Prohedonic properties of gamma-hydroxybutyrate are associated with changes in limbic resting-state functional connectivity

Hum Psychopharmacol. 2018 Nov;33(6):e2679. doi: 10.1002/hup.2679. Epub 2018 Nov 13.


Objective: Gamma-hydroxybutyrate (GHB) is an endogenous GHB-/GABA-B receptor agonist and a narcolepsy treatment. However, GHB is also abused for its prohedonic effects. On a neuronal level, it was shown that GHB increases regional cerebral blood flow in limbic areas such as the right anterior insula (rAI) and the anterior cingulate cortex (ACC). We aimed to further explore the association between the subjective and neuronal signatures of GHB.

Method: We assessed subjective effects and resting-state functional connectivity (rsFC) of an rAI- and an ACC-seed in 19 healthy male subjects after GHB (35 mg/kg p.o.) using a placebo-controlled, double-blind, randomized, cross-over functional magnet resonance imaging design.

Results: GHB increased subjective ratings for euphoria (p < 0.001) and sexual arousal (p < 0.01). Moreover, GHB increased rAI-rsFC to the right thalamus and the superior frontal gyrus and decreased ACC-rsFC to the bilateral paracentral lobule (all p < 0.05, cluster corrected). Moreover, GHB-induced euphoria was associated with rAI-rsFC to the superior frontal gyrus (p < 0.05, uncorrected).

Conclusions: GHB induces prohedonic effects such as euphoria and sexual arousal and in parallel modulates limbic rsFC with areas linked to regulation of mood, cognitive control, and sexual experience. These results further elucidate the drug's effects in neuropsychiatric disorders and as drug of abuse.

Keywords: anhedonia; libido; liquid ecstasy; mania; sodium oxybate.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cerebral Cortex / diagnostic imaging
  • Cerebral Cortex / drug effects*
  • Cerebral Cortex / physiology
  • Connectome / methods*
  • Cross-Over Studies
  • Double-Blind Method
  • Euphoria / drug effects*
  • GABA-B Receptor Agonists / administration & dosage
  • GABA-B Receptor Agonists / pharmacology*
  • Gyrus Cinguli / diagnostic imaging
  • Gyrus Cinguli / drug effects
  • Gyrus Cinguli / physiology
  • Humans
  • Libido / drug effects*
  • Limbic System / diagnostic imaging
  • Limbic System / drug effects*
  • Limbic System / physiology
  • Magnetic Resonance Imaging
  • Male
  • Sodium Oxybate / administration & dosage
  • Sodium Oxybate / pharmacology*
  • Young Adult


  • GABA-B Receptor Agonists
  • Sodium Oxybate