became dependent.

To our knowledge, this is the first report of a patient who self-treated his social phobia—the third most common psychiatric disorder—with GHB and who subsequently developed GHB dependency. GHB has been shown to possess anxiolytic effects in some animal models (1). However, anxiolytic properties in humans apparently have never been studied explicitly. Because of the potential anxiolytic properties of GHB, patients with anxiety disorders may be at a higher risk of abusing GHB and becoming dependent on this sedative drug. In addition, its anxiolytic properties, the therapeutic potential of GHB, and the exact mode of action deserve further research.