The complication targeted by an added treatment matters to interpretation of a successful case.
A severe GBL/GHB withdrawal case remained difficult to control despite multiple medicines, including high-dose benzodiazepines. Hyperthermia and rhabdomyolysis raised concern for an NMS-like presentation, and dantrolene was added during the complex ICU course.
Several treatments and physiological processes overlapped. A case report cannot isolate dantrolene’s contribution or establish that benzodiazepine resistance always reflects the same mechanism.
Separate agitation, withdrawal, temperature, muscle injury and drug effects on the timeline. Improvement after escalation does not make the added agent a general benzodiazepine alternative. The report cannot prove which intervention caused recovery or which treatment would have prevented the complication in another patient.
Source: PMC8362866, supplied full-text paper. Findings are paraphrased; forensic implications are an interpretation.
Related: Zolpidem Withdrawal Seizures: Why Non-Benzodiazepine Chemistry Does Not Eliminate Related Risks.