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doi: 10.1053/joca.1998.0217 46 TaniokaTNakataniYSemmyoNMurakamiMKudoI

The primary physiological driver is an acute imbalance of electrolytes: sodium, potassium, calcium, and magnesium are minerals that govern neuromuscular signaling

Elevation of cellular NAD levels by nicotinic acid and involvement of nicotinic acid phosphoribosyltransferase in human cells

When used together, the effects of both drugs are magnified, increasing the risk of: Accidents and injuries Blackouts Respiratory depression Overdose Coma Death People who use high levels of GHB and those who use it with alcohol also have a greater risk of overdose